Our Gyno Health

Leaking Poop, Difficult to Discuss and More Difficult to Address

ACOG has just issued states about incontinence of BM

About 1/10 women gets a bit of leak of poop, sometimes it’s solid, mostly it’s not. Physicians are struggling with what to do about this Based on the newest evidence, evaluating what to recommend for our patients is even more difficult, as there has been so little research, and so few successful trials the newest policies say there are NO ‘A level’ recommendations; which means there are ‘no recommendations on good or consistent scientific evidence.

We do have strategies to recommend for women with fecal incontinence based on limited or inconsistent data; or ‘B level’ guidance.

We do not recommend exhaustive testing, some tests however, can be useful.

Based on what we know so far we can recommend fibroid, anti-diarrheal agents and even laxatives in some settings.

Pelvic floor exercises are important for this condition.

Surgical treatments are only used as a last resort, unless there are the medical conditions of a fistula or rectal prolapse.

Scheduling your bowel movements, manipulating your diet, and adding fiber to the diet are all good solutions to attempt to correct the problem.

Specialized bulking agents can be injected into the anal sphincter, but they seem to only help in the very short term.

The use of energy based therapies such as MonaLisa Touch or ThermiVa did not make it into the recommendation conclusions as most of the treatments in the rectal area have only been described in case reports. However, some patients have reported some success with this, and if treating urinary incontinence with these therapies, it’s worth trying to correct fecal problems as well.


Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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