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Fecal Incontinence

7 years after take-down I still have nightly accidents.   Examined for pouchitis but that is not the problem.  Any advice, similar situations?   I have a friend who has similar problem with urination but he got a mechanical implant to help.  Docs tell me no similar device exists for fecal incontinence.

Yes, there is such a device
No, there is no device
Posted by TCM ·

Comments (48)

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Originally Posted by Joann:

It depends upon when I eat and drink. If I drink wine and don't eat right away then I have problems at night. My cycle time for food digestion through the small intestine is 5 hours. I try to eat early enough that I have more than 5 hours after I eat before I go to bed.


i have a j pouch so I realize that wine, broccoli, and any thing gaseous is not good to consume before bed. 


With wine, consider the sanitisers that wine makers use before bottling. Phosphates are one that can effect your bowel. Unfortunately, I find that the more expensive wines have less detrimental effect on my bowel.

I have no problem passing gas but I think it has a great deal to do with other factors. Read my other post regarding position in bed and slowing the emptying of the stomach.






Originally Posted by Beth-Jpouch1991:

I have the EXACT same problem.  It is horrible.  For me it varies on what I eat or how late I eat.  Salad for dinner is the worst!    Would love to know other people's triggers or if anything helps.  

Salad is one of those interesting things that can cause all sorts of problems. One thing that many people forget is that salad needs washing and often this is done under the kitchen tap. Depending on where you are in the world, you could be introducing bacteria to your meal from the tap water. Consider old pipes, old infrastructure, does the local pumping station need to be dosed with a sanitiser (ie chlorine), are you in the tropics where giardia is often present in the water supply. (Also note that the treatment for giardia is the same treatment for pouchitus ie metronidazole)


The other thing to consider about salad, is the dressing. I have a reaction to Palm Oil and, because it is cheap, many companies are substituting this in the manufacture of many food products such as instant coffee mixes, salad dressing, sauces etc.

Is a specific in the salad causing a problem? You may have a mild allergic reaction to one item that, without a large bowel, causes the flow to hasten through. (shellfish, such as shrimp, takes the rapid route of 3 minutes from hitting my stomach to exiting...seriously!)

Final thought is use of a binding material. If I have a meal such as a salad, I will also try to include a side dish of pasta or rice or even a heavy dough bread, to help bind the other parts of the meal into a more solid mass which then slows the motility down.

Originally Posted by rcrossco_1:
Codiene phosphate is a GODSEND, forget loperamide, its useless compared to the codiene. With the above, I can go to the toilet nearly as little as 2/3 times a day, its a life changer and helps with any night time issues too.
Codiene Phos. is for me a last resort as it effects the consistency of the stool to a point where I end up with constipation and sludge. Ick...I know. I have found that pseudoephedrine which is available in tablet form for blocked noses to be one way I reduce the need to go to the toilet for a period of time. As a side effect of drying up the sinuses, the production of mucus within the small intestine is reduced and there is less motility.

However, be warned that a possible rebound effect can happen and everything that slowed up is going to move at some time. So, what I do, is use the pseudoephdrine if I plan on being somewhere I can't readily go to the toilet, such as for a trip to the zoo where stopping frequently would be an absolute pain in the butt...'scuse the pun....
I very much agree codiene phos. is an effective medication for us with pouches but it can effect people differently and this is certainly an alternative which some people would find useful and effective.



Originally Posted by Ronda from Oregon:
Originally Posted by ChristineinDenver:

There is a device for assisting you with this. It is a Medtronic Sacral Nerve Stimulator. It is a small device with probes that is inserted under your skin right at the top of your buttock. It sends impulses to the sphincter to keep it toned and tight. 


Following my takedown after my J Pouch I was fecally incontinent. Was a total mess. I felt the need to hold it but either from birthing four large babies or the surgery, or both, my sacral nerves were severely damaged. This unit was an easy procedure and made a huge difference. As long as I don't have diarrhea, I can hold it and I wake up to go (not wake up in my own mess, which has happened). 


It's given me my life back. The same surgeon that did the J Pouch inserted it. I can turn it higher or lower, or even off. My gastro was the one who figured it out though.

 Believe it or not I can hold it most of the time...  I just need to stop losing so much fluid.. My BM 's are 90% water I have to drink two gallons of water aday to keep up . I lose all my salt and vitamins. the mayo clinic said I have dump syndrome and malabsorbtion issues. I don't keep my food. and when I lose it I dump a lot of green fluid  with it. My kidneys are suffering.  


I've had my ouch for 18 years and never had a problem with this until the past two years or so. I use Imodium more often now (never ever used it before despite being advised to), and watch what I consume. Sugary foods or drinks are usually the culprits. 

I have had a j pouch for thirteen years and the nightly problem for at least 10 years.  Having a good bowel movement before going to bed and stopping your eating after 7-8 pm is helpful.  I'm taking  a 4 billion probiotic that I have purchased from CVS which also helps.

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