Faecal Incontinence - the last taboo?

On the second day of Women on Fire I went to the Bowel and Bladder Health Extravaganza! talk, as requested by one of my clients. To start with I was kind of yes, yes, I know all this. And then the bombshell hit - Faecal Incontinence in Menopause.  

1 in 5 women over the age of 40 experience faecal incontinence.  Yet it’s not really talked about - you don’t see happy adverts of women in pads getting on with their lives. It’s not a little “ooops! moment”. Is this the last taboo?

The change in hormone levels at menopause are part of the reason for faecal incontinemce. But there are other risk factors too:

• oral HRT
• anal sex
• urinary incontinence
• obesity
• smoking
• chronic diarrhoea 
• IBS
• cholecystectomy 
• obstetric ie any anal sphincter injury.

This is the one that got my attention. Having had a forceps delivery and an extended episiotomy with my second birth, I’m at risk!

The good news is that several of the risk factors are preventable or modifiable.  So we can be proactive, not pessimistic. 

Things we can do to help:

• walking - 20 minutes a day, especially in the morning, and even better, in nature
• posture - particularly try not to slouch and avoid sitting on the coccyx 
• sleep better - or at least give yourself the opportunity to sleep better
• manage stress - lots of ways to do this but mindfulness is a quick and easy way
• change diet - in particularl eat more fibre/vegetables. It may also be worth looking at your intake of red and/or processed meat, and also dairy and alcohol
• strengthen pelvic floor muscles - practice good toiletting habits. Use a stool for your stool, don’t strain, make sure you go when you need to go
• good breathing - use diaphragm, not chest or belly, and no sucking in
• strength training - especially the bum!
• cardiovascular training - may need to be low impact if you have any pelvic floor dysfunction or prolapse
• yoga/Pilates - especially twisting moves

These lifestyle changes can also help other gut issues too, from bloating to IBS, constipation to cancer. It may even help with dementia, which is thought to have a link to gut health.