The intestines are designed to extract nutrients from the food that we eat. Most of the goodness and nutrients are removed in the small intestines, and the colon or bowel, is responsible for removing any extra water and salts. The resulting stool is stored in the rectum until we are ready to evacuate it through a bowel movement.

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There are multiple areas within this system where things can go wrong, but they generally lead to either bowel leakage or constipation.

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Bowel leakage is common, and can affect up to 1 in 10 people at some time in their lives. It includes leakage of gas or stool (feces) through the anus (back passage). It can range from difficulty with control of gas to more severe loss of control over liquid or formed stool. Some affected women have bowel accidents that are caused by not being able to get to a toilet quickly enough (urge leakage), or they may experience leakage from the bowel without being aware of it (passive leakage).

 

Fecal incontinence can have many different causes. It can be distressing and can severely affect everyday life. Many people with bowel leakage find it very difficult and embarrassing to talk about with doctors and nurses, or to tell their family and friends. However, once bowel leakage has been identified there are treatments that can help manage or sometimes cure it, as well as strategies to help people cope with the condition.

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Constipation is a symptom, not a disease. Constipation means the bowel does not move easily or regularly. This may mean having a bowel movement fewer than every three days or the stools may be hard and difficult to pass. Some people who are constipated find it painful to have a bowel movement and often experience straining, bloating, the sensation of a full bowel or a sense that the bowels are not empty. Some people think they are constipated if they do not have a bowel movement every day. However, normal bowel movements may vary from three times a day to once every three days depending on the person. Moreover, most everyone gets constipated at one time or another. It is not necessary to seek treatment unless it is new and prolonged.

 

Constipation occurs when the colon absorbs too much water or if the colon’s muscle contractions are slow or sluggish. This means the stool moves through the colon too slowly and as a result, stools can become hard and dry. The most common causes of constipation are lifestyle factors including poor diet and lack of exercise. Many commonly used medications also can cause constipation, including; blood pressure medications (calcium channel blockers and diuretics), iron supplements, narcotics, antacids, antispasmotics, anti-parkinson drugs, and antidepressants.  Irritable bowel syndrome is another common cause. Pelvic floor problems, such as spasm of the pelvic floor muscles, vaginal prolapse, and rectal prolapse, are less common causes of constipation.

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