By Vicki Patton, Clinical Services lead, continence foundation of australia
WHY DO I SOIL MY UNDERWEAR?
Having a small amount of bowel incontinence (or soiling) can be very distressing and embarrassing. It may also mean an extra change of underwear and using additional stain removers when washing clothes. Either way, it is a troublesome problem that is particularly prevalent in men.
WHY DOES IT HAPPEN?
The soiling mostly happens after the bowel has been open (defaecation or using the toilet for your bowels) and for that reason it is called post defaecation soiling. It is generally because the bowel hasn’t completely emptied and some of the stool has been trapped low down in the rectum (lowest part of the bowel).
Another reason soiling may happen is when there are significant skin tags or haemorrhoids outside the anus that makes cleaning up the bottom after a bowel motion difficult.
A further reason it may happen is that the anus doesn’t close properly due to the presence of haemorrhoids or scarring from some previous surgery around the bottom. As we walk about, the stool then leaks out onto the underpants without us even feeling it.
HOW CAN I FIX IT?
The first approach is making sure you are having enough fibre in your diet. Using a soluble fibre supplement such as psyllium, guar gum or methyl cellulose may help. You can obtain these from the supermarket or check with your local pharmacy. Using one of these supplements may help the rectum to empty completely so there is nothing left to leak. These fibre supplements can soften any hard stool by keeping the water in and will bulk up the stool if it is a bit runny.
Having a good water intake is essential for a properly formed stool. If our body is a bit dry it will take the fluid from the bowel, leaving the stools hard. If we are well hydrated the fluid will stay in the colon and the stools will be a bit softer. Sometimes if the stool is very hard, there can be loose fluid and mucus that is unable to mix in with the stool and more likely to cause leakage after. If you are taking the soluble fibre supplements, it is important to make sure you have adequate water intake. If you are on fluid restrictions, you should speak to your GP about how much water you need to have every day.
Sitting correctly on the toilet will help the bowel to empty better. Using a little footstool to elevate your feet so your knees are slightly higher than your hips puts you in a position similar to squatting.
Lean forward slightly so that your elbows are on your knees and relax your tummy. This is the way we were designed to empty our bowels. Avoid straining as that will make any haemorrhoids worse and won’t help with improving your bowel emptying.
Sometimes cleaning up after a bowel motion can be difficult. It may be easier to use wet toilet paper, wipes or even baby wipes so you can get a better clean. You must make sure you don’t put anything in the toilet that could cause a blockage. If the bowel leakage is causing some irritation to the skin around your bottom, try using a light coating of barrier cream after you have cleaned. Do not put an excessive amount on as that may make it more difficult to clean off if you open your bowel again later in the day.
If you are concerned by soiling or are passing any blood you should be checked by your GP. Once given the all clear by them, make an appointment with your Nurse Continence Specialist, Pelvic Floor Physiotherapist or continence specialist who will be able to assist you further. You can call the National Continence Helpline on 1800 33 00 66 (8am-8pm AEST) for free, confidential advice.