Stool leakage is a problem that is more common than we like to admit. Not only is it bothersome, but it can cause us to avoid going out, spending time with loved ones, and taking full care of ourselves. The two most common reasons why stool leakage occurs are that the bowels are not emptying completely (Constipation) and that the stool is loose (diarrhea) and hard to control or prevent from seeping out.

If you feel like after a bowel movement, you just can’t seem to get clean, it is likely that you are not fully emptying. This will often lead to small amounts of stool leakage later in the day. In this case, we want to optimize the completion of your bowel movements. The question becomes- are the bowels too firm to move, or is there not enough bowel motility for the bowels to move? Depending on the answer to this question, I typically recommend starting with conservative measures. If the stool is too firm, increasing fiber in food and fiber supplements is a good place to start. If bowel motility is the issue, a trial of bowel stimulants can be helpful. I typically recommend Magnesium Calm, Senna products (to be taken 1-3 times per week), and stimulant teas like Smooth Move. In either case, I recommend adding probiotics to the daily regimen. If these measures do not work, we then move into some diagnostic testing and discuss various non-surgical and surgical options.

On the other hand, you may be having trouble with loose stools, or stool that comes quickly and often, which can cause you to have run to the bathroom to avoid an accident.  The goal here is to bulk the stool and calm down the urgency. I like to recommend pure psyllium husk to start. You would start out with a teaspoon and gradually increase it to the amount that works for you. If you can anticipate the episodes of urgency, or if you want to leave home, you can try using Imodium. I recommend the liquid version over the capsules, so that you can really dial in the amount that works for you without tipping you into constipation. I also recommend probiotics for this condition. With the bowels, we always want to make sure the microbiome is as well balanced as possible. As with constipation, if these measures do not work, we move into diagnostic testing, and discuss various treatment options, one of which includes sacral neuromodulation. This is a device that is implanted into your lower back to reset your bowel function.

In addition to the above, there are several other reasons why you are having stool leakage. Make an appointment today if you have concerns about your bowel function. You deserve to learn about all your options and regain control of your life!