Is fecal incontinence more common with age? What to know about the facts and treatments

Did you know that the prevalence of fecal incontinence increases significantly with age? While not a normal part of aging, studies show that fecal incontinence is more common with age, affecting a greater number of older adults globally. Here’s what you need to know about its causes, management, and treatment options.

Quick Summary

Yes, fecal incontinence is indeed more common with age, though it is not a normal or unavoidable part of the aging process. Several age-related factors contribute to its higher prevalence in older adults.

Key Points

• Prevalence Rises with Age: Fecal incontinence occurs more frequently in adults over 65, but this is due to associated risk factors, not age itself.

• Multiple Causes: Several age-related factors contribute to incontinence, including muscle weakness, nerve damage, chronic illnesses like diabetes, and certain medications.

• Not a Normal Part of Aging: Despite the increased risk, fecal incontinence is a medical condition that is treatable, not an inevitable consequence of getting older.

• Effective Management Exists: Treatment options range from simple dietary changes and pelvic floor exercises to advanced therapies like nerve stimulation and surgery.

• Diagnosis is Key: A thorough medical evaluation is necessary to determine the specific cause and create a tailored and effective treatment plan.

• Quality of Life: By addressing the problem directly with a doctor, individuals can significantly improve their symptoms, restore confidence, and maintain their social life.

Understanding the Link Between Aging and Fecal Incontinence

Research indicates a clear link between advancing age and the risk of developing fecal incontinence (FI). A study published in Clinical Gastroenterology and Hepatology found that the prevalence of fecal incontinence was greater for persons aged 60 years and older compared with younger persons. It's crucial to distinguish this statistical correlation from the misconception that incontinence is a normal, inevitable consequence of getting older. Instead, it is a treatable medical condition, often stemming from specific, age-related changes and health issues that become more frequent later in life.

Why Do Risk Factors Increase with Age?

The rise in fecal incontinence with age is not caused by age alone, but by a combination of contributing factors that compound over time. These include:

• Weakened Muscles: The pelvic floor and anal sphincter muscles, which are vital for maintaining bowel control, naturally lose strength and elasticity over the years. This decline in muscle tone makes it harder to hold back stool, especially liquid stool, or to respond to a sudden urge.
• Nerve Damage: The nerves that signal the brain about the need for a bowel movement can become damaged or less effective. This can result from conditions more prevalent in older adults, such as diabetes, stroke, multiple sclerosis, or chronic straining due to constipation.
• Chronic Health Conditions: Many chronic illnesses common in the elderly can impact bowel control. Conditions like Parkinson’s disease, Alzheimer’s, or dementia can interfere with a person's ability to recognize the need to use the toilet or to get there in time. Additionally, chronic diarrhea or constipation, often stemming from other medical conditions or medication side effects, can exacerbate incontinence issues.
• Decreased Rectal Sensation and Capacity: The rectum's ability to stretch and send sensory signals can diminish with age. This leads to a reduced awareness of a full rectum, making it difficult to preemptively get to a restroom. Reduced capacity means the rectum cannot hold stool for long periods.

Common Contributing Factors and Risk Assessment

To effectively manage fecal incontinence, understanding its root cause is essential. Your doctor will likely perform a thorough evaluation to identify which specific factors are at play. A detailed risk assessment can reveal crucial insights.

Here are some common risk factors associated with FI:

• Chronic Diarrhea or Constipation: Both extremes of bowel habits can lead to incontinence. Chronic constipation can cause a blockage of hardened stool, with softer, liquid stool leaking around it. Diarrhea, being harder to control, can overwhelm weakened sphincter muscles.
• Childbirth Trauma: Past injuries from vaginal delivery, especially with the use of forceps, can damage the anal sphincter muscles or nerves. This damage may not manifest as incontinence until later in life, as supporting muscles weaken with age.
• Previous Surgeries: Procedures involving the rectum or anus, such as surgery for hemorrhoids or colorectal cancer, can cause nerve or muscle damage.
• Physical or Mental Disability: Limited mobility or cognitive impairment can hinder a person's ability to reach a toilet promptly or recognize the urge to go.

Comparing Age-Related and Other Causes of Fecal Incontinence

Feature	Age-Related Incontinence	Other Causes (Non-Age Specific)
Primary Cause	Degenerative changes (muscle weakness, nerve decline), compounding health issues.	Specific injuries (childbirth), disease, surgery, medication side effects.
Onset	Gradual, often worsening over time.	Can be sudden, following a specific event like surgery or new medication.
Muscle Involvement	General weakening of pelvic floor and anal sphincters over years.	Localized damage to specific muscles or nerves from a single event.
Nerve Involvement	Generalized decline in nerve function and sensation, often systemic (e.g., from diabetes).	Targeted nerve damage from injury or trauma.
Associated Conditions	Often linked with dementia, Parkinson's, and chronic illnesses.	Can be related to inflammatory bowel diseases (e.g., Crohn's) or specific gastrointestinal disorders.

Practical Management and Treatment Strategies

Managing fecal incontinence effectively involves a multi-pronged approach tailored to the individual's specific circumstances. It starts with a comprehensive medical evaluation to diagnose the underlying causes.

1. Dietary Adjustments: Keeping a food diary can help identify triggers that worsen symptoms, such as caffeine, alcohol, artificial sweeteners, and spicy foods. Gradually increasing fiber and fluid intake can improve constipation, while certain anti-diarrheal foods can help with loose stools.
2. Bowel Training and Scheduled Toileting: For some, establishing a regular routine for bowel movements, such as after a meal, can help retrain the body. Consistency is key to improving control.
3. Strengthening Exercises: Pelvic floor exercises, such as Kegels, can help strengthen the anal and pelvic muscles. Biofeedback therapy can provide real-time feedback, helping patients learn to properly contract these muscles.
4. Medication: A doctor may prescribe medications to address underlying issues. This could include anti-diarrheal drugs for loose stools or laxatives and stool softeners to manage chronic constipation.
5. Nerve Stimulation: For specific nerve issues, sacral nerve stimulation can be used. This involves a device that sends mild electrical impulses to the nerves that control bowel function, helping them work properly.
6. Surgical Options: In cases of severe muscle damage or rectal prolapse, surgery may be necessary. Procedures like sphincteroplasty can repair damaged sphincter muscles. An artificial anal sphincter or a colostomy may be considered as a last resort.

The Path Forward: Seeking Help and Living with Confidence

Living with fecal incontinence does not mean sacrificing your quality of life. The condition is treatable, and a wide range of strategies exist to manage symptoms and restore confidence. Early intervention is crucial, as many of the underlying causes can be addressed effectively. It is vital to overcome the embarrassment associated with this issue and speak with a healthcare professional.

For more detailed information on causes and treatments, consult the experts at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) on their Treatment of Fecal Incontinence page. Remember, open communication with your doctor is the first and most important step toward regaining control and peace of mind. By taking a proactive approach, older adults can continue to lead full and independent lives.

Conclusion

In summary, while is fecal incontinence more common with age, it is not a normal or unavoidable part of the process. It is a symptom of underlying conditions that become more prevalent later in life, such as weakened muscles, nerve damage from chronic disease, and mobility issues. The good news is that with a proper diagnosis and personalized treatment plan—which can include lifestyle changes, medication, exercises, and in some cases, surgery—most people can significantly improve their symptoms and regain control. The key is to seek help from a healthcare provider rather than suffering in silence.

Frequently Asked Questions

Is fecal incontinence a normal part of aging?

No, fecal incontinence is not a normal part of aging. While it is more common in older adults due to age-related changes, it is a medical condition that warrants a proper diagnosis and treatment plan from a healthcare provider.

What are the primary reasons fecal incontinence increases with age?

The increase in fecal incontinence with age is often due to a combination of factors, including weakened pelvic floor and anal sphincter muscles, damage to the nerves controlling bowel function, and chronic health conditions like diabetes or dementia.

Can diet help manage fecal incontinence in seniors?

Yes, dietary changes are often a first-line treatment. Adjusting fiber and fluid intake can help manage constipation or diarrhea, both of which can contribute to incontinence. Identifying and avoiding trigger foods is also important.

Are there specific exercises to help with age-related fecal incontinence?

Yes, pelvic floor exercises, often called Kegels, can help strengthen the muscles that control bowel movements. A physical therapist may also use biofeedback to help you perform these exercises correctly.

Is surgery an option for older adults with fecal incontinence?

Surgery may be an option, particularly if the incontinence is caused by significant muscle damage (e.g., from prior childbirth or trauma), rectal prolapse, or if other treatments have been unsuccessful. Your doctor can help determine if this is the right course for you.

How can an older adult cope with the emotional impact of fecal incontinence?

Fecal incontinence can be emotionally distressing, leading to anxiety and social isolation. Speaking openly with a doctor, family, and friends can help. Additionally, using products like absorbent pads, keeping clean-up supplies handy, and knowing the location of public restrooms can build confidence when leaving home.

What role do other health conditions play in fecal incontinence in seniors?

Many chronic health conditions common in older adults, such as diabetes, dementia, stroke, and multiple sclerosis, can interfere with nerve function and muscle control, significantly increasing the risk of fecal incontinence. Managing these underlying conditions is vital.