Poop happens. Farts happen. But they aren’t supposed to happen simultaneously — ever — unless you’re comfortably positioned over a toilet, expecting this occurrence. Yes, we’re going there. If you’ve ever farted and realized that it wasn’t just a fart . . . welcome to the club. The club no one actually wants to belong to, but one that about 15 percent of us (at least) will join at some point.
So let’s be prepared, if not with toilet paper and an extra pair of undies, then with knowledge and understanding (or maybe all of the above). Here’s why it happens, how it happens and what you should do if disaster strikes.
Why?
There are many reasons. The most basic, all-encompassing answer: Your body may be losing the ability to differentiate stool from gas, says Darren Brenner, a gastroenterologist at Northwestern Memorial Hospital in Chicago. The prevalence increases with age. Here are the dirty details. As we get older, Brenner explains, our anal sphincters (more specifically, our internal anal sphincter) weaken, which increases our risk of fecal incontinence. Other things that can damage the sphincters over time and increase the risk include childbirth, anal trauma and surgery. “If enough risk factors are present, fecal incontinence can occur,” Brenner says. “This threshold is different for everyone.”
Who is more likely to experience this?
Women (because of course!). The childbirth trauma, tears, episiotomies and pelvic floor weakening lead to the decreased ability to control gas and fecal matter, says Niket Sonpal, a gastroenterologist at Touro College of Osteopathic Medicine. Diabetes, inflammatory bowel disease and multiple sclerosis are other risk factors.
How common is this?
There have been few studies specifically about gas accidentally turning into a bowel movement. One study found that 15 percent of people over age 65 have fecal incontinence (they can’t control when they poop or will have some soiling on their underwear or sheets). Another study found that incontinence increases with age: While about 2.5 percent of young women (20 to 29) have experienced it, about 15 percent of women over 70 have. “As we get older, the incidence of incontinence becomes more common,” Sonpal says. In fact, other estimates suggest that this affects up to 1 in 4 women, says Sonali Palchaudhuri, a gastroenterologist at Mass General Hospital.
Oy.
How can you prevent it?
It depends on why it’s happening. If it’s occurring because you’re constipated (a common reason), you should aim for comfortable daily stools with a laxative or stool softener, and if you’re having diarrhea, you can use fiber to firm up your liquid stools, Palchaudhuri says. The problem often occurs when you’re traveling, so be sure to keep your meds with you when you’re out of the country. When should you start to worry? If it happens once in a while, it’s normal, Sonpal says. But if it starts happening on a regular basis, then you need to see your gastroenterologist.
What is the real concern?
Sonpal says the cause could be the anal sphincter becoming loose, or there could be something growing in the rectum that’s causing it to stay open. More specifically, the biggest worry is rectal cancer, so the gastroenterologist would need to do tests, usually a colonoscopy, to rule out a mass. Unexplained fecal incontinence plus blood or diarrhea could be signs of rectal cancer.
What tests can you expect?
The gastroenterologist would most likely do what’s called an anorectal manometry. “It’s a test in which a probe with a small balloon attached is inserted up the rectum to measure the strength and sensitivity of the rectum and pelvic floor," Sonpal explains. The patient will bear down, while the gastroenterologist will measure the squeeze pressure to help assess the pelvic floor muscles. From there, the doctor can see if you need further tests, or if you need more in-depth pelvic floor physical therapy (which may include Kegels and Pilates) to strengthen your rectus muscles.
How embarrassed should you be explaining all this to your doctor?
You shouldn’t be embarrassed at all, Sonpal says. In fact, 90 percent of his consultations with patients are about how their stool looks and how gassy they are. “There isn’t a single gastroenterologist on the planet who will make you feel bad about this,” Sonpal says. “The things that come out of us tell us more about you than the things you put in."
Has the above ever happened to you? What do YOU think is an embarrassing aging symptom? Let us know in the comments below.
Josie Norton
Follow Article Topics: Health
