Living with bowel problems

Bowel symptoms can vary depending on the underlying cause. The most common bowel problems people experience are:

Bowel leakage

Bowel leakage is the involuntary passage of stool e.g. you cannot control when your bowel opens, often resulting in bowel accidents.

Constipation

There is no exact science to what constitutes constipation as the symptoms vary from person to person. It is often characterised by decreased bowel movements and straining at defaecation.

Overflow incontinence

This is a combination of bowel leakage and constipation. You can be constipated but still experience loose stool that leaks past the hard stool.

Typical symptoms of bowel leakage

• Feeling the urge to have bowel movement but not being able to control when your bowels open, resulting in a bowel accident (urge incontinence)
• Leaking stools (passive incontinence)
• Soiling of underwear
• Being unable to control when you pass air (flatus)

Typical symptoms of constipation

• Inability to have a bowel movement
• Bloating
• Discomfort
• Severe stomach ache
• Spending long amounts of time trying to pass stool

When to get in contact with your healthcare professional

A lot of people who experience bowel problems may be reluctant to go and talk to their healthcare professional, as bowel problems are very personal and potentially embarrassing subject. It is important to go and seek help, otherwise you may find that your bowel problems start to encroach on daily life.

Test your bowel symptoms

If you are experiencing episodes of faecal incontinence and/or chronic constipation, we recommend you to consult your health care professionals. To prepare yourself for the consultation, you can take a self-assessment test that both indicates the severity of your symptoms and gives your doctor relevant insights to decide on a proper treatment.
Test your bowel symptoms now.

Neurogenic bowel can be described as slow movement of stools, constipation, bowel leakage, and difficulty emptying the bowel. Control of the external anal sphincter muscles may also be disrupted, increasing the risk of bowel accidents. 

There are two main types of neurogenic bowel dysfunction:

• Reflex bowel  
• Flaccid bowel

Reflex bowel

Reflex bowel causes loss of the ability to feel when the bowel is full. Although the anal sphincter muscle (the muscle that keeps the anus closed) remains tight, it will open on a reflex basis when the rectum becomes full and, therefore, the bowel can empty at any time unless appropriately managed. Reflex bowel can occur when the spinal cord is damaged above the T12 level.

Flaccid bowel

Flaccid bowel is when the anal sphincter muscle (that normally keeps the anus closed) becomes relaxed and stays open, often leading to accidental emptying of the bowel. Flaccid bowel is generally caused by damage below the T12 level.

One cause of neurogenic bowel is spinal cord injury (SCI). The impact on bowel function depends on the level of spinal cord injury and where the damage occurs (as mentioned above).

Other possible causes of neurogenic bowel include multiple sclerosis, spina bifida and Parkinson’s disease. 

Why is bowel care so important?

Having a good bowel care routine will improve your physical and emotional well-being and help you to:

• Have regular and pain-free bowel movements
• Prevent bowel leakage and constipation
• Improve your quality of life

Options available to help manage bowel problems

To manage both bowel leakage and constipation, there are a number of treatment options available in increasing order of invasiveness:

• Conservative treatment
• Digital stimulation
• Trans anal irrigation, also known as bowel irrigation e.g Peristeen® Plus
• Sacral nerve stimulation
• Antegrade colonic irrigation (ACE)
• Sacral anterior root stimulation
• Stoma

It is most likely that you will be offered conservative treatments first, such as moderating diet and fluid intake and/or taking medication, such as bulking agents, laxatives and enemas. 

Bowel irrigation

If your bowel problems are not solved using conservative methods, and you are still experiencing bowel accidents or having difficult emptying your bowel, then bowel irrigation may help. Bowel irrigation can prevent bowel leakage and constipation by making sure that bowel movements are regular and predictable. 

Test your bowel symptoms

If you are experiencing episodes of faecal incontinence and/or chronic constipation, we recommend you to consult your health care professionals. To prepare yourself for the consultation, you can take a self assessment test that both indicates the severity of your symptoms and gives your doctor relevant insights to decide on a proper treatment.

Test your bowel symptoms now.

Find out more

Read more about Coloplast’s bowel irrigation system, Peristeen® Plus, that can help you manage your bowel problems.

This FAQ is intended as a guide to commonly asked questions. Please always consult your healthcare professional regarding bowel problems. 

How does the bowel work?

The bowel is the last section of the digestive system and is divided into the small intestines and the large intestines (the colon, rectum and anus). The main function of the small intestine is to absorb nutrients from food digested in the stomach. The main function of the large intestine is to absorb water and to form stools from any waste products that cannot be used by the body. Stools are discharged from the body via the rectum and anus. View a video of how the bowel works.

What is bowel leakage?

Bowel leakage occurs when you cannot control when your bowels open, resulting in a bowel accident. The condition can range from minor leakage and soiling of underclothes to complete and uncontrolled emptying of the rectum. 

What is constipation?

The symptoms vary from person to person but are often characterised by decreased bowel movements, bloating, discomfort, straining and spending long amounts of time try to pass stool. 

What are the causes of bowel problems?

Bowel problems can be caused by a number of different conditions – some relatively minor and some potentially life threatening. Neurogenic causes include spinal cord injury, spina bifida and multiple sclerosis. Non-neurogenic causes include obstetric trauma (sphincter muscle damage after childbirth), cancer of the bowel or colon, Inflammatory bowel disease. This list is by no means exhaustive.

What is neurogenic bowel?

Neurogenic bowel describes a lack of nervous control which prevents the bowel from functioning effectively. The effect on bowel function depends on where the spinal cord is damaged.

How can bowel problems affect my lifestyle?

Bowel leakage and constipation can be very uncomfortable, and they also have a significant impact on our quality of life. Apart from the frequent physical discomfort and bloating, you may worry about having an accident in public. It makes it important to find a way to take care of your bowel.

What can I do to manage my bowel problems?

Bowel problems can often be improved by changing diet; there are also several types of medication that can help. Transanal irrigation can be used to help prevent constipation and bowel leakage.

How can I prepare for the HCP consultation?

To prepare yourself for the consultation with your health care professional, you can take a self assessment test that both indicates the severity of your symptoms and gives your doctor relevant insights to decide on a proper treatment.

Test your bowel symptoms now.

Find out more

Read more about Peristeen®, a bowel irrigation system, for predictable bowel management.

This FAQ is intended as a guide to commonly asked questions. Please always consult your healthcare professional regarding bowel irrigation. 

What is bowel irrigation?

Bowel irrigation is where water is introduced into the bowel using a rectal catheter. The water stimulates the bowel and flushes out the stool, leaving the lower half of the bowel empty. It is important to do it regularly to prevent constipation and the risk of bowel accidents. Read more about Coloplast’s bowel irrigation system, Peristeen® Plus. 

Where can I get  Peristeen® Plus?

In order to use Peristeen Plus, you need to get a prescription from your GP or nurse. You must also always consult an experienced specialist healthcare professional before starting up the irrigation procedure and you must receive thorough instruction from a healthcare professional before using this product. 

How often should I irrigate?

Most people start with irrigating every day. It takes approximately 3 months to establish a regular routine. Once you have an established routine, irrigating every other day may work well. With time and practice you will find out what works best for you. What is important, is to remember to irrigate regularly to prevent constipation and minimise the risk of bowel accidents. Always ask your doctor or nurse for advice.

What time of the day is best for irrigating?

Try to get into a routine where you irrigate around the same time of the day. Eating and drinking helps the bowel’s natural movement, so about 30 minutes after a meal is a good time. But do not be afraid to change the routine slightly to suit your day-to-day routine.

Can I travel with the irrigation equipment?

Yes – remember to bring your irrigation system along with lots of disposable catheters as they may not sell them everywhere. If you are going to use the system abroad, use bottled or cooled boiled water in places where the tap water is not safe to drink. Remember in different time zones your body may take a while to get used to a new routine. You may also be eating different types of food, which can affect the bowels.

What should I do if I leak between irrigations?

If you experience bowel leakage between irrigations, it may be due to insufficient emptying of your bowel due to constipation or hard stool. Alternatively, you may be using too much water during irrigation. Contact your doctor or nurse to help you adapt to your bowel plan. A Peristeen® Anal Plug may help if the problem persists.

Find out more

For more information, watch the video about getting started with Peristeen Plus.