Does diet affect fecal incontinence?
Yes. What you eat is one of the main things you can control. Food changes how loose or firm your stool is, how fast it moves through your bowel, and how much gas you make. The right changes can cut down on accidental leakage, and for some women that’s enough without any other treatment.
How food changes bowel control
Bowel control is easiest when stool is formed but soft. Loose stool is much harder to hold than formed stool. Some foods speed stool through the bowel, which gives you less warning before you have to go. Extra gas adds to the urgency and can push out leakage along with it.
When I see a patient with fecal incontinence, diet is one of the first things we talk about. Sometimes one small change makes a big difference, like cutting back on caffeine or adding a fiber supplement.
Foods that often make it worse
These are the ones I ask about most:
- Caffeine, which speeds up the bowel and loosens stool
- Alcohol, which irritates the gut and speeds things along
- Spicy food, which can bring on urgency and loose stool
- Fatty or greasy food, which is harder to digest and may loosen stool
- Artificial sweeteners like sorbitol and mannitol, which pull water into the bowel
- Dairy, if you’re lactose intolerant, which causes gas and loose stool
- High-fructose foods, which can cause bloating and urgency
Not everyone reacts to all of these. You may do fine with some and have trouble with one or two.
Changes that help
I start most patients with a food diary before they change anything. Write down what you eat and when you have symptoms. Patterns often show up within a week or two. Once you know your own triggers, a few targeted changes work better than a strict diet, and you’re more likely to stick with them.
Soluble fiber is the change I suggest most often. Oatmeal, bananas, and psyllium (Metamucil) add bulk to stool, and firmer stool is easier to hold.
Eating meals at about the same times each day makes your bowel movements more predictable. Drink enough water to keep your stool at a normal consistency.
Go slowly with all of this. Changing a lot at once can make symptoms worse for a while. If you’re working through it with me, bring your food diary to your visit and we’ll go over it together.
References
- Brown HW, Dyer KY, Rogers RG. Management of Fecal Incontinence. Obstetrics & Gynecology. 2020. doi:10.1097/AOG.0000000000004054
- Meyer I, Richter HE. Accidental Bowel Leakage/Fecal Incontinence: Evidence-Based Management. Obstetrics and Gynecology Clinics of North America. 2021. doi:10.1016/j.ogc.2021.05.003
- Sultan AH, Monga A, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction. International Urogynecology Journal. 2017. doi:10.1007/s00192-016-3140-3
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