Incontinence & fiber intake

[forrest]

I have fecal incontinence, I take 2 heaping tbsp of fiber every night before bed. I also take Loperamide, 1 capsule, twice a day. Usually, maintaining this regimen, I have small formed bowel movements once a day. My doctor recommended I increase my fiber intake to 2 heaping tbsp of fiber twice a day. I told them that if I increase my fiber intake, it would change the consistency of my poo & I would therefore have even less control over it. My doctor told me that the more fiber I take, meaning 2 heaping tbsp TWICE a day, would cause me to have better formed poo.

This is hard for me to believe or to understand. I thought fiber would loosen up my poo, the loperamide would help it get a formed consistency. My doctor said most people take on average about 2 large tablespoons of fiber Twice a day. I have very little control over my bowels, & keeping them small & formed is the only way I can have even a little bit of control.

Whenever I eat high fiber meals, I always skip taking my fiber for that night. If I took my fiber after a high fiber meal, I would have a large soft bowel movement the next day, and with little notice, wouldn’t be able to make it to a toilet, would have a huge mess on my hands.

Can anyone relate to this? Appreciate any thoughts or advice.

 

[sj2016]

I'm trying some metamucil fiber gummies that's being delivered today. Hope you have a good new Year?

 

[John davis]

Fiber will help you have formed stools.

The trick is to find the right amount. Excessive fiber may cause stools to be so large that they are difficult to pass.

--John

 

[MichaelDahlke]

Hello Forrest,

so from my own experience I can confirm that it is a good idea to take fiber (e.g. psyllium husks) in the evening with the right amount of liquid. You can certainly experiment with the amount - but taking a lot of fiber, especially in the morning (in whatever form) is not recommended for fecal incontinence problems from my experience.

In my experience, nutrition is the most important point that decides in the end about success or failure. Here only trying actually helps. It tends to be my experience that it is better to avoid too much fiber-rich foods with too thin stools during the day

The question, however, is whether the stool is actually too thin or whether the thin stool is not rather the result of constipation. This sounds paradoxical at first - but it is not. If you drink too little or eat too little fiber or take medications such as loperamide, this can lead to constipation. The body tries to get rid of the blockage by absorbing less fluid in the intestine. The consequence of this is that you then have partly hard lumps but also thin stools in the intestine. This then becomes a problem, especially in the case of sphincter weakness.

It is therefore important to produce not only firmer but also a uniform stool consistency. For various reasons, loperamide is rather unsuitable for this. Loperamide is also not intended for long-term medication but for taking acute diarrhea and requires - if it is taken more than two days - the doctor's prescription and follow-up.

My tip: Talk to your doctor about whether he thinks the use of loperamide makes sense in your case and what alternatives he sees. It can also be helpful to take advantage of nutritional advice in which you take a closer look at what you are eating when and what you could change.

Best regards
Michael