Products for managing bowel leakage.
There are no perfect answers to the problem of coping with leakage from the bowel. Some of the following products may be of help to you, but it is very difficult to find anything that reliably disguises bowel leakage and smell and which keeps you feeling comfortable. It is hope that in the future more time and investment will go into developing products to contain this embarrassing problem.
Promocon is a national resource centre for information on continence products. The website is www.disabledlivingg.co.uk
Pads and Pants
There are very few products designed specifically for managing faecal incontinence. Most of the disposable pads used for urinary incontinence can be used for containment, but some people find them unnecessarily thick, bulky, and not exactly the right shape at the back to contain anal leakage.
The simplest dort of pad for minor leakage is a panty liner, available in supermarkets and chemists. Unfortunately, if used inside the pants, the area between the buttocks often becomes sore as stool is on the skin. Some people have found that folding a panty liner between the buttocks and holding it in place with a close fitting 'G-string', helps to contain soiling and prevents the skin from getting sore. (See figure 1)Some panty liners have a soft cover, which seems to be better than a stay dry cover.
Figure 1. G String with folded pad.
For people with a very occasional leak, especially if this leak tends to be very liquid or mucus, it may be reassuring to wear pants with a built in waterproof gusset (See figure 2) when you know that you will be away from toilets for a long time. These should stop any leaks from staining clothes and embarrassing you. However, they are designed for bladder leaks, and stool may stain them.
Figure 2. Pants with built in protective gusset.
More major incontinence will require larger pads. These come in all shapes and sizes (See figure 3). Many are available free of charge on the NHS via the district nurse or local continence advisor if you have a severe or regular problem. If you are not already in touch with your local services, ask at your doctors surgery, or contact the Bladder and Bowel Foundation 0845 345 0165 or email info@bladderandbowelfoundation.org to find your local contact.
Figure 3 Pads
Anal plug
Some people with minor leakage of mucus or stool from the anus find that a small piece of cotton wool, rolled between the fingers and then gently inserted just inside the anus, will stop the problem. If this feels sore try it with a small amount of vaseline.
An anal plug has been developed to help people with bowel leakage. It is designed to be worn inside the rectum to plug the exit from the anus from the inside (See figure 4).
Figure 4 Anal plug picture.
The anal plug comes wrapped up in a water soluble film, so that it is easy to put in. It should be covered with vaseline and then gently inserted witha finger through the anal canal into the rectum. The film dissolves once inside the rectum, and the plug opens into a cup shape, with a string fro removal in the anus. It can be left in place for up to 12 hours. It comes in 2 sizes, small and large and only trying it will tell which is best. The manufacturers Coloplast Ltd will send samples on request.
Some people find an anal plug uncomfortable, or that it gives a constant feeling of needing to open the bowels. Others find the plug comfortable and effective, and it is not possible to tell whether it will help without trying it.
The anal plug has to be taken out before a bowel action, and so is not suitable for someone who needs to opne their bowels frequently. It is disposable. It cannot be flushed down the toilet, and so must be wrapped in paper or a disposal bag and put in the rubbish bin.
Faecal collection pouch
Occasionally people who are seriusly ill and confined to bed and who have uncontrolled diarrhoea can benefit from wearing a collection bag over the anus. Ask your healthcare professinsal for further advice.
Peristeen Irrigation system (see Figure 5)
Peristeen irrigation is a system where luke warm tap water is introduced into the bowel via a catheter. Peristeen helps to empty your bowels effectively and securely and if used on a regular basis can help prevent faecal incontinence and constipation.
Irrigation will usually only be tried if other less invasive methods of bowel management have failed to adequately control the individual bowel problem. This should be discussed further with your healthcare professional.
Figure 5 Peristeen irrigation system
Qufora mini irrigation (see Figure 6)
The Qufora mini irrigation system is a system used for irrigating the lower rectum with tap water whilst sitting on the toilet. It contains a pump and cone, which is carefully introduced into the rectum. As the pump is slowly compressed water enters the bowel. The pump can be released without soiled water being drawn in. When the cone is removed, faeces, water and gases can be expelled, thus preventing leakage.
For further information discuss with your healthcare professional.
Figure 6. Qufora mini irrigation system
Planning ahead
Having a bowel accident when you are away from home can be very embarrassing. A little forward planning can make this a little easier to cope with. Some or all of these may help:
- Public toilets eldom have a washbasin in the toilet cubicle, and it is often difficult to get clean just with dry tissue. Take a small packet of wet wipes in your bag or pocket. These can be found in supermarkets or chemist and some have a pocket size rigid plastic case.
- Or take a small plastic squeezy bottle that you can fill with warm water to take into the toilet with you. These are usually available in most chemists.
- If you need both hands to get clean or change a pad, a couple of clothes pegs can be useful to keep your clothes out of the way.
- A small pocket mirror can be useful to check that you are clean.
- There is a variety of anitary towels or nappy disposal bags avaialble in large chemists and supermarkets. Most are slightly scented and have tie handles. These are useful for disposal or to carry soiled pants home for washing.
- Dark colours and pattenred fabrics tend to shown any stains less than light fabrics.
- A small aerosol of neutraliser or spray perfume, used sparingly, may help you to disguise any odour.
- You may find it most convenient to carry a clean-up kit in a small wash bag (the sort many airlines give free is ideal), or on a waist belt.
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