Jessica McKinney, PT, DScPT, MS
Career-long women’s health provider (PT), educator & advocate with current roles as VP at a digital women’s health company, adjunct university faculty, & consultant in global/community women’s health.
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This week is World Continence Week, an annual campaign “designed to raise awareness of all forms of incontinence (bladder and bowel) in every demographic – from infants to the elderly.” An aim of such a health awareness campaign is to shed some of the shame and stigma that keep people from seeking treatment and to foster collaborative and constructive conversations about incontinence and its treatment and management. Many have heard that impaired pelvic floor muscles can contribute to bladder leakage. I recently wrote about how urinary incontinence (UI) can have significant negative impacts on women’s mental health, quality of life and relationships. The loss of control at the heart of this personal, sensitive issue leads too many women to feel alone and ashamed. But a large number of these same women also experience another pelvic floor-related condition: fecal incontinence (FI).
FI, also commonly known as accidental bowel leakage (ABL), refers to the involuntary loss of stool. It’s a debilitating condition affecting over 12 million women in the United States. Even the mildest, most infrequent episodes of ABL can be emotionally devastating for a woman. It’s not difficult to understand why women with this condition are at increased risk for depression, feelings of shame, and social isolation.
The uncertainty and unpredictability that come with FI often lead to restrictions on social activities, travel and exercise. FI impacts more than women’s day-to-day lives: It’s also associated with increased risk of nursing home placement. Many women end up needing this higher level of care because FI tends to worsen as women get older. As our population ages, FI prevalence is predicted to increase by 59% between 2010 and 2050, jeopardizing the physical and mental health and independence of millions of people.
An article published in the October 2020 edition of Obstetrics & Gynecology found that FI is more common in older woman and in those with chronic bowel disturbance, diabetes and obesity. But pelvic floor weakness is the culprit in many cases. Bladder leakage and bowel leakage share pelvic floor damage as a contributing factor, explaining why 20% of women with UI also experience FI, a condition frequently referred to as dual incontinence.
We know there’s a high level of reluctance to talk about their condition among people with both types of incontinence. Women with FI, however, are especially hesitant to speak up and seek help. Among women seeking urogynecologic care for UI, very few of those with FI symptoms disclose this additional problem. In fact, only 30% of women with FI report the condition to their doctors, making it vastly undertreated.
Lack of awareness also exists within healthcare, leading many doctors to not ask questions about incontinence and so women don’t tell. That’s one reason why World Continence Week is so critically important. There are effective therapies for UI and FI. Strengthening the pelvic floor is one of the most recommended as a first step in care and when done correctly, can help people make meaningful improvements in symptoms. Other interventions, including medications, supportive devices, and surgery also exist. If you want to learn more, you can register for any of the daily webinars offered by the organizers of World Continence Week, the World Federation of Incontinence and Pelvic Problems (WFIPP), including the webinar on Wednesday June 23, ‘Continence issues in Women – Supportive Strategies to Help Women Live a Full Life’, in which FI/ABL will be discussed. Click HERE for more information and HERE for the registration link.
Women’s health deserves better. Everyone’s health deserves better. Too many people are dealing every day with the consequences of untreated incontinence. Do you know someone who is living with UI or FI? I encourage you to talk with them. Let them know that many types of treatments are available. Encourage them to talk with their health care provider. Share with them the WFIPP website, or that of other credible patient-focused organizations, such as the National Association for Continence, Voices for PFD, and Simon Foundation for Continence. Don’t underestimate the impact conversations like this can make. #MakeAnImpact #WCW2021 #continencematters #supportincontinence #NoShame