The Clinton Herald, Clinton, Iowa

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August 15, 2013

Help with incontinence

DEAR DR. ROACH: My husband, age 67, has had an increase in bowel movements in the past year or so. These are more watery or mucus-filled than ever before. They also are urgent.

He had a colonoscopy that showed little, but the doctor recommended adding more fiber to my husband’s diet, which we have done. He has had episodes of not making it to the toilet before the movement, thereby soiling himself. He is very frustrated and embarrassed. Are there any other dietary changes we can make? — C.B.

ANSWER: Fecal incontinence is a common and potentially devastating problem that many people are reluctant to talk about. Only one-third of people with this condition tell their doctor about it.

There are many causes of fecal incontinence, including neuropathy and fecal impaction, but often the cause is never found. In addition to the evaluation you have had done, I agree with the addition of fiber to try to make the stools less watery. Watery bowel movements are much more difficult to control than solid. Unfortunately, it doesn’t sound like fiber has done the trick. I would consider a trial of methylcellulose, such as Citrucel, and even loperamide, such as Imodium.

Biofeedback and surgery have been tried for this condition but haven’t been so helpful.

DEAR DR ROACH: I have had a very enlarged testicle for the past 60 years. As a young boy, I had mumps, and that was when this condition occurred. Since then it has posed no problem in any way — no pain, little discomfort. I’m a very active senior and am used to playing sports such as soccer, swimming and working out.

However, during the past few years, I am more aware of its presence insofar as it seems to have dropped. There has never been any associated pain.

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