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Protecting against Accidents

Since my last bowel resection surgery 5 years ago I have had an increasing loss of bowel control. I suffer from leakages and have been wearing diapers ever since. I've had this incredible urges to go and have had to develop several strategies to minimize accidents.

Since I cannot absolutely afford to have accidents at work I do a preemptive strike of 1 Imodium in the morning, if the day is bad I take another Imodium. This slows it all down and the sense of urgency stops.

I had a job interview about 4 months back, had lunch and was on my way to the bathroom, everything normal. All of a sudden this massive urge comes and I was only 15 feet from the bathroom. I stopped, squeezed my butt and stood there for 15 seconds. I resumed the walking and it all started coming out on its own. I crapped my diapers, my dress pants it was a massive surprise. No warning. Luckily there was a mall nearby and went into Macys. They tell me that the mens Macys is at the OTHER END OF THE MALL. I had to walk through the entire mall with crap stains in the backside. Tried not to think about how it will look like.

I picked black dress pants and took it to the clerk, he starts cross-selling me on Macys cards, on special he has, I lost it: I told him that I needed to change my pants right away that this is an emergency and please ring my sale, he looked flustered.

The interview went well and I got the job 3 months ago. I have only had two accidents at work even though I am very vigilant when I need to do preemptive strikes to the bathroom.

Wanted to get your strategies in preventing accidents.

First and foremost for me: when I have a strong urge I resist going to the bathroom right there and then. The problem is that once I started walking to the bathroom 15 feet away, the bowel movement suddenly starts with no warning. If I accelerate my pace it all begins to come out, no way to hold it. The first thing I do with an urge is TO SIT DOWN AND LET IT PASS. 99% of the time it does pass, 5 minutes later with no urge I calmly walk to the bathroom and do the deed.

The faster I am trying to get to the bathroom, the LESS CONTROL I HAVE. If it moves from the colon to the rectum while you are hurrying – GAME OVER.

The second point for accidents is when I am about to sit in the toilet: As I am on the way down the sphincter relaxes and this final 18 inches is when it all comes out, smearing all around the toilet. This is so preventable, all I need is wait 2 seconds but the movement starts on its own when the butt is relaxed in the way down. So now when I am about 5 feet from the toilet I stand, with heels together in a V formation, tighten up for 3 seconds, then I proceed to the toilet. Its the control you can exert at the colon more than the sphincter that is very effective. It works like a charm.

At work and in the car I have an extra pair of pants and diapers. The diapers I will need about once every 3 weeks. The pants about every 6 weeks. Some people suggest to carry a trash bag in the car, it can get very messy unless the trash bag is spread wide enough.

The other thing I do is have regular bowel movements after every meal, before the urges come. About half the time is the passing of massive amounts of gas.

What are your strategies in preventing accidents ?
 

nogutsnoglory

Moderator
I completely understand this fear and problem. I do kegel exercises to strengthen my sphincter, I use imodium, I keep a spare change of pants and a diaper or underwear.

I also try to eat foods that bulk me up like potatoes, peanut butter, avocado etc.
 
Accidents are no longer an issue for me since I've got a stoma, so really my stoma is how I fixed the problem (my stoma also fixed a lot of other problems).

Two suggestions for you: One: you could try taking more anti-diarrhoea meds. If Imodium (loperamide) helps you, can you increase your dose? It's a very safe med and you can take a lot of it. You could also try Lomotil (co-phenotrope). Two: have you seen a colorectal surgeon to have investigations into possible sphincter or nerve problems?
 
Imodium has helped considerably, it suppresses these sudden urges and if I take 2 in the morning I am good for the day. Twelve hours later the urge may come but I can cope at home.

I have talked to the GI and colorectal surgeon about this and I heard the nerve explanation from them. They both suggested Imodium and more Imodium (without limits which sort of worries me on overusing it). Lomotil was also suggested. I also have heard that Questran (cholestyramine) which treats cholesterol and bile secretions may help. They don't have another solution for me.

I have found doctors have solutions using drugs or surgery. They themselves don't have first hand knowledge as to how to manage these problems. That is why I hope that I get more insight from the people in this forum as to how they manage.


The urges comes deep from within the colon, sort of an electrical feel which cannot be ignored. It comes without warning with an estimated evacuation warning time of 5 minutes at most. Need to understand where each toilet is when I am around the city. Got to watch out for those toilets that have combination locks (Walgreens have a lot of those) and single bathroom businesses that may be busy (many coffee houses). At least when I am driving I can predict where I go before counting on a bathroom to be there when I need it.

I keep my bowels cleared by periodically going to the bathroom on a schedule (About 5 times a day). The urge is accompanied by lots of gas which makes it quite explosive when I go. Most of the time is the gas pressure that initiates the urges. Those 5 times smooth out the unpredictability of other times when the urge may come. I have observed the times it comes, most often it comes after my hour long commute as I get home. While I am seated at the car it is all sealed up, no urges ever. As I get out of the car, ZAPP, it starts. Knowing this I am ready for it, start tightening and most of the time can make it to the bathroom. Occasionally it may start as I am swinging down into the toilet, that is the most common culprit. So I go through my process, still once or twice a week it may not work and have accidents.

All in all, once or twice a week is not that bad. I have developed an understanding at the cause-and-effect of these urges, keeping the bowels cleared in the process.
 
I kind of stopped caring, I have literally shit in public in front of people 4 times now. After the first incident I thought it wasn't too bad and it actually made a funny story for my friends. So now I don't let it bother me, if it happens it happens and I will drop my pants on the spot. Although if you're in a place that you need to frequent a lot.... that is very different. It can be quite embarrassing and my post probably didn't help any : /
 

nogutsnoglory

Moderator
For severe diarrhea you can also try tincture of opium. This is a highly controlled substance your dr needs to prescribe. Usually you can only get it at a specialty pharmacy.
 
Imodium has helped considerably, it suppresses these sudden urges and if I take 2 in the morning I am good for the day. Twelve hours later the urge may come but I can cope at home.

I have talked to the GI and colorectal surgeon about this and I heard the nerve explanation from them. They both suggested Imodium and more Imodium (without limits which sort of worries me on overusing it). Lomotil was also suggested. I also have heard that Questran (cholestyramine) which treats cholesterol and bile secretions may help. They don't have another solution for me.
Before I had my stoma, I was taking 10 loperamide capsules and 10 co-phenotrope pills a day. I had no side effects and there are no risks with long-term use. Have you had any tests done to asess the nerves and sphincter muscle? There are a number of tests that can be done.
 
Tests to test nerve and sphincter functioning. Can you respond with the actual name of these tests so I can ask the doctor (was it a GI or colo rectal doctor)
 
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