Bowel incontinence 'not part of ageing'

SGH doc urges those with problem to come forward and get treated early
By Linette Lai, The Straits Times, 7 Oct 2014

FOR years, Madam Matilda Miranda lived with what seemed like a persistent stomach upset.

Within minutes of eating, she would have to rush to the toilet to empty her bowels.

Doctors prescribed diarrhoea medication to little effect. It was only after more than a decade that one doctor told her the problem was bowel incontinence.

The condition - a lack of control over one's bowels - affects mainly women, with those aged above 52 at highest risk.

Many are too embarrassed to seek help, or believe that nothing can be done.

"A lot of times, patients accept it as part of ageing, which is a myth," said Dr Mark Wong, director of Singapore General Hospital's (SGH) pelvic floor disorder service.

"And others feel that there is a stigma if they come forward."

He has been seeing a 10 per cent increase in patients each year since 2009, following efforts to raise awareness of the condition among general practitioners (GPs) and polyclinic doctors.

Many patients come forward only after struggling for years with the problem.

Some, like Madam Miranda, may even quit their jobs because of it.

"How to work?" said the 59-year-old, who left her supermarket job more than 10 years ago.

"I couldn't go anywhere. Even when I went for a movie, I wouldn't eat. In church, halfway through mass, I would have to run to the toilet."

The hospital conducted Singapore's first bowel incontinence study last year and found that about 5 per cent of the population is affected.

About half of this group also has urinary incontinence, or the loss of bladder control.

Dr Wong urged those with the problem to come forward and get it treated early.

"Like with any medical condition, if you allow it to deteriorate... the cumulative damage over the years can be irreversible in some aspects," he said.

"Sometimes all you need is an adjustment of dietary habits and simple medication."

Treatment options include ingesting more fibre to firm up stools, exercises to strengthen muscles, and surgery.

After Madam Miranda underwent the latter, she no longer has continence issues.

Now, she visits Dr Wong only once a year for check-ups, and avoids "trigger" foods like milk products or gassy drinks.

Said Dr Wong: "Don't accept it as a part of ageing.

"You should give yourself the chance to age with dignity."