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.

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 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. 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.

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 ?

Scifigal2k, the word "spew" came to mind when you said that about the fistula and diarrhea. Fernando, those are good tips to keep in mind. I've found that to be the case too. The faster I move, the less control I have. I keep a large tote packed with spare clothing, wipes, etc. that I take whenever I leave home. A few of my meds have the side effect of constipation which is a plus for me. A low dose of Elavil has been the main one that helps.

Have you considered taking Questran to try and firm things up a bit? I know it helps a lot of people after resections. I started taking it after having my gallbladder out, it's helped me a lot.

Otherwise I wish I knew, sometimes I just have to pray and run like hell!

Yes I have a city chart where all the bathrooms are. My problem is that from the beginning of the urge (that can occur anytime) to the point of the toilet is at most five minutes. The biggest problem is when someone is already sitting there, then I have no shame in going to the women's bathroom.

Needless to say I carry lots of tissues with me. The other day I ran into 3 consecutive bathroom with no toilet paper, 3 of them in a row !

Kegels have been used for many years for childbirth and urinary control, most of the muscles involved are more towards the bladder but I guess it could have some benefit in the sphincter too.

http://en.wikipedia.org/wiki/Kegel_exercise

In Tantric Yoga there are Bandhas which are locks to hold the Kundalini energy. There are three main locks (contractions) one with the chin down, another with the lower abdomen sucked in and the Mula Bandha which is the contracting of the sphincter muscle. Exercising this one will help tighten up the sphincter. Do a google on Mula Banda:

http://www.yogaindailylife.org/esystem/yoga/en/110400/bandhas/mula-bandha/

My rectal surgeon said that some leakage is so thin that it just drips out of the anus. He suggested that I wear a small cotton wad inserted in the anus after a bowel movement, this catches most of the leakage. For the larger stuff I have been wearing diapers for years, needed specially when I am almost sitting at the toilet it all starts to come out since the sphincter is half way open at that point. I also notice a major skid mark sometimes during the night, underwears will be very, very messy.

I was surprised when my GI recommended kegals because I always associated them with urine control and vaginal muscles. The first time I ever experienced leaking was after I gave birth to my son. He was 10 pounds and I suffered significant tearing, which healed well but I think led to a decrease in my muscle tone. I don't think I would have ever noticed if I didn't have Crohn's and frequent D honestly. I have been a stickler about Kegals ever since then and the leaking pretty much diminished entirely until I had a resection a couple years ago. Now I have a lot more D due to losing so much bowel and do notice some leaking if I don't get to the bathroom on time, but nothing requiring a change in clothing or really even that noticeable. Maybe there's only so much you can do mechanically when you are literally having liquid stools, IDK. I do know that if I have another baby I will be having a C-Section because I absolutely cannot risk any more damage down there. Even though it seems like my incontinence in very mild, it still effects me mentally at times, especially when straining myself. I have all but given up on cardio-type exercise and always have a twinge of self-awareness during sexual activity (luckily nothing has happened in this area, knock on wood).

My GI has offered to refer me to a specialist (don't remember what he was called exactly) if I wanted, but I am holding off for now because it really isn't that bad (or maybe I just get used to things, IDK). But the take-away I got from that was that incontinence is not something that should just be accepted as part of Crohn's Disease.

Another thing I didn't add before was that if I know I am going out at night (which seems to be the time by bowels are most active) I will stop eating at noon that day. I hate immodium, it just makes me crampy and gassy, so not eating is really all that has worked for me. I also am lucky enough to make my own schedule for work, so I usually eat a big breakfast, go to the bathroom 5+ times, then go to work. I will skip lunch and eat when I am home from work. This is sometimes problematic because I am always fighting to maintain a healthy weight, but it's all I can do for now. Since my surgery even liquids cause D.