There are plenty of things you're used to planning your life around: work, school, family, finances, chores, errands. What you don't expect to plan your life around, however, is knowing where the closest bathroom is at all times.

If you're suffering from bowel incontinence, you've probably tried a thing or two to help relieve your symptoms and get your life back to normal. But can home remedies really help make bowel incontinence go away?

"Bowel incontinence, which is also called fecal incontinence, is a condition that causes a person to have accidental leakage of stool. Certain home remedies may help individuals keep their condition under control, but if bowel incontinence is recurring despite these remedies and affecting quality of life, it's time to be evaluated and treated by a specialist," says Dr. Diego C. Marines, colorectal surgeon at Houston Methodist.

What causes bowel incontinence?

Sometimes, bowel incontinence is an isolated event that happens just once. Other times, it's recurring — either from time to time or even daily.

"The number one cause of bowel incontinence is obstetric trauma. When a woman delivers a large baby and an episiotomy is needed, it can affect the sphincter muscles in the rectum. This ultimately can create a weakening of the bowel continence mechanism, making it harder for the muscles to hold stool back completely," explains Dr. Marines. "A woman doesn't always develop symptoms immediately after childbirth, however. Sometimes it can take decades for bowel incontinence to develop as a result of obstetric trauma."

Other causes of bowel incontinence include:

• Muscle damage – in addition to occurring during childbirth, intestinal muscle damage that occurs as a result of various types of injury or surgery can lead to stool leakage
• Nerve damage – leakage can occur when the nerves that either sense stool or control the sphincter don't work properly, which can be due to straining during bowel movements, an injury or as a result of certain medical conditions, such as diabetes and multiple sclerosis
• Chronic constipation – over time, passing dry or large stool can weaken the muscles of the rectum or lead to nerve damage
• Enlarged hemorrhoids – prevent the sphincter from holding back stool
  
  

Which home remedies for bowel incontinence actually work?

Before trying any home remedies, Dr. Marines urges anyone experiencing bowel incontinence to first consult his or her physician.

"Bowel incontinence is not only frustrating and embarrassing, it can be a sign of a more serious health problem, such as a polyp or tumor in your colon or rectum," warns Dr. Marines. "Your doctor will need to evaluate your symptoms and advise whether you need to be screened for colorectal cancer before you begin any home remedies. In addition, he or she can recommend the home remedies that are most effective for your specific condition."

While there are supplements for everything these days, Dr. Marines recommends starting with a few tried-and-true home remedies to relieve symptoms of bowel incontinence:

• Eating plenty of fiber. Did you know that most people don't get the daily recommended amount of fiber, which is 38 grams for men and 25 grams for women? Fiber helps bulk up your stool, making it less likely to accidentally leak loose stool.
  
  
• Limiting caffeine. Caffeine increases the rate at which your intestinal muscles push stool through your colon. With less time for your stool to absorb water and bulk up, you're more likely to accidentally leak loose stool.
  
  
• Keeping a food journal and avoiding problem foods. By tracking both what you eat and your bowel movements, you may find that certain foods make your bowel movements looser. Make an effort to avoid these foods, especially if you can't be near a restroom.
  
  
• Having a bowel regimen. Try to plan your bowel movements for the same time every day, if possible. If your bowel incontinence is more frequent, plan to use the restroom before leaving your house.
  
  
• Performing Kegel exercises. This exercise can help strengthen the pelvic floor muscles that support your bowel, helping to keep stool from leaking out. Try using post-it notes or phone alerts to remind yourself to do these several times a day.
  
  
• The occasional water enema. This more invasive at-home option can help provide more predictable bowel movements. While this may be okay to try initially, approach with caution and consult your doctor if you need to do this frequently.
  
  

"The key thing to know about these home remedies is that they're not a substitute for speaking with your doctor — these are just the things you can try before it's time to consider more time-consuming or advanced treatment options," adds Dr. Marines.

How is bowel incontinence treated?

If the home remedies suggested by your doctor aren't controlling your bowel incontinence, it's time to see a colon and rectal specialist.

"Typically, the first thing we recommend for bowel incontinence is pelvic physical therapy or sacral nerve stimulation," says Dr. Marines.

Pelvic floor physical therapy can take between 6 and 8 weeks. Pelvic physical therapists are licensed professionals who have expertise in helping people strengthen the pelvic floor muscles that support the bowel. Through biofeedback exercises guided by a pelvic physical therapist, the goal is to help retrain your anal muscles to sense and hold back stool.

"Sacral nerve simulator is performed as an outpatient procedure, in which an implant is placed in your lower back that helps signal your brain when it's the proper time to start heading to the restroom," explains Dr. Marines.

Physical therapy and/or sacral nerve stimulation typically improve the condition significantly. When they don't, there are surgical treatment options a colorectal surgeon may recommend, including:

• Surgical sphincter repair – a surgical procedure used to repair weakened and damaged portions of the sphincter to prevent stool leakage
• Permanent colostomy – used as a last resort, this procedure creates an opening for the colon through the abdomen so that stool can be drained into a bag or pouch
  
  

"Sacral nerve stimulation is the first-line treatment option for people who have bowel incontinence and don't respond to or aren't good candidates for more conservative treatment options, such as home remedies and pelvic physical therapy. This treatment option can be incredibly effective, and many people who have had a sacral nerve simulator implanted express to me that they feel like they've gotten their life back — no longer afraid to leave the house or go on trips," adds Dr. Marines.