Bowel incontinence can feel distressing, but understanding its causes is the first step towards finding relief.
If you’ve been experiencing unexpected bowel leaks or difficulty controlling your bowel movements, it’s worth looking closely at the medications you’re taking.
Some prescription and over-the-counter drugs can disrupt normal bowel function, and knowing which ones are more likely to do so can make a big difference.
What is bowel incontinence?
Bowel incontinence, also known as faecal incontinence, is when you can’t control your bowel movements, leading to accidental leakage of stool. It can range from occasional leaks when passing gas to a complete loss of control over the bowels.
It’s more common than you might think, especially among older adults, but it can affect people at any age. Causes vary and include underlying medical conditions, damage to muscles or nerves, and certain medications.
How medications affect bowel control
Some drugs interfere with how your digestive system works. They might:
- Relax the muscles involved in bowel control
- Cause diarrhoea or loose stools
- Speed up digestion, reducing time for proper absorption
- Disrupt nerve signals to and from the rectum
Understanding which medications can have these effects is key to managing or preventing bowel incontinence.
Common medications that can cause bowel incontinence
1. Laxatives
It might seem obvious, but it’s worth mentioning. Laxatives are meant to relieve constipation by making stools softer or stimulating bowel movements. However, overuse or incorrect use can lead to loss of bowel control.
Types of laxatives that may cause problems:
- Stimulant laxatives
- Osmotic laxatives
- Stool softeners
Tip: Use laxatives only as advised by a healthcare provider, and avoid long-term use unless prescribed. Prolonged use may make your bowel “lazy,” reducing natural motility and increasing dependency.
2. Antibiotics
Antibiotics can disturb the natural balance of bacteria in your gut. This may lead to diarrhoea, which increases the risk of bowel incontinence.
Some people may also develop Clostridioides difficile (C. diff) infection after antibiotic use, which causes severe diarrhoea.
The risk is greater in hospital settings or among those taking multiple antibiotics.
3. Cholesterol-lowering drugs
Certain medications used to lower cholesterol, such as bile acid sequestrants, can loosen stools and make bowel control harder.
These drugs work by binding bile acids in the gut, which can cause bloating, diarrhoea, and increased urgency. Though effective for cholesterol, they may affect those with sensitive bowels.
4. Diabetes medications
Some drugs used to manage type 2 diabetes can affect your digestive tract and speed up bowel movements.
If you’ve just started diabetes medication and noticed changes in bowel habits, it’s worth discussing with your GP. Sometimes, these effects ease over time, but not always.
5. Medications for high blood pressure and heart disease
Drugs that treat high blood pressure or heart conditions may impact your digestive muscles or nerves.
Watch for:
- Calcium channel blockers: Can cause constipation but, in some cases, may lead to incontinence due to muscle relaxation
- Diuretics: Increase fluid loss, which may result in diarrhoea or urgency
In some cases, the problem isn’t the drug alone but how it interacts with others, especially in people managing multiple conditions.
6. Antidepressants and antipsychotics
Some mental health medications affect your nervous system, including the nerves that control bowel movements.
Examples include:
- Selective serotonin reuptake inhibitors (SSRIs): Can cause diarrhoea in some people
- Tricyclic antidepressants: May relax the anal sphincter or slow down digestion
- Antipsychotics: Often interfere with digestive signals
It’s not uncommon for people taking these medications to experience either constipation or diarrhoea, both of which can lead to bowel incontinence over time.
7. Non-steroidal anti-inflammatory drugs (NSAIDs)
Used for pain and inflammation, NSAIDs can irritate the stomach and bowel lining, leading to diarrhoea or bowel urgency.
Frequent or high-dose use increases your risk, especially if combined with alcohol or certain antibiotics.
8. Chemotherapy drugs
Cancer treatments often affect fast-growing cells, including those in your digestive tract. This can result in diarrhoea and poor bowel control.
Side effects vary depending on the specific drug, but many people report significant gastrointestinal symptoms during chemotherapy. These effects may continue for some time after treatment ends.
How to tell if your medication is causing bowel incontinence
It’s not always easy to connect the dots. But here are signs your medication might be the cause:
- Symptoms started after beginning a new medication
- Your bowel habits changed suddenly
- Symptoms improve when you stop or reduce the dose (only under medical advice)
- No other clear cause is found
What you can do about it
If you suspect your medication is causing bowel incontinence, don’t stop taking it on your own. Instead:
1. Speak to your GP or Pharmacist: They can review your medication list and suggest alternatives if needed.
2. Ask about dose adjustments: Sometimes, lowering the dose can reduce side effects without losing the benefits.
3. Keep a bowel diary: Track what you eat, your medications, and when symptoms occur. This can help your doctor pinpoint the cause.
4. Support your digestive health:
- Eat a balanced diet with enough fibre
- Stay hydrated
- Avoid known irritants like caffeine, spicy foods, and alcohol
- Exercise regularly
5. Consider a medication review: If you’re taking multiple medications, especially as an older adult, a review can identify interactions or unnecessary prescriptions.
When to seek immediate help
Contact a doctor right away if you experience:
- Severe or sudden bowel incontinence
- Blood in your stool
- Unexplained weight loss
- Abdominal pain or cramping
- Signs of dehydration (e.g. dizziness, dry mouth)
These could be signs of a more serious issue, including infections or bowel disease.
The bottom line on medication-related bowel incontinence
Bowel incontinence can be uncomfortable and frustrating, but it’s often manageable, especially if a medication is the underlying cause. Many drugs that affect bowel control can be adjusted or replaced, and a few lifestyle tweaks can also help ease symptoms.
Don’t ignore the signs. If you’re dealing with changes to your bowel habits, speak with your GP. A simple review of your medicines could lead to a big improvement in your quality of life. Take control, ask questions, and don’t let bowel incontinence go unchecked.
