Flatal Incontinence and Women: What is it and Why does it Happen?

Women suffer from flatal incontinence

Uncontrollable gas (flatus or flatulent gases) is known as flatal incontinence. This condition is defined as involuntary flatulence at least once or more per week. The big problem: it can happen anywhere. Involuntarily ‘breaking wind’ while at the store, restaurant or at the office creates embarrassing situations. It can erode self-confidence. It can negatively impact one’s relationships. Worse yet, the feeling of being powerless to control oneself can stress and isolate an individual. Unfortunately, it’s a problem that afflicts women around the world.

Pregnancy, Childbirth and Uncontrollable Gas

During pregnancy and natural childbirth, the anal sphincter (the muscle that controls the anus) and the perineum muscles (the muscles of the pelvic area) suffer trauma. As a result, many women experience a loss of control over bowel movements and gas immediately following childbirth. While this is very common, it certainly isn’t desirable.

Studies have found that nearly 1 in 3 women who deliver vaginally report experiencing uncontrollable gas. For some women, the problem occurs for only a short time. For others, the problem becomes chronic. [1]

Researchers have sought to identify why this affects some women, but not others, particularly after pregnancy and delivery. One study linked the use of instruments, such as forceps or vacuum delivery, to an increased risk of trauma to the perineal muscles, resulting in flatal incontinence. [2]

The use of instruments during delivery doesn’t alone explain the problem. It has been noted that women who have multiple natural births report a higher incidence of flatal incontinence. While this might suggest a C-section might offer a way to prevent this problem, researchers have found C-sections did not offer protection against flatal incontinence. [3]

Maybe Childbirth is Not the Cause…

One study of Korean women and post-delivery anal and flatal incontinence did deliver an interesting result. The Korean women in this study experienced the trauma typical to a natural delivery, with lacerations to the sphincter occurring. Vacuum extraction was also used. Yet, the study reported flatal incontinence occurs nearly 20% less in Korean women than in women from Western countries, despite similar risk factors. [4]

Of course that leads to the question…

What Other Factors Contribute to Flatal Incontinence

Age appears a contributing factor to the problem of controlling gas. As the Korean study shows, the problem exists globally. Researchers from several countries report that about 1 in 3 women ages 30 and older suffer from the involuntary release of gas. [5] [6]

Another study identified menopause, obesity and an increased occurrence of urinary incontinence as factors that increased the likelihood of flatal incontinence. [7] This suggests additional factors can impact the ability of the perineal and anal muscles from functioning properly.

Research supports this idea. One study of women ages 18-50 reported stress significantly increased the chance of an involuntary release of flatus. [8] While childbirth has long been associated as a cause, this continued research demonstrates that the problem of flatal incontinence extends beyond birthing as a simple explanation.

Hope for Women Suffering from Flatal Incontinence

The research has shown factors beyond childbirth can cause flatal incontinence in women. This problem should not be ignored or ‘lived with.’ For those suffering from this unpleasant and potentially embarrassing condition, understand many women suffer from it. Has flatal incontinence affected your life? How have you dealt with it? Please leave a comment and share your experience.

- Dr. Edward F. Group III, DC, ND, DACBN, DCBCN, DABFM

References:

  1. Casillas S, Hull TL, Zutshi M, Trzcinski R, Bast JF, Xu M. Incontinence after a lateral internal sphincterotomy: are we underestimating it? Dis Colon Rectum. 2005 Jun;48(6):1193-9.
  2. Chiarelli P, Murphy B, Cockburn J. Fecal incontinence after high-risk delivery. Obstet Gynecol. 2003 Dec;102(6):1299-305.
  3. Goldberg RP, Kwon C, Gandhi S, Atkuru LV, Sorensen M, Sand PK. Prevalence of anal incontinence among mothers of multiples and analysis of risk factors. Am J Obstet Gynecol. 2003 Dec;189(6):1627-30; discussion 1630-1.
  4. Jung E, Huh CY, Choe BK. Anal incontinence after childbirth: incidence in the Korean population. Gynecol Obstet Invest. 2008;66(4):248-52. doi: 10.1159/000148655. Epub 2008 Jul 31.
  5. Boreham MK, Richter HE, Kenton KS, Nager CW, Gregory WT, Aronson MP, Vogt VY, McIntire DD, Schaffer JI. Anal incontinence in women presenting for gynecologic care: prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol. 2005 May;192(5):1637-42.
  6. Rømmen K, Schei B, Rydning A, H Sultan A, Mørkved S. Prevalence of anal incontinence among Norwegian women: a cross-sectional study. BMJ Open. 2012 Jul 30;2(4). pii: e001257. doi: 10.1136/bmjopen-2012-001257. Print 2012.
  7. Abramov Y, Sand PK, Botros SM, Gandhi S, Miller JJ, Nickolov A, Goldberg RP. Risk factors for female anal incontinence: new insight through the Evanston-Northwestern twin sisters study. Obstet Gynecol. 2005 Oct;106(4):726-32.
  8. Zutshi M, Hull TL, Bast J, Hammel J. Female bowel function: the real story. Dis Colon Rectum. 2007 Mar;50(3):351-8.

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  • anonymous

    I am surprised that you would include this blog on your site without mentioning probiotics, prebiotics. enzymes, or homemade fermented foods.
    If you grew up in mainstream U.S. culture, you probably heard fart jokes in elementary school. Maybe you even told some. Now, I make a point of asking my friends from bean eating cultures whether ‘fart jokes’ are part of their culture. The answer almost always seems to be no!
    Allopathic medicine is inventing new diseases and conditions all the time, and new drugs to treat them! Is ‘flatal incontinence’ just another new name for bodily function that might be a sign that more enzymes or friendly bacteria are needed in the gut?

  • ghc_health

    Excellent perspective. Many people are very quick with the labels. I bet there has been more than one occurence of someone thinking, “Oops, gas slipped out once, I must have flatal incontinence.” In my opinion, that would be jumping the gun.

    However, childbirth, age, and weight can compound the issue. If someone is regularly unable, despite their efforts, to control their gas, then I don’t know what else you’d call it besides flatal incontinence if for no other reason than to isolate some potential remedies — and the ones you mentioned are excellent.
    Nobody can turn back the clock but we can do our best to stay at a reasonable, healthy weight and give our bodies the nutrition that makes it perform at its best.
    -Dr. G

  • http://naturalsolutionsformaximumhealth.blogspot.com/ Janet

    What is really bothersome is that it seems for a lot of people it is not uncommon when laying on a therapy or massage table, though I haven’t had this problem for a while.

  • ghc_health

    Well, getting a massage is very relaxing.

  • Anonymous2

    Honestly, chronic flatal incontinence, i.e. regularly releasing noxious dead-meat smelling gas without even knowing its coming yourself, is awful. Imagine how it is received in an office or school environment. People think and sometimes say “Why can’t this person just go to the loo, its disgusting!”. You overhear it but don’t want to have to go around explaining to people that you would if you could. It is out of your control. It’s socially isolating and can lose you your job. It also causes additional stress and can lead to depression.

    I have tried all sort of things to try to fix this but none work on an ongoing basis. I have not had kids. I have lived with this for years. Are there any remedies please?

  • Renee

    My sister has a similar problem. She passed foul smelling gas on one or two occasions in public. When she told me what had happened, my initial thought was omg, that’s disgusting, but then I noticed how distressed she was – to the point that she was in tears. One thing is for certain, that people can be forgiving about many things, but passing gas doesn’t seem to be one of them. It’s just something that is not socially accepted, even if it is accidental. It is the most natural of functions and of course , most of us would flee to the bathroom to relieve ourselves, but that doesn’t work for everyone unfortunately. It can happen so quickly and without warning.

    The best advice I could give my sister was to tell her that it isn’t worth thinking about, even if the people she undoubtedly will run into again will stare at her and judge her for something that wasn’t within her power to control. Let them look, I said. If they can judge you for something so human, they aren’t worth your time. I told her that life is too short worrying about what someone else may think. You can’t take it back so any distress over it is not going to matter. I also added that in a hundred years, it won’t matter anyway because none of us will be here!

  • Jane Exit

    I had a housemate with this issue and she did have three kids vaginally. The problem grew over time as she had more children. She has finally begun wearing charcoal panty liners. At least it squelches the most objectionable public problem. I’m not sure this problem has as much attention as it should. I don’t think there are medical queries, never mind answers.

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