The Washington Post

It’s time to end the taboo on talking about accidental bowel leakage

Prevalence of incontinence among non-institutionalized people aged 65 and over. (Source: National Center for Health Statistics)

Like erectile dysfunction 10 years ago, accidental bowel leakage is a common disorder that no one wants to talk about. Tens of millions of men and women over 40 are affected, but fewer than three in 10 even mention it to their health-care providers.

The time has come for this stop.

Known in medical literature as fecal incontinence, accidental bowel leakage or ABL is the accidental passing of liquid or solid stool. It happens unexpectedly, at inconvenient times, and can greatly limit daily activity. In fact, medical professionals know ABL as one of the benign conditions that have the greatest impact on wellness and quality of life.

It is associated with common conditions such as irritable bowel syndrome, obesity, neuromuscular disorders of the pelvic area and diabetes, as well as menopause and some prostate treatments.

So, why haven’t we heard about ABL before? Three reasons:

First, health-care advances move slowly, and ABL research has only recently begun to expand to adults living outside nursing homes and other institutions for older people. In 2012, the results of the largest prevalence study among people living at home showed that one in five women over the age of 40 experiences ABL.  Other research shows that ABL affects similar numbers of men, and that 70 percent of them experience onset before age 60.

Second, we have lacked a common language to talk about leaking stool in the context of health and wellness.  Fecal incontinence—the medical term used by physicians—is not a description that tends to provoke conversation.  And most people who experience ABL don’t even have a name for it themselves.

In a recent paper in the International Journal of Clinical Practice, Heidi Brown, M.D. and Associate Professor in the University of Wisconsin School of Medicine & Public Health, wrote that women over 40 prefer the term “accidental bowel leakage” and those who have it easily relate to this term.  They know instantly what ABL means and are able to say “Yes, I have that.”  Accessible language will increase conversations and care.

Third, industry has been slow to address the issue because of the stigma that surrounding this condition. Fortunately, new treatments are becoming available.  Just this year, a totally new personal hygiene product, my company's Butterfly Body Liners, hit the shelves of Wal-Mart and Target.  Finally, there are things people can do about the symptoms of ABL.

Increased education about ABL and more open conversation are the key to improving many lives.  To learn more about ABL, go to

Kelly Lewis Brezoczky is founder of and CEO of Butterfly Health, Inc.

Read more: Incontinence is surprisingly common among people living outside nursing homes.


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