Accidental bowel leakage can be an uncomfortable topic to discuss, which may be why there continues to be persistent myths regarding this condition. Here are some myth–busting facts about ABL:

MYTH # 1: ABL is uncommon and only affects a small number of people.

FACT: ABL is defined as the involuntary loss of liquid or solid stool. It affects an estimated 46 million adults in the U.S. This is over 10% of the population. In people over the age of 65, it is even more common, occurring in 1 out of 5 individuals. This is a very common problem but one that is not discussed openly. There are many reasons for this, including embarrassment, lack of good treatment options, and a lack of health care provider comfort on how to discuss and manage ABL.

MYTH # 2: ABL occurs as part of aging and is “normal.”

FACT: ABL does increase with age, but it is NOT normal. Many underlying disease states lead to ABL and should be excluded. The most common diseases include:

  • Hemorrhoids
  • Pelvic floor muscle weakness
  • Obstetrical injury from childbirth
  • Inflammatory bowel disease and other diarrhea-causing diseases
  • Nerve injury related to back injuries and diabetes
  • Neurological conditions such as Parkinson’s and Alzheimer’s Rectal tumors

MYTH # 3: If none of the above diseases are discovered, then patients must either live with their ABL or undergo major surgery as the only treatment options.

FACT: Many times, none of the above diseases are found. In fact, most ABL’s are related to weak nerve signals which control the muscles of the rectum and allow proper sensation of stool in the rectum. The nerve is called “S3” and is the 3rd nerve of the sacrum. Stimulation of this nerve can lead to improved or completely resolved ABL. There is a simple device called Interstim, which helps to stimulate the S3 nerve. Interstim is the TOP rated treatment for ABL. As you can see from the picture, Interstim does NOT go anywhere near the spine, as the S3 nerve is a PERIPHERAL nerve, so the procedure is very safe.

MYTH # 4: Having the device placed is painful and is a major surgery.

FACT: Having the device placed is a simple outpatient procedure. The device is slightly larger than a quarter and sits below the fat pad of either hip. There are no restrictions of activity once the device is implanted.

MYTH # 5: Doctors do not like to be bothered with patient complaints of ABL.

FACT: ABL is a difficult and challenging problem to tackle. The good news is that there are physicians who have the necessary experience to deal with this problem and offer the best therapies for it.



Illustrative anatomy of the buttocks showing hip bones and spineA board-certified Gastroenterologist can provide a complete workup to exclude the conditions listed. Additionally, some GI physicians have chosen to specialize the helping patients suffering from ABL.

They have been certified in evaluating patients for devices such as Interstim. They also have access to other specialized diagnostic tools and specialists such as a pelvic floor physical therapist who can provide additional complementary therapies.

It is important to find a Gastroenterologist who is passionate and experienced in treating patients with ABL.

About the author

Dr. Lukasz Kowalczyk, “Dr. K,” is a physician and partner at Peak Gastroenterology Associates
Dr. Lukasz Kowalczyk

Dr. Lukasz Kowalczyk, “Dr. K,” is a physician and partner at Peak Gastroenterology Associates, a current GI Center of Excellence for Interstim. He is a national trainer for the Interstim device. He is dedicated to helping patients regain their independence and confidence by alleviating ABL.

Peak Gastroenterology Associates
2920 North Cascade Avenue, Suite 300
Colorado Springs, CO 80907