Brief Answer: Need work up and management Detailed Answer: Thank you for asking XXXX! I am Dr S Khan and i would like to answer your query for fecal and urinary incontinence. Lets first discuss the urinary incontinence.Miss XXXX, i want you to know that Treatment is keyed to the type of incontinence. The usual approaches are as follows: Stress incontinence - Surgery, pelvic floor physiotherapy, anti-incontinence devices, and medication Urge incontinence - Changes in diet, behavioral modification, pelvic-floor exercises, and/or medications and new forms of surgical intervention Mixed incontinence - Anticholinergic drugs and surgery Overflow incontinence - Catheterization regimen or diversion Functional incontinence - Treatment of the underlying cause As your history is too brief to sort out what type of incontinence it is i am afraid i wont be able to classify that. You need a team of neurologists and urologists for that to help.I suggest starting a least invasive management with Behavioural therapies, urethral occlusion devices, weight losing efforts followed by Medicines like Alpha adrenergic agonists,Anticholinergic agents, Antispasmodic drugs,Tricyclic antidepressants, Estrogen, Alpha-adrenergic blockers and Botulinum toxin.Pelvic floor rehabilitations like kegel exercises, vaginal cones, electrical stimulations and biofeedback, Extracorporeal magnetic resonance therapy and acupuncture has also proved helpful. Three food groups need to be avoided to help incontinence. First group is spices family.Spicy foods may contribute to urge incontinence. Some examples of hot spices include curry, chili pepper, cayenne pepper, and dry mustard. 2nd Family of foods is citrus fruit. Fruits and juices that have an acidic pH worsen preexisting urge incontinence. Examples of fruits that have significant acidity include grapefruits, oranges, limes, and lemons. 3rd food group that may worsen urinary bladder incontinence is chocolate-containing sweets. Chocolate snacks and treats contain caffeine, which is a bladder-irritating agent. Excessive intake of chocolate confectioneries worsens irritative bladder symptoms and should be avoided. Keep daily water intake in 24 hours upto 6-8 glasses.No more no less. Avoid coffees and cola beverages and alcohol etc. Consult with the neurologists and urologist for better management. Now the fecal incontinence. Fecal Incontinence usually needs surgical corrections as medicines have not proved efficacious. Biofeedback, fibrous diets and good healthy bowel habits have proved helpful but with surgery.bulking agents are helpful, as formed stools are easier to control than liquid stools. Methylcellulose (Citrucel) or psyllium (Metamucil, Fiberall, Hydrocil) can be taken daily. Opioid derivative like imodium and gut motility slowing agents like loperamide and lomotil has also proved promising. Thank you Miss XXXX for your patience and i hope i was of some help.Take good care and consult with the suggested specialists. Close the discussion please. May the odds be ever in your favour. Khan

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