Which conservative management strategies are recommended for faecal incontinence in adults?

Conservative management strategies for faecal incontinence in adults include a combination of initial interventions such as dietary modifications to promote ideal stool consistency and predictable bowel emptying, and advice on bowel habits, including encouraging bowel emptying after a meal and adopting a sitting or squatting position to facilitate evacuation while avoiding straining ¹.

Patients should be advised to modify one food at a time to identify potential dietary triggers, and to aim for at least 1.5 litres of fluid intake daily if dehydration or hard stools are present ¹.

Addressing toilet access by ensuring private, comfortable facilities, providing equipment for access, and advising on easily removable clothing are also recommended ¹.

Use of antidiarrhoeal medication, particularly loperamide hydrochloride, is recommended once other causes are excluded, with doses tailored to stool consistency and lifestyle ¹.

Supportive strategies include skin-care advice, odour control, laundry needs, and planning routes for travel to access public conveniences, including carrying a RADAR key or toilet access card ¹.

People should also be offered advice on continence products such as disposable pads, anal plugs (if tolerated), and barrier products, along with psychological and emotional support, and information about support groups ¹.