What medications can cause bowel incontinence?
Bowel incontinence is when you are unable to hold in your feces and they leak out of your bowel before you get a chance to get to the toilet. The most common medications that can cause bowel incontinence (or diarrhea that can lead to bowel incontinence) include:
- Antibiotics, such as cephalosporins (eg, cefaclor), penicillins (eg, amoxicillin), or macrolides (eg, clarithromycin)
- Cancer medications, such as cyclophosphamide, 5-fluorouracil, or paclitaxel
- Laxatives, such as lactulose, docusate, or bisacodyl
- Antacids that contain magnesium
- Proton pump inhibitors (PPIs), such as Prilosec (omeprazole), Nexium (esomeprazole) and Prevacid (lansoprazole)
- Erectile dysfunction treatments, such as sildenafil
- Heart drugs, such as quinine and digoxin
- Thyroid replacement medicines
- Colchicine, used to treat gout
- Diabetes medications, such as metformin or Precose (acarbose)
- Medications that may cause a relaxation of the anal sphincter, such as nitrates (eg, isosorbide mononitrate), calcium channel antagonists, beta-adrenoceptor antagonists (beta-blockers)
- Prostaglandins for glaucoma such as latanoprost
- The weight loss medication Xenical (orlistat), particularly if you don't follow a low-fat diet
- Sugar substitutes in sugar-free foods called sugar alcohols, like xylitol, sorbitol and mannitol
- SSRI antidepressants, such as citalopram or fluoxetine
- Topical preparations that are applied to the anus (can reduce pressure in the anus), such as nitroglycerin ointment, diltiazem gel, bethanechol cream, or botulinum toxin A injection
In many cases, stopping or changing a medication can help. Talk to your doctor if you are experiencing bowel incontinence that has come on soon after starting a new medication.
Other causes of bowel incontinence include nervous system diseases like stroke, Parkinson’s disease, multiple sclerosis and dementia. Having type 2 diabetes may also increase your risk. Fecal incontinence can also be an early sign of bowel cancer.
Frequent constipation can also be a risk factor for bowel incontinence. Constipation can cause a large, hard stool to block your rectum. Liquid stool may then move around the obstruction and leak out. Constipation may also weaken the muscles of your bowel and make your bowel too weak to control bowel movements.
With bowel or urge incontinence, you may feel the urge to move your bowels but not be able to get to the bathroom in time. You may also have bowel movements without warning.
You may be at higher risk for this condition if you are over age 65, have one or more long-term medical conditions, or you do not get enough exercise. People who smoke or have had their gallbladder removed are also at higher risk.
- American Society of Colon and Rectal Surgeons. Fecal Incontinence. Available at: https://fascrs.org/patients/diseases-and-conditions/a-z/fecal-incontinence#. [Accessed August 23, 2022].
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms & Causes of Fecal Incontinence. July 2017. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence/symptoms-causes. [Accessed August 23, 2022].
- Burgers K, Lindberg B, Bevis ZJ. Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis. Am Fam Physician. 2020 Apr 15;101(8):472-480. https://www.aafp.org/afp/2020/0415/p472.html
- Adelborg, K., Veres, K., Sundbøll, J., Gregersen, H., & Sørensen, H. T. (2019). Risk of cancer in patients with fecal incontinence. Cancer medicine, 8(14), 6449–6457. https://doi.org/10.1002/cam4.2509
- Kelly, K., Posternak, M., & Alpert, J. E. (2008). Toward achieving optimal response: understanding and managing antidepressant side effects. Dialogues in clinical neuroscience, 10(4), 409–418. https://doi.org/10.31887/DCNS.2008.10.4/kkelly
- Faecal Incontinence: The Management of Faecal Incontinence in Adults. London: National Collaborating Centre for Acute Care (UK); 2007. (NICE Clinical Guidelines, No. 49.) APPENDIX J, DRUGS THAT MAY EXACERBATE FAECAL INCONTINENCE AND LOOSE STOOLS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK50674/
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