Alex Ortiz, 61, experienced a mortifying accident in bed with her new partner Andy during a Greece holiday that revealed a silent medical condition affecting thousands of women in their 50s and 60s. The mental health care manager from Wallingford, Oxfordshire, suffered unexpected fecal incontinence in their hotel room, initially dismissing it as an embarrassing one-off before discovering she had microscopic colitis. Approximately 67,000 people in the UK have this inflammatory bowel disease, with women over 50 disproportionately affected.
Alex Ortiz’s Mortifying Accident in Bed With New Partner
During a vacation in Greece with her new partner Andy, Alex Ortiz experienced an embarrassing incident that would change her life. After dining out one evening, Andy fell asleep in their hotel room while Alex faced a sudden and urgent need to use the restroom, resulting in a mishap on the bed.
“I urgently needed to go but didn’t make it in time,” she recounts. Quietly slipping out of the room, she managed to clean herself up and covered the soiled sheets with a towel. Fortunately, Andy remained unaware of the situation, and the following morning, as he showered, Alex took the opportunity to strip the bed and requested fresh linens from hotel staff.
“It was already embarrassing, but even more so with a new partner,” shares Alex, who works as a mental health care manager.
What Happened in Greece: “I Suddenly Needed the Loo But Couldn’t Get There”
In the aftermath of the Greece holiday accident, Alex became cautious about her diet and consumed “lots of anti-diarrhea tablets,” unsure of the underlying issue. She first noticed significant changes to her bowel habits in January 2022, attributing it to an infection.
However, persistent “very watery diarrhea” made it difficult for her to reach the restroom in time while at work. Her nights were even more challenging: “I often got up seven or eight times to go to the toilet,” she explains, leading to exhaustion and occasional dizziness.
Hailing from Wallingford, Oxfordshire, Alex visited her GP a few months later, but tests, including stool samples, returned normal results even after being repeated. The GP’s initial recommendation of anti-diarrhea medication proved ineffective, and Alex began losing weight, dropping from 9 stone 4 pounds to approximately 8 stone 4 pounds over six months.
“I looked quite drawn; my skirts were just hanging off me,” she recalls.
The Silent Condition: Fecal Incontinence Affecting Thousands of Women in Their 50s and 60s
Alex eventually learned she was suffering from microscopic colitis, a type of inflammatory bowel disease. It’s estimated that around 67,000 individuals in the UK have this condition, characterized by inflammation of the large intestine lining.
Key Symptoms of Microscopic Colitis:
The disorder is more prevalent in individuals over age 50, particularly among women, and is believed to stem from immune system issues. Although it can be effectively treated once diagnosed, many endure symptoms for extended periods before receiving the correct diagnosis.
Why Menopause and Pelvic Floor Weakness Cause Loss of Bowel Control
Research indicates that approximately 70% of individuals with microscopic colitis were initially misdiagnosed with irritable bowel syndrome (IBS). The Guts UK charity study involving 185 patients found nearly 25% required five or more GP appointments before hospital testing referral, with some waiting up to eight years for diagnosis.
Why Women in Their 50s and 60s Are Most Affected:
The pelvic floor muscles help prevent loss of urine from the bladder and faeces from the bowel. During menopause, these muscles may weaken, leading to strong need to go to toilet, difficulty holding on, and finding it hard to control passing wind or gas.
“All participants reported the condition significantly affected their physical and mental well-being, disrupting professional and social lives, with almost half noting negative impact on intimate relationships”.
Alex’s Diagnosis Journey and Initial Embarrassment
As Alex started dating Andy, now 61 and a sash window restorer, she became hesitant to go out, avoiding long drives and feeling anxious about potential accidents while walking Andy’s dog, Ralf. Her constant worry about food and drink choices began dominating her life.
She steered clear of orange juice and most fruits, opting instead for bread, porridge, or eggs at breakfast “to try and bind me for a bit”. Every time she consumed something, Alex would hear “loud, terrible gurgling” in her stomach, followed by sudden bloating and frantic rush to restroom.
Diagnostic Challenges:
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A colonoscopy is part of standard diagnostic process, but biopsy is also necessary
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Microscopic colitis often misdiagnosed because it doesn’t show up during standard colonoscopy without biopsies
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Many GPs simply don’t consider microscopic colitis as potential diagnosis
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Only 15% of patients had condition recognized and correctly referred for hospital tests
Due to higher prevalence among older women, symptoms may be mistakenly attributed to menopause, aging, or stress. “I’ve heard of individuals advised to use incontinence pads or drink peppermint tea, which does nothing. It demonstrates how poorly understood the condition remains,” says Pearl Avery, nurse practitioner specializing in gut diseases at NHS clinic.
Common Symptoms of Fecal Incontinence in Midlife Women
Two Types of Bowel Incontinence:
Warning Signs to Watch For:
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Stool leakage during physical activity or after eating
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Needing to pass urine often or urgently
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Leaking urine on way to toilet
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Leaking urine when coughing, sneezing, laughing, lifting, or exercising
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Getting up more than once at night to pass urine (nocturia)
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Frequent urinary tract infections
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Pelvic pain
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Finding it hard to control passing faeces or flatus
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Constipation
Fecal incontinence is extremely common, affecting up to one in four women at some point in their lives. In women living in community, bowel incontinence occurs in 6% of those younger than 40 and increases to 15% in older women.
When to See a Doctor About Bowel Control Issues
Professor Chris Probert, gastroenterology professor at University of Liverpool, advises anyone experiencing diarrhea for six weeks or longer to consult their GP for further evaluation. He cautions against self-medicating with over-the-counter diarrhea medications.
“Don’t dismiss it – it might be a reaction to a new medication you’re taking, which could be a cause of microscopic colitis,” Probert warns.
Treatment Options:
Once diagnosed, microscopic colitis can be effectively treated with budesonide, a steroid also commonly used for asthma:
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Standard treatment: 2-3 month course of budesonide
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Effectiveness: Works immediately for most patients, works well on colon’s surface tissue with minimal absorption
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Side effects: Rare due to minimal body absorption
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Maintenance: Some may need repeat prescriptions if symptoms recur, others may need low dose to sustain remission
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Advanced cases: Immunosuppressants or biologics (engineered antibodies inhibiting inflammation) may be considered
Alex began a three-month course of budesonide after diagnosis: “It worked immediately for me,” she states. Since then, Alex has experienced five flare-ups, each managed with additional steroids, and in March enrolled in new trial at Oxford.
Current Research: A global trial including Oxford University Hospitals is testing new drug SAR444336, which boosts white blood cell type that aids immune system in combating diseases.
FAQ:
What caused Alex Ortiz’s accident in bed?
Alex Ortiz’s mortifying accident in bed was caused by microscopic colitis, an inflammatory bowel disease causing watery diarrhea and fecal incontinence. The condition affected her ability to reach the toilet in time during her Greece holiday.
How common is fecal incontinence in women over 50?
Fecal incontinence affects up to one in four women at some point in their lives. In older women, bowel incontinence occurs in 15% of women over 40, increasing with age.
Is microscopic colitis linked to menopause?
Yes, hormonal shifts during menopause may help explain why microscopic colitis is more common in women over 60. Estrogen decline weakens pelvic floor muscles.
What are the first signs of bowel incontinence?
First signs include stool leakage during activity, sudden urgent need to use toilet, difficulty reaching toilet in time, nighttime bathroom trips, and unexplained weight loss.
Can fecal incontinence be cured?
Yes, microscopic colitis can be effectively treated with budesonide steroid, with most patients improving within 2-3 months. Over 50-80% of women improve with treatments including pelvic floor therapy and dietary adjustments.
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