Prescribing a treatment is one thing. Helping a patient succeed with it over time is another.

For patients living with fecal incontinence, the initial conversation — acknowledging symptoms, discussing options, starting a care plan — is often the hardest part. However, what happens after that conversation matters just as much.

Many patients who begin treatment for accidental bowel leakage eventually discontinue or disengage. Sometimes it’s because the approach isn’t working. Often, it’s because the challenges they’re facing, such as fear of intimacy, anxiety about travel, and embarrassment in social situations, aren’t being addressed.

This article offers practical guidance for clinicians on how to support long-term success for patients using device-based options like StaySure™, with a focus on the lifestyle factors that often go unspoken.

Why Long-Term Support Matters

Treatment initiation is only the beginning. Research suggests that adherence and satisfaction with incontinence management are closely tied to ongoing support, realistic expectations, and attention to quality-of-life factors beyond symptom control.¹ ²

Patients who feel unsupported or unprepared for the realities of daily management are more likely to:

  • Discontinue treatment prematurely
  • Avoid follow-up visits
  • Return to avoidance-based coping (social withdrawal, limiting activities)
  • Experience declining confidence and participation

The gap between prescribing and sustained success is often where care falls short, not because clinicians don’t care, but because there isn’t always a framework for what ongoing support should look like.

What Patients Don’t Always Say

Fecal incontinence (FI) affects more than bowel function. It reshapes how patients move through daily life, often in ways they don’t volunteer during appointments.

Intimacy

Intimacy concerns are among the most common — and most under-addressed — challenges for patients with FI. Fear of leakage during sexual activity can lead to avoidance, relationship strain, and emotional distress.³

Most patients won’t bring this up unless asked directly, and many assume nothing can be done.

Travel and Social Activities

Patients often limit travel, outings, and social engagement, not because of severe symptoms, but because of uncertainty. The fear of “what if” can be more limiting than the symptoms themselves.

Embarrassment and Isolation

Even patients with mild-to-moderate symptoms may carry significant shame. They may minimize their concerns in clinical settings while quietly withdrawing from activities they once enjoyed.

What Patients May Not Tell You

  • “I haven’t been intimate with my partner in months.”
  • “I stopped traveling because I don’t trust my body.”
  • “I say I’m tired, but really I’m afraid of having an accident.”
  • “I feel like I’m the only one dealing with this.”

Practical Guidance for Clinicians

Supporting long-term success requires intentional questions and a willingness to address more than symptom frequency.

Ask Beyond Symptom Control

At follow-up visits, consider asking:

  • “How has this been affecting your daily routine?”
  • “Are there activities you’ve been avoiding?”
  • “Has this affected your relationships or intimacy?”
  • “Do you feel confident using the device, or are there challenges?”

These questions signal that you understand the broader impact of FI — and that it’s safe to talk about it.

Related: Starting the Conversation: Helping Patients Discuss Bowel Leakage

Questions to Ask at Follow-Up

Beyond Symptoms:

  • “What activities have you been able to do — or not do — since we started this?”
  • “How are things at home? With your partner?”
  • “Is there anything about using the device that’s been frustrating or unclear?”

For Patients Using StaySure™:

  • “How has the fit and comfort been?”
  • “Are you using it as often as you’d like, or are there barriers?”
  • “Is it helping you feel more confident in daily activities?”

Address Intimacy Directly (With Sensitivity)

Patients rarely bring up intimacy concerns on their own. A simple, normalizing statement can open the door:

  • “Many patients with bowel leakage have concerns about intimacy. Is that something you’d like to talk about?”
  • “Some patients find that using a device like StaySure™ helps them feel more confident. Has that been your experience?”

You don’t need to have all the answers. Acknowledging the concern and offering to discuss options is often enough to shift the conversation.

Support Travel and Activity Goals

Ask patients what they want to be able to do, not just what symptoms they want to control. Then help them plan for it.

  • “What activities would you like to get back to?”
  • “Let’s talk about how to plan for travel or outings.”
  • “Would it help to have a backup plan for situations you’re worried about?”

For patients using StaySure™, this might include discussing when and how to use the device around specific activities, such as travel days, social events, exercise, or time with family.

Involve Caregivers Appropriately

For patients in care-supported settings, caregiver involvement can make or break long-term success. Include caregivers in education, set realistic expectations together, and check in on caregiver burden as part of follow-up.

Read More: How Fecal Incontinence Contributes to Long-Term Care Placement

Setting Realistic Expectations

One of the most important things clinicians can do is reframe what “success” looks like.

Device-based options like StaySure™ are tools, not cures. They may help reduce leakage episodes, but they won’t eliminate the condition. For many patients, success looks like:

  • Fewer accidents during important activities
  • Greater willingness to leave the house
  • Improved confidence in social or intimate situations
  • Reduced reliance on avoidance as a coping strategy

When patients understand this from the start, they’re less likely to feel discouraged, and more likely to stay engaged with their care plan.

Where StaySure™ Fits in Long-Term Care

StaySure™ is a prescription-only silicone anal insert designed to help prevent accidental bowel leakage for up to 24 hours. It fits within the conservative management spectrum—after first-line strategies have been tried, and before or alongside consideration of procedural options.

For patients using StaySure™ over time, clinicians should monitor:

  • Fit and comfort: Is the device being used consistently? Are there issues with sizing or tolerance?
  • Usage patterns: Is the patient using it daily, situationally, or not at all? What’s driving that?
  • Lifestyle impact: Is the patient reengaging with activities? Are there remaining barriers?
  • Satisfaction: Does the patient feel supported? Are expectations aligned with outcomes?

Long-term success with any device-based option depends on more than the device itself. It depends on the relationship between clinician and patient, and the willingness to keep the conversation going.

Learn How StaySure™ Works Download the Clinician StaySure™ Brochure

Related: How to Identify the Right Patient for a Fecal Insert Device

The Goal: Prescribe and Support

Fecal incontinence management doesn’t end with a prescription. For many patients, the real work begins after they leave the office — navigating daily routines, relationships, and the ongoing uncertainty of living with a chronic condition.

Clinicians who check in on lifestyle factors, address unspoken concerns, and set realistic expectations are more likely to see patients succeed over time.

The goal is to keep the conversation open, and to help patients feel supported, not just treated.

View Clinician Brochure Download Prescription Form

Keep Reading: Starting the Conversation — Helping Patients Open Up About Bowel Leakage

Disclaimer

StaySure™ is a prescription-only medical device designed to help manage symptoms of accidental bowel leakage. It is not a cure for underlying conditions. Individual results may vary. Please review the Instructions for Use for indications, contraindications, warnings, and precautions.

References

  1. Bharucha, A. E., Zinsmeister, A. R., Locke, G. R., Schleck, C., McKeon, K., & Melton, L. J. (2006). Symptoms and Quality of Life in Community Women With Fecal Incontinence. Clinical Gastroenterology and Hepatology, 4(8), 1004–1009. https://doi.org/10.1016/j.cgh.2006.01.003
  2. Brown, H. W., Guan, W., Schmuhl, N. B., Smith, P. D., Whitehead, W. E., & Rogers, R. G. (2018). If We Don’t Ask, They Won’t Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers. The Journal of the American Board of Family Medicine, 31(5), 774–782. https://doi.org/10.3122/jabfm.2018.05.180045
  3. Dunivan, G. C., Heymen, S., Palsson, O. S., von Korff, M., Turner, M. J., Melville, J. L., & Whitehead, W. E. (2010). Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. American Journal of Obstetrics and Gynecology, 202(5), 493.e1–493.e6. https://doi.org/10.1016/j.ajog.2010.01.018