When a Swedish manufacturer of adult diapers sent every countryman 55 and older a sample pair, the company received thousands of angry calls.

And that's not surprising: Although 7 percent to 10 percent of all men and women admit they have fecal leakage of solid or liquid stool or mucus, hardly anyone (until nursing homes enter the equation) ever mentions it, even to a doctor.

What causes the problem?

The usual suspects include: obesity and poor muscle tone; chronic constipation; gastroparesis (damage to nerves in the digestive system, often diabetes-related); hemorrhoids and rectal prolapse; difficult childbirth that damages the pelvic floor; and lack of physical activity.

What can be done? A combination of lifestyle changes, medications and sometimes surgery can relive the problem.

-Add fiber and exercise to your daily routine. Use fiber supplements, and eat 100 percent whole grains and vegetables. Practice Kegel-like exercises to strengthen muscles in the anus, buttocks, and pelvis. Contract and hold those muscles for five seconds, relax. Repeat 30 times, three times a day.

-Depending on the severity of your condition, consider medications that either slow down or speed up bowel movements. You also can opt for a series of four gel injections (hyaluronic acid combined with a wound-healing substance) into the anal wall. The gel supports the sphincter, the muscle that opens and closes to keep stools in or out.

Advanced cases can require surgery to repair or replace the anus or sphincter muscle. You also might opt for an implantable device that stimulates the sacral nerve and helps control the sphincter.

© 2013 Michael Roizen, M.D. and Mehmet Oz, M.D.
Distributed by King Features Syndicate, Inc.