Ask Dr Miriam

Q I’m a man in my early seventies and I have an embarrassing problem. I wake up to find that I have soiled my pyjamas in the night. I can’t believe I’m doing this without knowing. What can I do? A As we get older most of our muscles become slack and weak, and this applies to the muscles in our sphincters too like the one at the bottom of the gullet which stops the acid content of the stomach regurgitating and causing discomfort.

In a similar way, the muscles that form the anal sphincter also lose their tightness and so it’s possible for faeces to escape, particularly when passing wind.

You can try pelvic floor exercises to tighten up a slack sphincter and as an added precaution wear a pad like an incontinence pad. Sometimes the anal sphincter is weakened by the presence of a varicose vein which prevents it from closing tightly. This happens mainly in women as a result of childbirth but you may have one so talk to your doctor.