What you need to know about fecal incontinence

“Fecal incontinence” is the term for an unwanted bowel movement. It can include solid, liquid, or mucous stools, or a combination of these.

Fecal incontinence is a common problem affecting 1 in 3 people who consult GPs. Doctors may also refer to the condition as “bowel incontinence” or “accidental bowel loss.”

Read on to learn more about the causes, treatments, and risk factors for fecal incontinence.

There are three general types of fecal incontinence:

1. urge incontinence is the most common form of fecal incontinence. It is the strong urge to defecate that can be difficult to control. Difficulty controlling bowels can be due to weakened pelvic floor muscles, possibly resulting from an injury or nerve damage.
2. Passive incontinence occurs when you don’t realize you’re passing stools, possibly because you can’t feel when your rectum is full.
3. fecal seepage occurs when stool leaks out after a typical bowel movement.

Various experiences can cause fecal incontinence.

Diarrhea can lead to incontinence if you have trouble controlling liquid stools. Diarrhea can occur for many reasons, including:

Learn more about diarrhea.

Constipation can cause the muscles in your rectum and anus to stretch and weaken, allowing liquid stool to leak out behind the hard stool. Constipation is one of the most common causes of fecal incontinence in children.

Learn more about constipation.

Hemorrhoids are swollen veins in the lower rectum or anus. They can prevent the muscles in the anus from closing completely, allowing stool to leak out.

Learn more about hemorrhoids.

Rectal prolapse occurs when your rectum falls through your anus. The anus cannot close completely, leading to incontinence.

Learn more about rectal prolapse.

Childbirth can be one of the causes of bowel incontinence in people assigned at birth to a woman. Vaginal deliveries can damage the anus.

Certain chronic diseases — such as type 2 diabetes or conditions that affect the nerves in your pelvic floor, rectum, or anus — can also lead to fecal incontinence.

Neurological disorders can affect the nerves in the pelvic floor, rectum, or anus. Some of these conditions that can cause bowel incontinence are:

Damage to your pelvic floor or the muscles in your rectum or anus can make bowel control difficult. This damage can be caused by:

Damage to the nerves that control your pelvic floor, rectum, or anus can prevent muscles from working properly or make it difficult to sense when you need to have a bowel movement. Nerve damage can be caused by an injury to the brain or spinal cord, or by straining to defecate frequently.

Certain congenital disabilities that affect the muscles or nerves in the intestines, rectum, or anus can cause fecal incontinence. For example, Hirschsprung disease is a congenital disorder that affects the colon.

Symptoms range from mild to severe, and you may have faecal incontinence only a few times or frequently.

Symptoms can include:

• Difficulty holding gas
• “silent” leakage that occurs without you being aware that you have leaked
• a strong urge that makes it difficult to reach a toilet in time

You may also have other symptoms, such as diarrhea, constipation, or abdominal pain or discomfort.

Some doctors also consider dirt or stool or mucus stains on underwear to be a side effect of fecal incontinence.

To diagnose the cause of fecal incontinence, your doctor will examine you and assess your personal and family medical history. They will also ask you some questions which may include:

• When do you have fecal incontinence?
• How often does it happen?
• What happens before it happens?
• Do any foods make it better or worse?
• Do you have more after eating?
• How does it look and how does it smell?

You may feel uncomfortable answering these questions, but your doctor needs this information to determine the right treatment. They may also ask you to keep a stool journal for a few days or weeks, detailing the foods you eat and the characteristics of your bowel movements.

You may also need blood, stool, or urine samples for testing. Other tests may include:

Treatments for fecal incontinence focus on relieving the underlying problem and may include:

• diet changes
• Medications such as antidiarrheals or stool softeners
• gut training
• Kegel exercises to strengthen your pelvic floor muscles
• faecal incontinence pads
• biofeedback therapy
• Sacral nerve stimulation
• vaginal balloons
• non-absorbable fillers

If other treatments are ineffective for you, your doctor may recommend surgery. There are several surgical procedures doctors can perform, including:

• Sphincteroplasty, which can reconnect the ends of a torn anal sphincter
• artificial anal sphincter implantation, in which a small pump is placed under the skin of your anus that you can inflate or deflate
• Colostomy to redirect the bowel to an opening in the abdominal wall, allowing stool to collect in a pouch outside the abdominal wall
• Hemorrhoidectomy to remove hemorrhoids

Your doctor may also have the following tips to relieve irritation, itching, or pain due to fecal incontinence.

• Keep the area clean.
• Use disposable underwear or absorbent pads.
• Change soiled underwear and pads as soon as possible.
• Wear underwear and clothing that allows air to pass through easily.
• Use moisturizers or non-medicated powders on this area.

The outlook for people with fecal incontinence varies depending on the underlying condition. Some causes, such as diarrhea or constipation, may be short-lived if treated. However, certain chronic conditions may require lifelong treatment.

Reduced quality of life and psychological stress can be common problems with fecal incontinence.

Complications of fecal incontinence can include:

In addition, surgery to correct fecal incontinence can result in infection, pain, or persistent incontinence.

Some people may be at higher risk of developing fecal incontinence if they:

• are older than 65
• currently smoke
• live a sedentary lifestyle
• had an operation to remove the gallbladder
• suffer from chronic health conditions that affect the body’s ability to hold stool

Children born with certain congenital disabilities of the spinal cord, rectum, or anus may have fecal incontinence. In addition, frequent constipation can also lead to fecal incontinence in children.

You may be able to prevent fecal incontinence by making certain lifestyle or medical changes. You can try the following:

• Increase your activity level.
• Talk to your doctor or a nutritionist about the right diet for your needs.
• Work with your doctor to treat any underlying medical conditions.

Fecal incontinence is the accidental leakage of stool. You may feel uncomfortable talking about this topic. As a result, some people hesitate to talk to their doctors about it.

However, talking openly and honestly about your incontinence can help your doctor diagnose and treat your condition.

Talk to your doctor if you have fecal incontinence. You should also consult your doctor if it is causing you psychological distress and affecting your quality of life.

Aside from finding the right treatments for you, they may be able to help you find resources to address your mental health and improve your experience, such as by connecting with people socially.