Fecal incontinence is the accidental leakage of stool. It can mean a small stain in your underwear, accidental leakage of gas, or a full bowel movement you cannot hold back. Although it can be difficult to talk about, treatment often helps. Here is what causes it, how it is treated, and when to see a specialist.
What is fecal incontinence?
Fecal incontinence, also called bowel incontinence, happens when you cannot fully control the passage of stool and/or gas. Some people feel a sudden urge but cannot reach the bathroom in time. Others leak stool without realizing it.
Bowel control depends on the muscles and nerves around the anus and rectum, as well as stool consistency. Problems with any of these can lead to leakage.
Symptoms
- Stool leaking before you reach the bathroom
- Passing stool without feeling it happen
- Repeated stains in your underwear
- Stool leakage when passing gas
- Skin irritation around the anus because of constant leakage
Some people have occasional accidents. Others have multiple accidents daily. Regardless of how often they happen, fecal incontinence can have a significant impact on your quality of life.
What causes fecal incontinence?
Common causes include:
- Diarrhea. Loose, watery stool is harder to hold than formed stool.
- Constipation. Hard stool can become stuck in the rectum, allowing looser stool to leak around it.
- Muscle injury or weakness. Childbirth, anal surgery, and aging can affect the muscles that keep the anus closed.
- Nerve damage. Diabetes, spinal injuries, and certain neurological conditions can affect bowel sensation and control.
- Rectal inflammation or scarring. Bowel disease, radiation treatment, or surgery can make the rectum less able to stretch and hold stool.
- Rectal prolapse. The rectum slips down through the anus, which can interfere with normal closure.
More than one cause may be involved. Injuries from childbirth can also cause symptoms years after delivery.
How fecal incontinence is treated
Treatment depends on the cause and how much the symptoms affect your life. Your doctor starts with a medical history and examination. Some patients need tests to check muscle strength or look for damage.
Diet and medication
Treatment usually starts without surgery. Your doctor may recommend adjusting fiber intake, avoiding foods that trigger diarrhea, or using medication to improve stool consistency.
Diarrhea and constipation need different treatment. If loose stool is leaking around trapped stool, taking an antidiarrheal can make constipation worse. Your doctor will help identify the cause before recommending medication.
Pelvic floor exercises and biofeedback
Guided exercises can strengthen the muscles used for bowel control. Biofeedback uses sensors to show how those muscles respond, helping you learn to control them and recognize when the rectum is filling.
Procedures for ongoing symptoms
If symptoms continue, sacral nerve stimulation may help. A small device sends electrical pulses to nerves involved in bowel control. A temporary trial shows whether it reduces leakage before a permanent device is implanted.
For some patients with a torn anal sphincter, surgery called sphincteroplasty can repair the muscle. Results vary, and the benefit may decrease over time. A colorectal surgeon recommends an approach based on the cause, examination findings, and response to earlier treatment.
How to manage symptoms day to day
- Keep a diary of meals, bowel movements, and leakage.
- Follow your doctor’s advice on fiber and bowel habits.
- Practice pelvic floor exercises as instructed.
- Gently clean and dry the skin after leakage.
- Use a barrier cream or absorbent pads if recommended.
When to see a colorectal surgeon
See a specialist if leakage keeps happening, treatment has not helped, or fear of an accident affects your daily life. You do not need to wait until symptoms become severe.
Tell your doctor about rectal bleeding or a lasting change in bowel habits. Bloody diarrhea or black, tarry stool needs urgent medical advice.
Sudden loss of bowel control with new back pain, numbness around the groin or buttocks, or trouble urinating needs emergency care.
Frequently asked questions
What kind of doctor treats fecal incontinence?
A colorectal surgeon can identify the cause and recommend nonsurgical or surgical treatment. A primary care doctor or gastroenterologist can also help with the initial evaluation.
Can fecal incontinence go away?
It depends on the cause. Some people regain full control after treatment. Others need ongoing care to reduce leakage and manage symptoms.
Does fecal incontinence always need surgery?
No. Diet changes, medication, and pelvic floor therapy can help. Procedures may be considered when these treatments do not provide enough relief or when a specific injury needs repair.
Can constipation cause stool leakage?
Yes. Soft stool can leak around hard stool trapped in the rectum. This can look like diarrhea, even though constipation is the cause.
Get relief
If bowel leakage is affecting your life, you do not have to manage it alone. Request a fecal incontinence evaluation with Colon Rectal Specialists or call (586) 739-5220.
