(Incontinence, Fecal; Bowel Incontinence; Incontinence, Bowel)
Fecal incontinence is the loss of control over the bowels. Some people may have uncontrolled release of just gas and liquid stool. Others have no control over the release of solid waste.
Women are more likely to suffer from this condition than men. Many cases are a result of an injury to the pelvic floor. The pelvic floor is a group of muscles that support pelvic organs. Injury can happen through complications from childbirth . Other causes include:
- Rectal prolapse
- A condition that is present from birth
- Trauma or injury to anal sphincter or its nerves—the healthy sphincter opens and closes to control the release of fecal material
- Scarring of the rectum from radiation therapy or surgery
This condition is more common in older adults.
Risk factors include:
The main symptom is the inability to control bowel movements, which leads to leakage of solid or liquid stool.
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may send you to a specialist, such as a:
- Colorectal surgeon
Your bodily structures may need to be viewed. This can be done with:
The pressure of your anal canal may need to be checked. This can be done with anorectal manometry.
Talk with your doctor about the best plan for you. Options include:
Your doctor may suggest changes to your diet. You may be referred to a nutritionist for diet ideas. Examples of dietary changes include:
- Eating smaller meals more frequently
- Avoiding foods that may trigger diarrhea such as spicy foods or foods with caffeine
- Eating more fiber and drinking more fluids—if incontinence is due to constipation
A bowel movement schedule can also train your bowels. For example, you can pick several times throughout the day to try to go to the bathroom such as after meals.
Learn how to do Kegel exercises . These exercises help strengthen the pelvic floor muscles.
Surgical procedures may be used to treat this condition when other treatments have failed. Examples include:
- Surgical repair of the anal sphincter
- Inserting an artificial bowel sphincter that you can open and close as needed
- Colostomy for severe cases—disconnects the colon and brings the end through an opening in the abdomen
To help reduce your chance of getting fecal incontinence, take the following steps:
- Prevent constipation by eating a high-fiber diet and drinking plenty of fluids.
- Pay attention to your diet and avoid foods that trigger diarrhea.
- Try to maintain a regular bowel movement schedule.
- Talk to your doctor if you are having trouble with diarrhea or constipation.
International Foundation for Functional Gastrointestinal Disorders
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Digestive Health Foundation
Canadian Society of Intestinal Research
Fecal incontinence. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/diarrhea/. Updated November 25, 2013. Accessed December 18, 2014.
Fecal incontinence: treatment. American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/fecal-incontinence/treatment.html. Updated April 2014. Accessed December 18, 2014.
Garg, P, Song J, Bhatia A, Kalia H, Menon G. The efficacy of anal fistula plug in fistula-in-ano: a systematic review. Colorectal Diseases. 2010;12:965-970.
Landefeld CS, Bowers BJ, Feld AD, et al. National Institutes of Health State-of-the-Science Conference Statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008;148:449-458.
Rectal prolapse. American Society of Colon & Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/rectal_prolapse/. Updated October 2012. Accessed December 18, 2014.
12/4/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Deutekom M, Dobben A. Plugs for containing fecal incontinence. Cochrane Database Syst Rev. 2009;(4):CD005086.
11/5/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Pannu HK, Glanc P, et al. ACR Appropriateness Criteria® pelvic floor dysfunction [online publication]. Reston (VA): American College of Radiology (ACR); 2014. 20 p. Available at: http://www.guideline.gov/content.aspx?id=48295#Section420. Accessed November 5, 2014.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.