What is fecal incontinence?
Continence is the ability to control passing gas, liquid stool or solid stool. Fecal incontinence, also called bowel incontinence, is the loss of bowel control. This can result in leaking stool and gas.
What causes fecal incontinence?
Fecal incontinence is often the result of weakened sphincter muscles or injury to the nerves that control them. This condition is often related to injury associated with childbirth.
Other common reasons people have bowel incontinence can include:
- Ongoing, or chronic, constipation. This causes the anal muscles and the intestines to stretch and weaken, leading to diarrhea and stool leakage.
- Fecal impaction, most often caused by chronic constipation. This results in stool that partly blocks the large intestine, and you may develop explosive liquid stools that travel around the blockage.
- Long-term use of laxatives
- Colectomy or bowel surgery
- Not sensing it’s time to have a bowel movement
- Emotional issues
- Gynecological, prostate or rectal surgery
- Severe diarrhea causing leakage
- Severe hemorrhoids or rectal prolapse
- Stress of being in an unfamiliar environment
Who is at risk for fecal incontinence?
Several factors can increase the risk of developing fecal incontinence, such as:
- Age: Fecal incontinence can occur at any age, but it’s more common in adults over the age of 65.
- Sex: Fecal incontinence can be a complication of childbirth. Research has also found that women who take menopausal hormone replacement therapy are more likely to have fecal incontinence.
- Nerve damage: People who have diabetes or multiple sclerosis, conditions that can damage nerves that help control defecation, might be at a higher risk of fecal incontinence.
- Dementia: Fecal incontinence is often experienced by people with late-stage Alzheimer’s disease and dementia
- Physical disability: An injury that caused a physical disability also might cause rectal nerve damage, which can lead to fecal incontinence
What are the symptoms of fecal incontinence?
Fecal incontinence can occur temporarily during a bout of diarrhea, but some people experience chronic or recurring fecal incontinence. They might be unable to stop the urge to pass stool, thereby experiencing urge incontinence.
Another type of fecal incontinence is an unawareness of the need to defecate; this type is known as passive incontinence.
Fecal incontinence can experienced with other bowel problems, including:
- Gas and bloating
How is fecal incontinence diagnosed?
Your provider will conduct a physical exam that focuses on your stomach area and rectum. They will also insert a lubricated finger into your rectum to check your sphincter and anal reflexes and look for any issues.
Your provider might also perform a variety of diagnostic tests, which can include:
- Barium enema
- Blood tests
- Electromyography (EMG)
- Rectal or pelvic ultrasound
- Stool culture
- Test of anal sphincter tone (anal manometry)
- X-ray procedure using a special dye to evaluate how well the sphincter contracts (balloon sphincterogram)
- X-ray procedure using a special dye to see the bowel while you have a bowel movement (defecography)
How is fecal incontinence treated?
Fecal incontinence can be treated at home through diet and/or bowel retraining and pelvic floor exercises. Surgery is also an option if these treatments don’t work. Type of surgery varies depending on the cause of fecal incontinence and the individual’s overall health.
What are the possible complications of fecal incontinence?
Complications of fecal incontinence can include:
- Emotional distress
- Skin irritation around the anus
- Loss of quality of life
- Bowel incontinence. (2020). https://medlineplus.gov/ency/article/003135.htm
- Fecal incontinence. (2020). https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/symptoms-causes/syc-20351397