Bowel Incontinence

Overview

Bowel incontinence, also known as fecal incontinence, is the involuntary loss of stool or gas from the rectum. It can range from occasional leakage while passing gas to a complete loss of bowel control. This condition affects people of all ages but is more common among older adults. Bowel incontinence is not a disease itself but a symptom of an underlying issue affecting the muscles, nerves, or structures of the rectum and anus. It can significantly impact quality of life, causing social embarrassment and emotional distress. 

Commonly Associated with Bowel Incontinence 

Other names and related terms for bowel incontinence include: 

• Fecal incontinence 

• Faecal incontinence 

• Anal incontinence 

• Loss of bowel control 

Causes

Bowel incontinence can result from various factors that affect the muscles, nerves, or structural support of the rectum and anus: 

• Muscle damage – Injury to the anal sphincter muscles, often from childbirth or surgery. 

• Nerve damage – Affects the ability to sense stool or control muscles (can occur due to diabetes, stroke, or spinal injuries). 

• Chronic constipation – Can lead to stretching and weakening of rectal muscles. 

• Diarrhea – Loose stools are harder to control. 

• Rectal prolapse – Part of the rectum protrudes through the anus, affecting control. 

• Age-related weakening – Muscles and nerves naturally weaken with age. 

• Inflammatory bowel disease or radiation damage – Can damage tissue and reduce control. 

Symptoms of Bowel Incontinence 

The symptoms vary in severity but commonly include: 

• Involuntary leakage of stool (solid or liquid) 

• Inability to control the passage of gas 

• Urgent need to defecate with little warning 

• Soiling of underwear 

• Recurrent skin irritation around the anus 

• Loss of sensation in the rectum 

Symptoms may occur occasionally or frequently, and they often worsen without treatment. 

Exams & Tests for Bowel Incontinence 

Diagnosis involves identifying underlying causes and assessing the degree of incontinence: 

• Medical history and physical examination – Includes a digital rectal exam. 

• Anorectal manometry – Measures muscle strength and nerve reflexes in the rectum and anus. 

• Endoanal ultrasound or MRI – Visualizes sphincter muscle structure. 

• Proctosigmoidoscopy or colonoscopy – Checks for structural abnormalities or inflammation. 

• Defecography – Imaging test to assess how the rectum functions during a bowel movement. 

• Nerve function tests – To detect neuropathy or nerve damage. 

Treatment of Bowel Incontinence 

Treatment depends on the underlying cause and severity of the condition: 

• Dietary and lifestyle changes – Increasing fiber intake, staying hydrated, and regular bowel habits. 

• Pelvic floor exercises (Kegels) – Strengthen the muscles controlling bowel movements. 

• Medications – Antidiarrheal drugs for loose stools or stool softeners for constipation. 

• Biofeedback therapy – Helps improve muscle control and sensation. 

• Sacral nerve stimulation – Electrical stimulation to improve nerve signals. 

• Surgical interventions – Sphincter repair, artificial sphincter, or colostomy in severe cases. 

With proper management, many people regain significant control and improve their quality of life. 

Source of Bowel Incontinence 

• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) – Fecal Incontinence 

• Mayo Clinic – Bowel Incontinence Overview 

• NHS – Faecal Incontinence Guide