What is fecal incontinence?

Fecal incontinence is the inability to control bowel movements, leading to unexpected leakage of stool. It happens when the muscles or nerves that help regulate bowel function don’t work properly. This condition can range from occasional leakage to a complete loss of control.

While it becomes more common with age, it is not considered a normal part of aging and can often be treated.

Possible causes include:

• Diarrhea, which makes stool harder to control
• Long-term constipation that weakens muscles
• Injury to the pelvic floor or anal muscles (often related to childbirth)
• Nerve damage from conditions like diabetes or spinal injury
• Rectal prolapse or enlarged hemorrhoids
• Digestive tract inflammation or disease
• Previous surgery in the rectal or anal area

Women and older adults are more likely to experience this condition, often due to muscle or nerve changes over time.

Symptoms

Fecal incontinence can affect people in different ways, depending on the cause.

Common symptoms include:

• Leakage of stool without warning
• Strong urgency to have a bowel movement
• Difficulty reaching the bathroom in time
• Accidental passing of stool during daily activities

How is it diagnosed?

Your provider will begin by discussing your symptoms, medical history, and daily habits. A physical exam helps assess muscle strength and control.

Additional testing may include:

• Anal manometry to measure muscle function
• Imaging tests like MRI or ultrasound to look at the structure
• Endoscopic exams, such as a colonoscopy, are used to check the colon and rectum
• Nerve testing if damage is suspected

These tests help identify the underlying cause and guide treatment.

How is it treated?

Treatment focuses on improving control and addressing the root cause. Many people benefit from starting with simple, noninvasive approaches.

Conservative treatments:

• Adjusting diet, especially increasing fiber
• Medications to control diarrhea or bowel patterns
• Pelvic floor exercises to strengthen muscles
• Biofeedback to improve muscle coordination

Advanced options:

• Nerve stimulation to improve bowel control
• Injectable treatments to support the anal muscles
• Devices such as anal plugs for selected cases
• Surgery to repair or support weakened structures

Recovery varies, but many people see improvement with the right combination of therapies. Ongoing management may be needed for long-term control.