Information on Fecal Incontinence

Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called bowel incontinence, fecal incontinence can range from an occasional leakage of stool while passing gas to a complete loss of bowel control.

Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called bowel incontinence, fecal incontinence can range from an occasional leakage of stool while passing gas to a complete loss of bowel control. Common causes of fecal incontinence include constipation, diarrhea, and muscle or nerve damage. The condition may be due to a weakened anal sphincter associated with aging. Fecal incontinence can also occur as a result of childbirth.

Fecal incontinence can be caused by injury to one or both of the ring-like muscles at the end of the rectum called the anal internal and external sphincters. The sphincters keep stool inside. When damaged, the muscles aren''t strong enough to do their job and stool can leak out. In women, the damage often happens when giving birth. The risk of injury is greatest if the doctor uses forceps to help deliver the baby or performs an episiotomy, which is a cut in the vaginal area to prevent it from tearing during birth. Hemorrhoid surgery can also damage the sphincters.

Muscle damage is involved in most cases of fecal incontinence. In women, this damage commonly occurs during childbirth. It''s especially likely to happen in a difficult delivery that uses forceps or an episiotomy. An episiotomy is when a cut is made to enlarge the opening to the vagina before delivery. Muscle damage can also occur during rectal surgery such as surgery for hemorrhoids. It may also occur in people with inflammatory bowel disease or a perirectal abscess.

Normally, the rectum stretches to hold stool until it is voluntarily released. But rectal surgery, radiation treatment, and inflammatory bowel disease can cause scarring, which may result in the walls of the rectum becoming stiff and less elastic. The rectum walls are unable to stretch as much and are unable to accommodate as much stool. Inflammatory bowel disease also can make rectal walls very irritated and thereby unable to contain stool.

''Accidents'' or fecal leakage should not happen in adults except during episodes of severe diarrhea. People with chronic or recurring fecal incontinence may have few or frequent accidents. The symptoms may range from the inability to hold gas, "silent" leakage of stool during daily activities or exertion, or being unable to reach the toilet in time. Other intestinal symptoms such as diarrhea, constipation and abdominal discomfort may also be present.

Embarrassment and the stigma associated with incontinence prevent people from seeking treatment, even when incontinence affects his or her quality of life. Many people resort to altering their social and physical activities, even their employment, to cope with the problem. In addition, some people with bowel incontinence do not see a doctor because they just don''t realize that their problem can be effectively treated. It''s important to understand that bowel incontinence is not uncommon and can be successfully treated.

Fortunately, effective treatments are available for fecal incontinence. Your primary care physician may be able to assist you, or you may need to see a doctor who specializes in treating conditions that affect the colon, rectum and anus, such as a gastroenterologist, proctologist or colorectal surgeon. Treatment for fecal incontinence can usually help restore bowel control or at least substantially reduce the severity of the condition.
Depending on the cause of your incontinence, treatment may include dietary changes, medications, special exercises that help you better control your bowels, or surgery.

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