Fecal incontinence, or bowel incontinence, describes the inability to control bowel movements. If you have fecal incontinence you may feel the urge to use the restroom and be unable to make it in time, or you may not have an urge at all.
It may not seem common, but over five million Americans live with fecal incontinence. If you have fecal incontinence, you’re not alone. There are tools and resources to help you every step of the way. As modern medicine advances, so do the ways to treat fecal incontinence, reduce leaks, and help you regain control of your bowel movements.
What is Fecal Incontinence?
Depending on whether fecal incontinence is more or less severe, you may experience small leaks every now and then, or large leaks every time you need to pass stool.
Fecal incontinence can present itself in different ways. For instance, you may feel a sudden, intense urge to use the restroom, or you may not even know you’re passing stool.
There are two main kinds of fecal incontinence. Passive incontinence is when leakage occurs without an urge or sensation. This means you won’t know you need to pass stool until after it’s passed. With passive incontinence, your body cannot sense when your bowels are full or the urge to contract.
The second kind of fecal incontinence is the most common and is called urge incontinence. This is characterized by an intense urge to pass stool, but the inability to reach the bathroom in time. You may feel urges and know you need to contract but might be unable to because of the intensity and suddenness of the urge. This is usually nerve damage or muscle injury.
Here are some descriptions of fecal incontinence:
- You may be unable to hold in stool while relaxing your rectal muscles to pass gas.
- Stool may leak out during physical exercise or certain movements that put pressure on your lower body.
- You may experience a strong, sudden urge to use the bathroom but be unable to make it in time.
- Stool may leak before or after a bowel movement, even if you completely emptied your bowels.
- Bowel control may be almost entirely lost.
There are many factors that can cause fecal incontinence. Here are the most common:
Diarrhea or constipation. The anal muscles are often known as sphincters, and they’re responsible for tightening the rectum to hold in stool. If you frequently experience diarrhea or constipation, these muscles can weaken and be unable to hold in stool.
Muscle damage. In addition to the weakening of the rectum muscles, the muscles can be damaged. Vaginal childbirth can sometimes result in muscle damage if labor was intense and the doctors had to cut open a larger opening. This is why fecal incontinence is more common in women than in men. Rectal or anal surgeries can also result in fecal incontinence.
Old age. Fecal incontinence is also more common in older adults. Our bodies naturally lose muscle as they get older which contributes to the weakening and loosening of the rectal muscles. When the rectal muscles are weak, it can become difficult to hold in the stool until we reach the bathroom. Loose stool is especially hard to control.
Nerve Damage. There are nerves that tell the rectal and anal muscles to contract when the bowels are full. However, if these nerves can become damaged, they lose the ability to control rectal contractions or urges. The most common causes of nerve damage are vaginal childbirth, anal surgery, straining while using the restroom, diabetes, multiple sclerosis, and stroke.
Rectal flexibility. Another common cause of fecal incontinence is the ability of your rectum to stretch. If the rectal muscles can’t stretch the way they need to, this can cause stool to build up and leak out. Crohn’s disease, chemotherapy and radiation, and inflammatory diseases can result in tightened rectal muscles which can lead to incontinence.
Medical conditions. Certain medical conditions can also result in fecal incontinence. For example, a rectal prolapse, chronic constipation, or a rectocele (when the rectum pushes into the vagina) can result in the inability to control stool.
- Other causes. Birth defects, nervous system defects, inflammatory bowel diseases, laxative abuse, and radiation can also result in fecal incontinence.
What to Do If You Have Fecal Incontinence
If you do have fecal incontinence, the first and most important step is talking to your doctor. Despite how common fecal incontinence is, there can still be a negative stigma around it, so we understand that talking to your doctor isn’t always easy. However, your doctor understands and will be able to help you remain healthy, make sure there are no underlying problems, and regain control of your bowels by discussing treatment options with you.
Here are some tests your doctor may want to do to determine the cause of your fecal incontinence and what treatment options are right for you.
- Anal manometry is a test to determine the strength of the anal sphincter and the strength of rectal sensation.
- Anorectal ultrasonography is a test that captures ultrasound images of the anal sphincter. This is done with a small ultrasound probe.
- Defecography is a way doctors can see the muscles of your rectum in action. After inserting a small tube into the rectum, doctors will ask you to contract your anal muscles and perform other movements.
- An MRI can be used to see the anal sphincter and the pelvic floor muscles.
- Nerve damage can be identified by anal electromyography (EMG). To do this, your doctor will use small electrodes around your anus to recognize nerve damage.
Being honest and thorough with your doctor about your bowel movements and fecal incontinence is one of the best ways to help them understand what’s causing your fecal incontinence and how to treat it. There are many treatment options to choose from.
Treatments for Fecal Incontinence
There is an abundance of ways to treat fecal incontinence and help you regain control of your bowels. After speaking with your doctor, you can discuss treatment options, and which may be right for you.
The pelvic floor muscles are the muscles stretching from the front of the pelvis to the anus. They control the pelvic floor, so when these muscles are strong, they hold in both urine and stool. If these muscles have been weakened, biofeedback therapy may be able to help.
This form of therapy uses biofeedback to help you sense when stool fills the rectum and control urges to empty the bowels. Especially if you incorporate pelvic floor exercises, biofeedback therapy can be very effective!
Sacral Nerve Stimulation
The sacral nerve is responsible for controlling the anal sphincters, colon, and rectum. Sacral nerve stimulation, or sacral neuromodulation, is a form of treatment that helps regulate the neurotransmitters in our brains that tell us to contract our bowels. If we have nerve damage, these messages may be inappropriately timed or erroneous, so sacral nerve stimulation can help correct them.
This treatment requires a small wire implant that goes just above the tailbone. It helps your sacral nerves function correctly, and it’s almost completely painless and can be done on your own time as you have control of the impulses.
Medications are a popular way to treat fecal incontinence. Your doctor will likely suggest over-the-counter medications at first, and then prescription meds if these aren’t working. These medications can treat the causes of fecal incontinence such as digestive health issues.
There are surgical options to treat fecal incontinence as well. When you talk to your doctor, he may suggest trying non-surgical options first to see if fecal incontinence can be managed without surgery. If these methods don’t help, then you can start talking to your doctor about surgical options.
Other Tips for Managing Fecal Incontinence
Surgery is a great option for some, but for others, it isn’t always ideal. It can be expensive, require months of recovery, and may pose other health risks from potential complications. If you’re hesitant to try a surgical treatment, here are some lifestyle tips and ways to manage fecal incontinence that are simple and affordable.
Incontinence underwear is one of the most popular ways to manage urinary and fecal incontinence. If you have tried incontinence underwear before, you may have had trouble finding exactly what kind you need. Here are three different kinds of underwear that can help you manage fecal incontinence and stay clean throughout the day.
If you tend to leak smaller amounts of stool throughout the day, try a booster for added protection! These are designed to protect against both urinary incontinence and fecal incontinence, so if your bladder tends to leak, you’ve got double protection!
If you tend to completely empty your bowels, our overnight underwear offers the most protection, even during the day.
Fecal incontinence can also lead to serious skin issues, rash, and inflammation if the skin is exposed to stool for long periods of time. This is why skincare for fecal incontinence is so important. Try using a cleanser and bringing a change of clothes and protective underwear with you, especially if you’re staying out for longer periods of time.
An on-the-go skincare package can also be helpful to bring to work, on trips, or just with you every day! With aloe wipes that are gentle on skin and effective for cleansing, hand sanitizer wipes to keep you clean wherever you are, and a no-rinse cleansing spray, this bundle is perfect to bring anywhere.
Fecal incontinence is a challenge for many Americans, but it is very treatable! Talk to your doctor about your fecal incontinence and discuss potential treatment options to figure out what might be right for you.
We’re here for you every step of the way. From products that help you stay clean to convenient, easy-to-use skincare, there’s an abundance of resources to help manage incontinence and regain control.