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Loss of Control of Bowel Movements (Fecal Incontinence)

 What is fecal incontinence?
 How does it occur?
 What are the symptoms?
 How is it diagnosed?
 How is it treated?
 How can I help take care of myself and prevent accidents?

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What is fecal incontinence?

Fecal incontinence is trouble keeping control of your bowel movements. It means that you have bowel movements that you cannot stop from coming out.

Having an urgent need for a bowel movement but having enough control to get to a toilet in time and avoid bowel accidents is not incontinence. However, it may mean that you have a bowel problem.

How does it occur?

Loss of bowel control can happen to anyone. The loss of control may be a one-time accident. Or it may happen several times in a short period of time. In some cases it is an ongoing problem that cannot be cured.

Bowel accidents can happen because you don’t feel the warning urges, and the movement just happens. This type of incontinence can happen if you have had a stroke, a paralyzing accident, or illness. It may result from being confused or having dementia. It can also happen because the bowel is irritated.

Loss of bowel control can happen if you have:

Bowel accidents that happen despite your efforts to stop them are called urge incontinence. Bowel habit problems or diseases that irritate the bowel and cause diarrhea are common causes of urge incontinence.

Sometimes constipation causes incontinence. The bowel movements (stool) get dry and hard and difficult to pass. As a result, the muscles of the rectum and intestines stretch and weaken. The weakened muscles may then allow some stool to leak out. Lack of activity and not getting enough fiber in the diet make constipation worse.

Medicines can cause incontinence. They may make it harder for you to know when your rectum is full. As a result, you may have a delayed and sudden need for a bowel movement. Some medicines also can cause severe constipation, leading to irritation and overflow incontinence. For example, some narcotic pain killers have a strong constipating effect and often are overlooked as something that may be causing fecal incontinence.

What are the symptoms?

The main symptom is having a complete or partial bowel movement when you don’t want one. You then have to clean up your clothes. If it happens often, you may need to wear protective underwear (usually called incontinence briefs).

If you have weak anal control, you may leak bowel material. If you are paralyzed, you may not know about your bowel accidents because you have no feeling in that area.

If you have more irritation than weakness, you may have urgency that gets too strong for your control.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you.

You may have some tests. For example:

All this helps your healthcare provider find if the problem is a nerve, muscle, or coordination problem.

How is it treated?

Treatment depends on the cause.

If constipation is the cause, or if constipation is making bowel movements more irritating, the treatment may include:

In rare cases, surgery may be needed. It may be done to:

When damage to the brain or spinal cord causes fecal incontinence, planning a schedule for regular bowel movements and wearing incontinence pads or briefs are the main treatments. Suppositories often are needed to help empty the bowel on a schedule.

How can I help take care of myself and prevent accidents?

healthinformatics info

Reference Sources:

Feldman: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed.; Saunders 2010; CHAPTER 17 - Fecal Incontinence (accessed via MD-Consult, June 19, 2011).

Drossman DA; Li Z; Andruzzi E; Temple RD; Talley NJ; Thompson WG; Whitehead WE; Janssens J; Funch-Jensen P; Corazziari E; et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993 Sep;38(9):1569-80.

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Last Modified: 2011-08-11

Last Reviewed: 2011-08-11

Website Updated: March 2014

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This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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