Fecal Incontinence


Fecal (or bowel) incontinence is the inability to control bowel movements. There has been damage to the muscles (sphincters) or their nerves surrounding the anus. Fecal incontinence is a lack of control over defecation, leading to involuntary loss of bowel contents – including flatus, liquid stool elements and mucus, or solid feces. FI is a sign or a symptom, not a diagnosis. FI can result from different causes and might occur with either constipation or diarrhea.

causes of fecal incontinence

  • Child birth
  • Anal surgery
  • Impacted stool (severe constipation), often in older patients
  • Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
  • Nerve damage (diabetes, spinal cord injury, multiple sclerosis, or other conditions)
  • Radiation damage to the rectum (prostate cancer)
  • Cognitive impairment (from a stroke or Alzheimer’s)
  • Anal intercourse

diagnosis of fecal incontinence

  • Examination by your physician
  • Stool testing
  • Endoscopy – a tube with a camera and a light that is inserted into the anus. You are sedated and will feel no discomfort.
  • Anorectal manometry – a pressure monitor that is inserted into the rectum to measure the strength of the sphincter muscles.
  • Endosonography – an ultrasound probe that is inserted into the anus which produces images that help identify issues in the anal and rectal walls.
  • Nerve tests – to measure the responsiveness to the nerves controlling the sphincter muscles.

Additional Information

treatment of fecal incontinence

  • Diet – eating 20 to 30 grams of fiber daily. This makes the stool more bulky and easier to control.
  • Avoid caffeine
  • Drinking plenty of water. This avoids dehydration and constipation
  • Medications – Imodium, Lomotil, Hyoscaymine, Viberzi
  • Exercise – pelvic exercises – Kegel
  • Bowel training – create a routine of timely bowel movements
  • Surgery