Thumbnail image of: Rectal Suppository, How to Insert: Illustration

Loss of Control of Bowel Movements (Fecal Incontinence)

What is fecal incontinence?

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

What is the cause?

Many kinds of things can cause fecal incontinence, for example:

  • Inflammatory bowel disease, like Crohn’s disease or ulcerative colitis
  • An injury in the rectal area
  • Irritation or infection of the rectum, anus, or the area around the anus
  • Diseases that irritate the bowel and cause diarrhea
  • Weakening or stretching of the muscles and ligaments that control your intestines or rectum. This may happen with aging or from frequent or severe constipation.
  • Spinal cord injury, or a brain condition such as head injury, stroke, or coma
  • Alzheimer’s disease or another type of dementia that causes you to not be aware that you need to go to the bathroom
  • Medicine that causes constipation or makes it harder for you to know when you need to have a bowel movement
  • Radiation therapy to the rectal area

What are the symptoms?

The main symptom is leaking of bowel movement, or having a complete or partial bowel movement that you are not aware of or cannot control. If it happens often, you may need to wear protective underwear (incontinence briefs or pads).

How is it diagnosed?

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

You may have tests to look for nerve, muscle, or coordination problems, such as:

  • Rectal exam: A test in which your provider will gently put a lubricated, gloved finger in your rectum and may place the other hand on your belly to feel and check the size and shape of your organs. The exam can also help your provider learn how strong your rectal and anal muscles are.
  • Neurologic exam: Test of your nervous system. In particular, your provider may check spinal cord and nerve functions in your back, groin, and legs. Fecal incontinence can be a sign of spinal nerve problems.
  • Anal manometry: A test that may use a small device to check the strength of your anal and rectal muscles
  • An EMG (electromyogram), which uses needles passed through your skin to send mild electric signals and check how your nerves and muscles respond

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:

  • Stool softeners
  • Laxatives
  • More fiber and liquid in your diet
  • Increased physical activity
  • Following a routine for going to the toilet to try to have a bowel movement. You may need suppository laxatives to help empty your bowel on a schedule. When you have the urge to go to the bathroom, don’t ignore it.
  • Medicines that help your body digest food more slowly

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

  • Repair the muscle at the opening of your rectum
  • Remove a part of your intestine that is causing problems
  • Attach part of your intestine to an opening in the wall of your belly (a colostomy). Bowel movements then pass through this opening instead through your rectum. They are collected in a bag outside your body.

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

  • Use the toilet just before leaving the house.
  • You can wear protective pads inside your clothing.
  • Clean your rectal area after each bowel movement to protect your skin.
  • Do exercises to strengthen your pelvic floor muscles. The pelvic floor muscles support your bowel and your bladder. Ask your healthcare provider about this.
  • Try sitting on the toilet at certain times every day. Having a routine helps your brain and body learn when to have a bowel movement. For people with dementia, family caregivers or nursing staff may need to assist the person with scheduled trips to the toilet or get a bedside commode.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-05-29
Last reviewed: 2014-05-28
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.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

Patient Portal

Our Patient Portal provides safe and secure online access to better communicate with your Tufts Medical Center Community Care doctor. This easy-to-use web tool is a convenient way to book appointments, request referrals, renew prescriptions, view medical records/test results and communicate with your healthcare provider from the privacy of your own computer.