Bowel incontinence may occur temporarily during an occasional bout of diarrhea, but for some people, bowel incontinence is chronic or recurring. People with this condition may be unable to stop the urge to defecate, which comes on so suddenly that they don’t make it to the toilet in time. This is called urge incontinence. Another type of bowel incontinence occurs in people who are not aware of the need to pass stool. This is called passive incontinence.
Bowel incontinence may be accompanied by other bowel problems, such as:
- Gas and bloating
When to Call
See your doctor if you or your child develops bowel incontinence, especially if it’s frequent or severe, or if it causes emotional distress. Often, people are reluctant to tell their doctors about bowel incontinence. But treatments are available, and the sooner you’re evaluated, the sooner you may find some relief from your symptoms.
For many people, there is more than one cause of bowel incontinence. Causes can include:
- Muscle damage. Injury to the rings of muscle at the end of the rectum (anal sphincter) may make it difficult to hold stool back properly. This kind of damage can occur during childbirth, especially is you have an episiotomy or forceps are used during delivery.
- Nerve damage. Injury to the nerves that sense stool in the rectum or those that control the anal sphincter can lead to bowel incontinence. The nerve damage can be caused by childbirth, constant straining during bowel movements, spinal cord injury or a stroke. Some diseases, such as diabetes and multiple sclerosis can also affect these nerves and cause damage that leads to bowel incontinence.
- Constipation. Chronic constipation may cause a dry, hard mass of stool (impacted stool) to form in the rectum and become too large to pass. The muscles of the rectum and intestines stretch and eventually weaken, allowing watery stool from further up the digestive tract to move around the impacted stool and leak out. Chronic constipation may also cause nerve damage that leads to bowel incontinence.
A number of factors may increase your risk of developing bowel incontinence, including:
- Age. Although bowel incontinence can occur at any age, it’s more common in adults over 65.
- Being female. Bowel incontinence can be a complication of childbirth. Recent research has also found that women who take menopausal hormone replacement therapy have a modest increased risk of bowel incontinence.
- Nerve damage. People who have long-standing diabetes, multiple sclerosis, or back trauma from injury or surgery may be at risk of bowel incontinence, as these conditions can damage nerves that help control defecation.
- Dementia. Bowel incontinence is often present in late-stage Alzheimer’s disease and dementia.
- Physical disability. Being physically disabled may make it difficult to reach a toilet in time. An injury that caused a physical disability may also cause rectal nerve damage, leading to bowel incontinence.
Complications of bowel incontinence may include:
- Emotional distress. The loss of dignity associated with losing control over one’s bodily functions can lead to embarrassment, shame, frustration, and depression. It’s common for people with bowel incontinence to try to hide the problem or avoid social engagements.
- Skin irritation. The skin around the anus is delicate and sensitive. Repeated contact with stool can lead to pain, itching, and potentially sores (ulcers) that require medical treatment.
Depending on the cause, it may be possible to improve or prevent bowel incontinence. These actions may help:
- Reduce constipation. Increase your exercise, eat more high-fiber foods, and drink plenty of fluids.
- Control diarrhea. Treat or eliminating the cause of diarrhea, such as an intestinal infection, may help you avoid bowel incontinence.
- Avoid straining. Straining during bowel movements can eventually weaken anal sphincter muscles or damage nerves, possibly leading to bowel incontinence.