Not being able to properly control passing stools is a medical condition known as fecal incontinence. This lack of control over the bowels means stools can leak out if you can't recognize the signs of an impending bowel movement and make it to a bathroom in time.
Fecal incontinence isn't limited to any particular age group or gender. Although it more commonly strikes older people and women, anyone — even children — can have fecal incontinence; it affects over 5 million Americans.
Fecal incontinence often occurs when nerves around the anal sphincter, the muscle that helps control a bowel movement, become damaged in some way. Common causes of damage to the anal sphincter and fecal incontinence include:
- Constipation — the most frequently cited cause
- Straining too hard to have a bowel movement
- Conditions and diseases that affect the nerves, including multiple sclerosis, diabetes, and tumors involving the spinal cord
- Inflammatory bowel disease
- Radiation therapy or surgery near the rectum
- Delivering a baby
- Weakness or abnormalities affecting the pelvic floor
Symptoms of fecal incontinence include:
- Leaking stool, even if infrequently
- Inability to prevent the release of gas
- Stools that leak during some sort of exertion
- Discomfort or pain in the abdomen
Diagnosing Fecal Incontinence
Although the occasional bout of severe and sudden diarrhea can cause fecal incontinence, regular uncontrolled bowel movements aren't considered normal. Talk to your doctor about your symptoms — he can perform some tests to help diagnose the cause of your fecal incontinence. Possible tests include:
- Anorectal ultrasonography. This is a small probe with a camera that is inserted into the rectum to look for abnormalities with the anal sphincter.
- Proctosigmoidoscopy. This instrument has a narrow tube with a camera to reveal tumors or other abnormalities in the lower part of the colon and the rectum.
- Proctography (defecography). This diagnostic test evaluates the capacity and function of the rectum. A tube containing liquid barium is placed in the colon. The patient sits on a specially constructed toilet. As the patient expels the colon’s contents, an X-ray is taken.
- Anal electromyography (EMG). With this test, small electrodes are inserted into the anus to assess nerve damage.
- Anal manometry. A tube is inserted into the rectum to see how strong it is and how well it can detect sensations.
Treating Fecal Incontinence
Once your doctor knows the cause of your fecal incontinence, he can recommend treatment options, which may range from diet changes to surgery:
- Bowel training. This treatment is used to teach better control over the bowels and can include creating a schedule for having bowel movements to prevent untimely (and uncontrollable) bowel movements. Biofeedback is one method you can use to train yourself to recognize and control the muscles required to hold in stools.
- Changing your diet. Adding fiber to your diet, drinking plenty of fluids, and sticking to small meals can help improve digestive health and control bowel movements. Keeping a log of foods that cause you to have diarrhea can also help by showing you what triggers to avoid.
- Medications to improve stools. Fiber or anti-diarrheal medications can change the consistency of stools and make them more regular, providing better control over fecal incontinence.
- Surgery to correct abnormalities. If there is an abnormality affecting the anal sphincter, surgery may be needed to repair it.
Though this can be an embarrassing issue to discuss, ignoring fecal incontinence won’t help. If you are dealing with uncontrollable bowel movements, talk to your doctor about possible causes and ways to better control your bowels.
Last Updated: 5/13/2010