A person with bowel incontinence, also called faecal incontinence, is unable to control their bowel movements.
There are different types and degrees of bowel incontinence. With urge bowel incontinence, a person may not be able to get to the toilet in time.
Other people may not realise they've had a bowel movement, called passive incontinence.
Passive soiling is another type of bowel incontinence that happens when passing wind.
Bowel incontinence may affect a person daily, or occasionally.
What causes bowel incontinence?
Normal control of bowel movements depends on proper functioning of the colon and rectum, the muscles surrounding the anus (anal sphincter muscles), the brain and the body's nerves (the nervous system), plus the amount and consistency of waste products produced.
There are many causes of bowel incontinence, including:
What can I do if I have bowel incontinence?
Seek medical advice if you have bowel incontinence. Tests to determine the cause for incontinence can be completed during an outpatient appointment and are not painful.
Once these tests have confirmed the cause of your incontinence, your doctor can make specific recommendations for treatment, many of which do not require surgery.
No matter how serious the problem seems, incontinence is a condition that can be significantly helped and, in most cases, cured.
How is bowel incontinence diagnosed?
Anal ultrasound makes it possible to view the anal sphincter muscles and precisely identify abnormalities. Ultrasound can be used to locate the exact position of a tear in a muscle, even before bowel incontinence becomes a problem.
Other procedures to diagnose bowel incontinence that may be used include:
- Flexible sigmoidoscopy. By using a thin, flexible lighted tube called an endoscope, your doctor can examine the lining of the final third of the lower digestive tract.
- Manometry. This test measures the pressure and strength of the anal muscles and can determine if they are too weak to function properly.
- Nerve studies. These tests check for nerve damage to determine if the nerves that communicate with the sphincter muscles are working properly.
- MRI. Magnetic resonance imaging can help identify areas of weakness in the sphincter muscles.
How is bowel incontinence treated?
Once the underlying cause of bowel incontinence has been identified, most people with this condition can be cured or the condition can be significantly improved. However, the method of treatment depends on the cause of the incontinence.
Sometimes simple changes in diet or eliminating certain medications can be effective in helping patients regain bowel control. More frequently, treatment involves a combination of medication, biofeedback, and exercise.
- Medication. Sometimes taking medications to change the consistency of the stools can provide relief, since a person can usually control stools better when they are firm rather than loose or liquid.
- Exercise. Muscle- strengthening exercises ( pelvic floor exercises) can be very helpful in treating bowel incontinence. To do these exercises, contract the muscles of the pelvic floor - between the anus and the pubic bone in front - and then hold as hard as possible for a slow count of five and then relax. Imagine you are trying to stop the flow of stools and urine or trying not to pass wind. A series of 30 of these exercises should be done three times daily. In a few weeks, the pelvic floor muscles will be stronger and often the incontinence improves or resolves.
- Biofeedback. Biofeedback training for bowel incontinence involves putting a pressure probe in the anus or a sensing electrode on the skin. These devices are attached to a visual or sound display to tell the patient when the correct anal muscles are being used. Biofeedback helps a patient improve the strength and coordination of the anal muscles that help control bowel movements, as well as heightening the sensation related to the rectum filling with stools.
- Surgery. Patients who continue to experience bowel incontinence despite other treatments may require surgery to regain control. Surgery may especially be needed for patients who have experienced anal muscle injuries (as can occur during childbirth).