Fecal incontinence, also called bowel or anal incontinence, is the inability to control your bowels. It is the second most common pelvic floor disorder. People with fecal incontinence may feel the urge to have a bowel movement but may not be able to hold it until they reach the toilet. Or they may leak stool from the rectum.

If you have fecal incontinence, you aren’t alone. More than 5.5 million American men and women of all ages are affected, although it tends to be more common in older adults. Fecal incontinence is not normal at any age and can be treated successfully. This can lead to a significant improvement in a person’s quality of life.

Your physician will start by asking questions about your medical history. Then he or she will conduct a physical exam and order some tests.

Physicians have several tools to understand the cause of fecal incontinence. These include:

  • Anorectal manometry, which checks the anal sphincter muscles that keep stool inside. This test also checks how well the rectum works

  • Defecography, which shows how much stool the rectum can hold, how well it can hold it and how well it can empty itself

  • Magnetic resonance imaging (MRI), which is sometimes used to examine the sphincter

Other tests may be ordered to look inside the rectum or colon for signs of disease or damage that could cause fecal incontinence.

Treatment can improve or restore bowel control for most people with fecal incontinence. Often, a treatment plan includes many approaches, depending on the cause of the problem. These may include:
  • Diet changes, such as eating smaller meals and avoiding caffeine, which relaxes the sphincter muscles and can make incontinence worse
  • Managing constipation with adding fiber to your diet, or a fiber supplement
  • Medication, which may be appropriate for some people to help slow down the bowel
  • Biofeedback, which helps people learn to strengthen their pelvic muscles so they can control their bowel movements
  • Surgery, which may help people whose fecal incontinence is caused by damage to the pelvic floor or anal sphincter. Surgeons can repair the anal sphincter using advanced techniques that restore bowel function. Surgeons also can improve bowel control by injecting bulking agents into the anus or stimulating the nerves in the lower pelvis