What is Fecal Incontinence?

Fecal incontinence, also called “accidental bowel leakage,” is when you accidentally pass solid or liquid stool or mucus from your rectum. This can happen when you feel the urge to go and cannot get to a bathroom in time, or you might pass stool in your underwear without knowing. Fecal incontinence can be embarrassing and wearing pads may not hide the problem because of the odor. The good news is that there are treatments.

Who gets fecal incontinence?

In the United States, about 8 percent of adults have fecal incontinence. The problem is more common in older women, but it can happen at any age. You are more likely to have fecal incontinence if you also have:

• Soft or watery stools (diarrhea)
• A sudden need (urgency) to rush to the bathroom
• A problem that affects the nervous system
• Other chronic health problems
• History of vaginal childbirth that damaged the muscles, or nerves of the vagina or rectum
  
  

Normally, you should be able to sense when you need to have a bowel movement and get to the toilet without a problem. There are a few reasons why fecal incontinence happens:

• You don’t feel when the rectum (the area that holds stool) is almost full.
• The muscles and nerves that hold the stool inside are weakened or damaged.

Who should I talk to about fecal incontinence?

If you have never mentioned this problem to anyone, start by talking with your primary care provider. If he or she is not familiar with treatment options, you may be referred to a specialist like a gastroenterologist, urogynecologist, or colorectal surgeon. The doctors may ask you some of these questions:

• When did this problem start?
• How often do you leak stool?
• How much stool leaks out (a smear, a piece, or a full-sized bowel movement)?
• Do you feel when you need to have a bowel movement? Are you ever surprised to find stool in your underwear?
• Do you have hemorrhoids?
• Do you worry about leaving the house because of fecal incontinence?
• Are you more likely to have stool leakage after eating?
• If you feel the need to pass gas, can you stop it?

The Spaulding Outpatient Center for Pelvic Health at Care New England is designed to offer interdisciplinary treatments and services to address your specific pelvic health needs.