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Faecal Incontinence

Faecal incontinence or bowel incontinence is more common than you would think. Unfortunately, it is a subject which is still not as openly talked about as it should be. Bowel incontinence affects over 53 million people in Europe making it more prevalent than many well known diseases such as asthma or diabetes.

Many people consider their bowel and its functions as a private area. Most of us are embarrassed when something goes wrong with our bowel.

Some people who suffer with faecal incontinence learn how to cope and do not let it interfere with their daily life. However others can become depressed and anxious about their condition or problem and feel that their problems are, in some way, their own fault.

People begin to feel alone and isolated if they cannot talk to anyone about their problems. Some people avoid any kind of social occasion or event and even avoid relationships and everyday activities.

What is faecal incontinence?

If you are unable to control a liquid stool (diarrhoea) or a solid motion, then you have faecal incontinence. This may be a daily problem or happen from time to time. You may also experience involuntary passage or loss of wind.

The most common cause of faecal incontinence is damage to one or both of the anal sphincter muscles.

The external anal sphincter is responsible for delaying bowel emptying once the rectum fills and the urge to empty the bowel is felt. The muscle may weaken or may even have a tear or disruption inside where it cannot be seen.

People with a weak or damaged external sphincter muscle typically experience urgency and if they can't reach a toilet in time, they become incontinent. This is because the weak or damaged muscle cannot squeeze hard enough to stop the stool from coming straight out. Alternatively, this muscle cannot squeeze for long enough to provide time for the bowel to relax and the internal sphincter time to close again. If the stool remains in the upper anal canal the urge does not wear off and is felt all the time until the toilet is reached.

People with a damaged internal anal sphincter usually complain of 'passive soiling'. Soft stool or small pellets of stool just leak out without the person realising it is happening. They have no control over these leaks. This can sometimes happen even after the bowels have been emptied and loss of stool can also occur with physical exertion.

Diarrhoea can be a cause of faecal incontinence and also a symptom of faecal incontinence. Diarrhoea can be chronic, i.e. ongoing and reoccurring, or acute, i.e. sudden and unexpected.

Constipation can be both a cause of faecal incontinence and also a symptom of faecal incontinence. You can become constipated if you have difficulty emptying your bowel. Constipation is a very common cause of faecal incontinence in older and disabled people.

Incontinence can sometimes be the result of disease or injury to the nerves. Nerve injury and disease can cause a loss of sensation so that you do not know the bowel is full or that you need to empty your bowel. This may mean that sometimes you can't distinguish between the passage of solid (stool), gas (wind) or liquid (diarrhoea). It can also cause a loss of control over the muscles so that you cannot choose to delay opening the bowel in the usual way.

Some medications like antibiotocs can cause loose stools /diarrhoea which may make symptoms worse, therefore its important to discuss these with your GP.

People with disorders such as Parkinson's disease, Multiple Sclerosis, Stroke, spinal cord injury and Alzheimer's can sometimes develop faecal incontinence that is associated with their illness.

Further Help for Faecal Incontinence

Before you see your GP, It is useful to keep a bowel diary for a week or so before your appointment to record things such as how many times you go to the toilet, any accidents you have and what you eat or drink. This will be useful for the Doctor as it may highlight an underlying cause of your symptoms.

If you are concerned about your problem and it is starting to affect your day to day life make an appointment to see your doctor, continence nurse, specialist physiotherapist or colorectal nurse specialist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems.

You can also call our specialist helpline on 0845 345 0165 (24 hour answerphone) for medical advice, or visit our Continence Clinic Database facility in the Specialist Services section to find out where your nearest clinic is or call our general enquiries line on 01536 533255 for details.

For information on faecal incontinence treatments and product options to help you manage symptoms, please use the drop down menu below.