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Fecal or bowel incontinence is the loss of control over bowel (stool) movements. Some people may lose only a small amount of liquid stool, while others may be unable to control an entire movement of solid waste. Women are more likely to have fecal incontinence than men, and it is a condition that becomes more common with age. Fecal incontinence can be temporary, such as severe diarrhea after eating a spicy meal, or it can be chronic and ongoing.

Because fecal incontinence is not something people like to talk about, you may not be aware that it is not uncommon, and the good news is that treatments are available.


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 nervous system, as well as the amount and consistency of stool produced.

There are many causes of bowel incontinence, including:

  • Damage or injury to the anal sphincter (rectum) muscles or the nerves surrounding these muscles; in women, this may occur during childbirth
  • Anal surgery for another condition
  • Conditions associated with chronic constipation or diarrhea
  • Use of certain medications, such as antibiotics
  • Improper diet
  • Radiation treatment to the lower pelvic region
  • Stroke
  • Chemotherapy
  • Spinal cord damage
  • Systemic (whole-body) diseases, such as diabetes

Tests and Procedures

  1. Endosonography (rectal ultrasound) - allows the doctor to view the anal sphincter muscles to find muscle tears and other abnormalities
  2. Flexible sigmoidoscopy - use of a thin, flexible, lighted tube (endoscope) to examine the lower digestive tract
  3. Defecography - a special X-ray test that shows the shape and position of the rectum as it empties
  4. Manometry - measures the pressure and strength of the anal muscles to determine if they are too weak to function properly
  5. Nerve studies - checks for damage to the nerves that serve the sphincter muscles


Most people can be cured or significantly improved with treatment once the doctor identifies the underlying cause of fecal incontinence. The treatment depends on the cause, but often the physician will suggest a combination of exercises, biofeedback and medication.
  1. Dietary changes - elimination of foods that cause the problem
  2. Changes in medication - switching from medications that cause chronic diarrhea to others that do not
  3. Kegel exercises (pelvic floor exercises) - exercises to strengthen the muscles that control elimination
  4. Over-the-counter or prescription stool-firming medications - most people control firm stools better than liquid ones
  5. Biofeedback - use of a device inserted into the anus or on the skin that tells the patient when she is using the proper muscles to control defecation; this helps improve the strength and coordination of the appropriate anal muscles
  6. Surgery - choice for patients who do not achieve success with other treatments or who have experienced anal muscle injuries, such as during childbirth

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