What is faecal incontinence?

Faecal incontinence is when you experience leakage from the bowel or pass a poo at the wrong time or in the wrong place due to poor bowel control. You may also have trouble with excessive wind or staining of underwear. As many as 1 in 20 people have poor bowel control, but there are treatments available.

It’s more common as people get older, but young people experience faecal incontinence too. People with the condition may also have problems with bladder control.

What are the symptoms of faecal incontinence?

The symptoms of faecal incontinence include:

• being unable to hold onto a poo very well
• needing to rush to the toilet to do a poo
• diarrhoea
• blockage of the bowel due to constipation, meaning you leak out some fluid

It’s important to see your doctor if you have any change in your bowel habits.

What causes faecal incontinence?

Faecal incontinence can happen because of poor toilet habits, like regularly straining to do a poo. It can also be caused by:

• some medicines
• weak pelvic floor muscles (for example, due to heavy lifting, having babies or having surgery)
• constipation or bad diarrhoea
• some health conditions including diabetes, bowel disease, or nerve disorders like multiple sclerosis or Parkinson’s
• dementia
• treatment for prostate cancer

Other conditions that can affect bowel control include:

• bowel cancer
• Crohn’s disease
• colitis
• diverticular disease
• haemorrhoids (piles)
• irritable bowel syndrome (IBS)
• rectal prolapse
• rectocoele
• worms

How is faecal incontinence diagnosed?

The first step is to see your doctor. Make sure you tell them if you have a change in your bowel habits, pain or bleeding from your back passage, dark or black poos, if you feel like your bowel is never empty, or you have lost weight without trying.

Your doctor will probably talk to you and examine you. They may ask you to keep a diary of your bowel habits, where you list what you eat and drink and how often you poo. They may also send you for some tests or an x-ray.

Depending on the cause of the problem, they might refer you to a specialist or a continence health professional.

How is faecal incontinence treated?

The best treatment will depend on the cause of your faecal incontinence. Your doctor will develop a plan for you based on your health, diet, exercise level and mobility. The plan will look at all the things that could be affecting your bowel function.

Treating diarrhoea or constipation or altering your medicine might cure faecal incontinence. Medicine is available to settle your bowels and give you firmer poos.

It’s also important to have a good bowel routine and to eat enough fibre and drink enough fluid.

If the problem is caused by weak pelvic floor muscles, physiotherapy can make a big difference.

Tips for living with faecal incontinence

If you have faecal incontinence, it’s important to use the toilet properly. Sit with your knees higher than your hips, lean forward and put your elbows on your knees. Push your tummy out, straighten your back and don’t strain.

To prevent the problem getting worse:

• Don’t strain.
• Don’t go to the toilet ‘just in case’ – only go when you have a strong urge.
• Don’t go to the toilet too often.
• Exercise your pelvic muscles.
• Check your diet and lifestyle, and make changes if necessary.