Bowel incontinence
Bowel incontinence
Overview
Bowel incontinence is when you poo by accident. It’s also sometimes known as faecal incontinence.
Some people experience bowel incontinence every day. For others it only happens from time to time. Bowel incontinence can be upsetting and hard to cope with but if this happens to you, you’re not alone.
Although it’s common, it shouldn’t be thought of as normal and it’s important that you get the help you need. There are things you can do to improve your incontinence symptoms, like:
- changing your diet
- strengthening your pelvic floor
Read more on lifestyle advice for managing constipation or further information about managing diarrhoea.
Types of bowel incontinence
There are 2 types of bowel incontinence:
- urge incontinence – when you feel a sudden and very intense need to poo and are unable to stop it before you reach a toilet
- passive incontinence or passive soiling – when you don’t feel the need to poo before it happens or when there is a little bit of poo when passing wind
You may experience both types of bowel incontinence.
Bowel incontinence is more common in women than men. Certain things can increase the chances of bowel incontinence developing. This includes:
- pregnancy and vaginal birth
- being overweight
- a family history of incontinence
- diseases of the bowel, like colitis
- getting older – but incontinence isn’t an inevitable part of ageing
Common Symptoms
Symptom information is not available for this condition yet.
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
When to See a Doctor
When to get medical advice
Speak to your GP practice if you:
- think you have bowel incontinence
- have any changes in your poo that aren’t getting better, like having softer poo, diarrhoea or constipation that isn’t usual for you
Causes
What causes bowel incontinence?
It can happen as a symptom of:
- diarrhoea
- constipation
- long-term conditions such as diabetes, multiple sclerosis and dementia
- a physical problem with the parts of the body that control passing stool (the rectum and sphincter muscles), or nerve damage
Please discuss any bowel problems with your doctor, since in rare cases they can point to something more serious, such as bowel cancer.
Diagnosis
Diagnosing bowel incontinence
Speak to your GP if you have symptoms which are bothering you or impacting your day-to-day life.
Your GP will try to understand what could be causing your symptoms. They’ll ask:
- when and how often your symptoms happen
- about your diet
- how much caffeine, fizzy drinks and alcohol you drink
You may find this embarrassing, but it’s important to answer as honestly and fully as you can. This will make sure you receive the most suitable treatment.
Depending on your symptoms your GP may refer you to a specialist.
Let the doctor know about:
- any changes in your bowel habits (when you poo) lasting for more than a few weeks
- bleeding from your back passage (rectum)
- stomach pains
- any changes to your diet
- any medication you’re taking
Your appointment may involve a physical examination. As this is an intimate examination, the doctor may have another person (a chaperone) present. Women can ask for a female doctor if they prefer. If there isn’t a female doctor available, you can ask if there’s another female health professional who can carry out the examination.
The doctor will look at your anus (where the poo comes out) and may put a gloved finger into your anus. You may be asked to squeeze around their finger so they can see how well the muscles in your anus are working.
In some cases, your doctor may find that you have haemorrhoids or a prolapse (where part of your lower bowel is pushing through your anus). It’s not life threatening and can be treated.
Further tests
If you’re eligible and haven’t had a recent bowel screening test, your GP may suggest this first. You may also be referred to a specialist who’ll explain if you need any further tests, like:
- colonoscopy (sigmoidoscopy) – a long, thin flexible tube with a light and video camera at the end (endoscope) is used to check your rectum (and sometimes lower bowel) for any obstructions (blockages), damage or inflammation
- anal manometry – a device with a small balloon attached to the end is inserted into your rectum and the balloon is inflated; it’s used to see how well the muscles and nerves in and around your rectum are working
- ultrasound scan
- defecography – an X-ray or MRI scan is used to see how well your rectum and pelvic floor muscles work while you poo; a liquid called barium or a gel is placed into your rectum to make it easier to see any problems when you poo
Treatment
In many cases, with the right treatment, a person can maintain normal bowel function throughout their life. Most people find that their symptoms significantly improve by:
- changing their diet
- taking a fibre supplement to help have regular, firm poos
- strengthening their pelvic floor muscles
Treatment will often depend on what is causing your incontinence and how severe your symptoms are. Other possible options include:
- exercise programmes to strengthen the muscles that control the bowel
- medications to help you have regular, firm poos
Only a small percentage of people need surgery.
Read more on lifestyle advice for managing constipation or further information about managing diarrhoea.
Non-surgical treatment
There are many non-surgical treatments used to treat bowel incontinence.
Dietary supplements like ispaghula husk (usually known by the brand name Fybogel) or psyllium husk which are taken daily to help make sure you have regular, firm poos. They usually come as plain or fruit-flavoured granules that you mix with water to make a high-fibre drink.
Medication like Loperamide can be used to manage diarrhoea or runny poo. It makes your poo less watery and reduces the number of times you need to go to the toilet. It can be prescribed in low doses for regular use over a long period of time.
Laxatives are used to treat constipation and help you to poo. There are different types of laxatives:
- stimulant laxatives, which speed up the movement of your bowels
- stool softener laxatives, which increase the fluid content of poo to make it easier to pass
Laxatives are available over the counter, at the pharmacy without a prescription. The pharmacist can help you choose the right one for you. You can also get them from supermarkets.
Enemas or rectal irrigation are used when your poo won't come out easily (this is sometimes called faecal impaction). A minienema (a squeeze of foam), a suppository (a small solid medication which goes in your bottom), or water irrigation is used to remove the poo. A healthcare professional would advise you on what to do.
Surgical treatment
Surgery is usually only needed in rare cases. There are different types of surgery depending on your symptoms. You would be referred to a colorectal surgeon who would explain your options and answer any questions you may have.
A colostomy is usually only recommended if other medical and surgical treatments are unsuccessful.