A person’s muscles and nerves in their pelvis and rectum (the bottom part of the large intestine) have to work in a coordinated way to prevent fecal incontinence.
When a person is not ready to have a bowel movement:
- The rectum’s circular muscles (sphincters) contract like rubber bands to keep feces from leaving the rectum.
- Muscles in the bottom of the pelvis (called pelvic floor muscles) also help keep feces from leaving the rectum.
However, if these muscles and their nerves don’t work together the way they should, fecal incontinence can happen.
The following conditions can lead to fecal incontinence.
Diarrhea
Diarrhea is an abnormal looseness of the feces, which can increase how often and how urgently a person needs to pass feces. Loose feces can be more difficult to hold in the rectum, making it harder to reach the bathroom on time.
Constipation
Constipation is defined as having fewer than three bowel movements a week. This condition makes stools hard and large, which can cause them to get stuck in the rectum.
- Watery feces can leak around the hard stool
- Constipation can weaken the sphincter muscles so they’re too weak to control the release of stool
- Frequently straining can also weaken sphincter muscles
Hemorrhoids
Hemorrhoids are swollen veins in the lower part of the rectum that may come part way out through the anus (the very end of the rectum). This can keep the sphincter muscles from closing completely and stool can leak out.
Muscle and Nerve Damage
Damage to muscles and nerves in the pelvis or rectum can increase the risk of fecal incontinence. People may not feel the urge to move their bowels. Their sphincter muscles may not close tightly. So feces can leak out. Many problems can cause fecal incontinence, including:
- strokes
- diabetes
- spinal cord injuries
- multiple sclerosis
- rectal or anal cancer
- Crohn’s disease, and ulcerative colitis (diseases that affect the digestive system)
- radiation treatment or surgery
Women who have had a forceps delivery or an episiotomy (a cut the doctor makes in the vaginal area to keep the baby’s head from tearing the vagina during childbirth) may have injuries that cause fecal incontinence.
Cognitive (Thinking and Memory) Problems
People with cognitive problems, such as dementia, may forget to move their bowels or become lost when trying to find the bathroom. When their cognitive problems are severe, people may not understand how to control their bowels or how their diets can cause fecal incontinence.
Risk Factors
Because of harms during childbirth, women have a higher risk of fecal incontinence than men.
Complications
Untreated fecal incontinence can cause:
- Urinary tract infections
- Skin rashes and skin ulcers
- Lack of sleep
- Loss of social activities, due to fears about getting to a bathroom in time
- Depression
- Low self-esteem
- Falls and fractures
- Sexual problems
Last Updated December 2022