A person’s muscles and nerves in the pelvis and rectum (the lower part of the large intestine) must work together in a coordinated way to prevent fecal incontinence.
When a person is not ready to have a bowel movement:
- The circular muscles in the rectum, called sphincters, tighten like rubber bands to keep stool from leaving the rectum.
- Muscles at the bottom of the pelvis (called pelvic floor muscles) also help keep stool inside the rectum.
If these muscles and nerves do not work together properly, fecal incontinence can occur.
The following conditions can lead to fecal incontinence.
Diarrhea
Diarrhea means loose or watery stool. It can make a person need to have a bowel movement more often and more urgently. Loose stool is harder to hold in the rectum, which makes it more difficult to reach the bathroom in time.
Constipation
Constipation means having fewer than three bowel movements in one week. This can cause stool to become hard and large, often making bowel movements uncomfortable and causing straining. Hard stool can get stuck in the rectum.
- Watery stool can leak around the hard stool.
- Constipation can weaken the sphincter muscles, making them too weak to control stool.
- Pushing or straining often during bowel movements can also weaken the sphincter muscles.
Hemorrhoids
Hemorrhoids are swollen veins in the lower rectum. They may stick out through the anus (the opening at the end of the rectum). This can prevent the sphincter muscles from closing fully, which may allow stool to leak.
Muscle and Nerve Damage
Damage to the muscles or nerves in the pelvis or rectum can increase the risk of fecal incontinence. A person may not feel the urge to have a bowel movement. The sphincter muscles may not close tightly, which can cause stool to leak.
Many health problems can lead to fecal incontinence, including:
- Stroke
- Diabetes
- spinal cord injuries
- multiple sclerosis
- rectal or anal cancer
- Crohn’s disease and ulcerative colitis (conditions that affect the digestive system)
- radiation treatment or surgery
- rectal surgery (such as hemorrhoid surgery or sphincter surgery)
Women who had a forceps delivery or an episiotomy (a cut made in the vaginal area during childbirth) may have muscle or nerve injuries that lead to fecal incontinence.
Cognitive (Thinking and Memory) Problems
People with cognitive problems, such as dementia, may forget to use the bathroom or may not find it in time. When memory problems are severe, a person may not understand how to control their bowels or how certain foods may worsen fecal incontinence.
Risk Factors
Women have a higher risk of fecal incontinence than men. This is often due to muscle or nerve injury during childbirth.
Complications
If fecal incontinence is not treated, it can lead to:
- Urinary tract infections
- Skin rashes or skin sores (ulcers)
- Poor sleep
- Avoiding social activities because of worry about reaching a bathroom in time
- Depression
- Low self-esteem
- Falls and broken bones (fractures)
- Sexual problems
Last Updated May 2026