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  • Writer's pictureBrian Dooreck MD

What is Fecal Incontinence?

Updated: Jul 27, 2023

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What is fecal incontinence?

Fecal incontinence refers to the inability to control bowel movements. This can include minor leakage or complete elimination of bowels. Although typically thought of as something that only older people tend to suffer from, fecal incontinence can strike at any age for various reasons. 1 in 3 young adults will experience fecal incontinence. Fecal incontinence can be temporary or chronic/recurring. Risk factors include:

  • Being 65 or older

  • Dementia

  • Nerve damage

  • Being female

  • Being physically disabled

  • Childbirth

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You are not alone,1 in 3 young adults will experience fecal incontinence.

What causes fecal incontinence?

There are many causes for fecal incontinence, including but not limited to:

  • Diarrhea: Whether caused by illness or some other GI complication, a loose stool is not as easy to contain as a solid stool and may result in leakage.

  • Constipation: Although seemingly counterintuitive, impacted stool may cause the muscle of the intestines and rectum to weaken slightly, which then gives way for watery stool to pass around the impaction and leak from the rectum.

  • Lack of rectal elasticity: For varying reasons, the rectum can become stiff and fail to conform to the stool it is accommodating. As a result, excess stool may leak through the rectum.

  • Muscle/Nerve damage: The inability to control muscle movements can result in stool leakage.

  • Hemorrhoids: Swollen internal veins (located in the rectum) can prevent the anus from fully closing, resulting in stool leakage.

  • Rectal prolapse: When the rectum drops into the anus, the rectal sphincter may stretch, and stool leakage may occur.

It is important to seek the opinion of a medical professional to determine the underlying cause of fecal incontinence.

What are the symptoms of fecal incontinence?

Symptoms of fecal incontinence, aside from the bowel leakage itself, include:

  • Strong urge to defecate

  • Gas and bloating

  • Diarrhea

  • Constipation

If you are experiencing common symptoms, schedule an appointment with your primary care physician.

How is fecal incontinence diagnosed and treated?

Regarding fecal incontinence, the diagnosis has less to do with confirming what is happening but rather why. The following diagnostic exams may be performed to pinpoint the cause:

  • Colonoscopy: To inspect the colon, a thin tube fitted with a light and camera is interested in your anus and through your intestines.

  • Digital rectal exam: The physician inserts a gloved finger into the rectum to test strength and feel for abnormalities.

  • Anal manometry: A small balloon is inflated in your anus and rectum to test the strength and responsivity of the anal sphincter and rectum.

  • Proctography: X-ray images are captured as you pass a bowel movement on a specially designed toilet that measures how much stool your rectum can hold and how well you can expel it.

  • MRI: Images of the sphincter can help determine whether or not it is intact.

The treatment for fecal incontinence depends on the reason it is occurring in the first place. Some possible avenues of treatment include:

  • Medication to treat any underlying illness causing temporary bowel leakage

  • Exercises and therapy to strengthen the muscles and improve anal sphincter control

  • Bowel training is when you train your body to pass bowel movements at scheduled times

  • Surgery to correct issues such as a prolapsed rectum or sphincter damage

Dietary changes may also be required to manage fecal incontinence. It is essential to consume plenty of fiber to prevent constipation, keep detailed notes of how your body responds to certain foods, stay away from foods that cause diarrhea, and drink at least eight glasses of water daily.

Remember: prevention is key 🔑. Paying attention to your body, maintaining a well-balanced diet 🍽 and an active lifestyle are significant factors in reducing your risk of experiencing fecal incontinence.

Check out this short informational video on fecal incontinence by John Hopkins Medicine:


I eat a high-fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.

"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"

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Connect with Dr. Dooreck on LinkedIn, where he focuses his sharing on Health, Diet, Nutrition, Exercise, Lifestyle, and Balance.


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