Bowel leakage, also referred to as fecal incontinence, is marked by the inability to control bowel movements. It occurs in both men and women but is more common in women.1
Causes of bowel leakage vary from person to person, and in many cases there are multiple causes and risk factors ranging from digestive issues to muscle or nerve damage, aging and childbirth.1
- Constipation: chronic constipation causes the the muscles of the rectum and intestines stretch and eventually weaken, allowing stool to leak out. It may also cause nerve damage that leads to incontinence and leakage.
- Nerve or muscle damage: Any injury to the muscles at the end of the rectum (anal sphincter) or the nerves that control the anal sphincter.
- Medical conditions: chronic conditions that can damage the nerves, like diabetes or multiple sclerosis
- Post-partum: bowel leakage can be a complication of childbirth.1 At 3-6 months after vaginal or cesarean delivery, as many as 13-25% of women report incontinence.2
Age: bowel leakage is more common in adults over 65.
Women may experience occasional leakage due to diarrhea or constipation, but some women experience what is considered “chronic leakage.” This can come in two forms - urge incontinence, when someone is unable to stop the urge to go to the bathroom, and passive incontinence, when someone is not aware they need to pass stool. Both forms of chronic leakage often lead to “accidents.”1
Bowel leakage will often be accompanied by other digestive issues, like:1
There are several tests your doctor can perform to determine the cause of your bowel leakage and identify an appropriate treatment. Some tests include:3
- Digital rectal exam: Your doctor inserts a gloved and lubricated finger into your rectum to evaluate the strength of your sphincter muscles and to check for any abnormalities.
- Bowel function tests: Your doctor may perform one or more of the following tests to see how well the muscles and nerves in your anus, pelvic floor, and rectum are working:
- Anal manometry
Colonoscopy: Allows your doctor to look inside your anus, rectum and colon to identify inflammation that may be causing bowel leakage.
- Mayo Clinic. Fecal Incontinence. Symptoms and Causes. https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/symptoms-causes/syc-20351397. Accessed January 2019.
- Fecal Incontinence. Epidemiology: Frequency. https://emedicine.medscape.com/article/268674-overview. Accessed January 2019.
- National Institutes of Health. Bowel Control Problems. Symptoms and Causes. https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence/symptoms-causes. Accessed January 2019.
- Mayo Clinic. Fecal Incontinence. Diagnosis and Treatment. https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/diagnosis-treatment/drc-20351403. Accessed January 2019.
- National Institutes of Health. Bowel Control Problems. Treatment. https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence/treatment. Accessed January 2019.