Bowel incontinence

Bowel incontinence, which is also called faecal incontinence, affects about one in 10 people at some point. It’s slightly more common in women than men and can happen at any age. However, you’re more likely to be affected if you’re elderly.

Bowel incontinence may be accompanied by other symptoms of digestive problems, including:

• Diarrhoea
• Constipation
• Flatulence
• Bloating

In many cases, bowel incontinence can be treated. There are also ways to manage the impact bowel incontinence has on your daily life, including bowel incontinence pads.

There are two main types of bowel incontinence:

• Urge incontinence – when your bowels open suddenly and without warning
• Passive incontinence – when you’re unaware you’re passing stools

There are several conditions that can cause bowel incontinence, including:

• Inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis
• Irritable bowel syndrome
• Severe haemorrhoids (piles)
• Damage to the muscles or nerves that control your bowels - perhaps due to spinal cord injury, surgery, diabetes, spina bifida, stroke or the ageing process
• Dementia
• Anal fistula

Causes of bowel incontinence in females can sometimes be linked to damage during childbirth to the muscles controlling bowel movements.

If bowel incontinence is affecting your life or your confidence, see your GP.

Your GP will ask about the frequency and severity of your bowel incontinence and how it’s affecting your life. Your GP will also discuss your diet, general health and any other symptoms, such as rectal bleeding or stomach pains. They may also examine your bottom (anus) and back passage (rectum) to check for abnormalities.

Your GP may refer you for:

• Endoscopy - a tiny camera attached to a thin, flexible tube that films inside your rectum and lower bowel
• Colonoscopy – an examination of your bowel using a thin, flexible tube with a camera on the end
• Anal manometry – to test the strength of your rectum’s muscles and nerves
• Ultrasound or MRI scan – to provide a clear image of the inside of your anus

Your GP may refer you to a consultant or a continence clinic for further assessment, diagnosis and treatment.

Your doctor will advise you on how you can reduce the effect bowel incontinence has on your life. Your GP or consultant may recommend:

• Using bowel incontinence pads
• Placing special plugs in your bottom to help prevent minor soiling
• If your bowel incontinence is linked to diarrhoea, avoiding high fibre foods, alcohol, caffeine and food and drinks containing sorbitol low-calorie sweetener
• Reducing the risk of irritation and discomfort by keeping the area around your anus clean and dry

Once the underlying cause of your bowel incontinence has been diagnosed, your doctor will decide which treatment is best for you. This may involve:

• Medication to relieve diarrhoea or constipation
• Pelvic floor exercises – a specialist continence nurse or physiotherapist will teach you exercises to improve bowel control
• Bowel retraining – to help you adopt good bowel habits
• Surgery – but this will only be recommended if other treatments have been unsuccessful