What is fecal incontinence?
Fecal incontinence can be a difficult, and embarrassing, subject to talk about, even with your doctor. But if you’ve experienced an accidental loss of bowel control, you’re not alone. The U.S. Department of Health and Human Services estimates that almost 18 million adults have fecal incontinence – that’s around one in 12 people. Whether you only experience an occasional loss of control while passing gas, or you have complete loss of bowel function, it’s important to discuss any concerns you may have about bowel control with your doctor.
Understanding bowel control
Most of us don’t give much thought as to how the body gets rid of waste. Yet the process is actually complex, involving several body systems.
Feces are the waste leftover from the body’s digestive process. Digestion begins when you eat food. In the stomach, digestive enzymes mix with food to help break it down. The mixture of food and enzymes then moves into the small intestine where additional enzymes are added, making it possible for most of the food’s nutrients to be absorbed into the bloodstream. In the large intestine (also called the large bowel or colon), water and any remaining nutrients are absorbed and the leftover waste becomes more solid, making it possible for the body to push the waste out of the large intestine into the rectum.
The rectum holds the waste until it’s ready to be expelled from the body. As the rectum fills with waste, nerves within the lining of the rectum send a signal to the brain that it’s time to use the bathroom. Once it’s time for a bowel movement, the muscles (sphincters) that hold in the waste in the rectum relax to allow the waste to leave the body through the anus. The anus is made up of the pelvic floor muscles and two sphincters that push the waste out – or, hold the waste in – until you can reach the bathroom.
Common causes of fecal incontinence
There are several reasons why bowel function may not work normally. Some common causes include the following:
Muscle damage or injury
Damage to either the pelvic floor or the anus sphincters from vaginal childbirth can lead to temporary fecal incontinence after birth or more lasting bowel control issues later in a woman’s life. In fact, women experience fecal incontinence at least twice as often as men. Other injury to those muscles, from cancer or hemorrhoid surgery may also leave the muscles weakened or damaged in both men and women.
The body relies on nerves in the anal sphincter and the rectum to indicate when it’s time to use the bathroom. If these nerves are damaged, whether by childbirth, spinal cord injury, stroke or diseases that affect the nerves like multiple sclerosis or diabetes, it can lead to loss of some, or all, bowel control.
Because diarrhea isn’t as solid, it’s more challenging for the rectum to hold it in.
Hard and/or large stools can make it difficult to push the feces out of the anus. The stool may become lodged in place, while more watery waste leaks past it.
Advancing age is also a risk factor associated with fecal incontinence. As a person ages, his or her muscles involved in controlling bowel movements can become weaker.
Note: These are just a few of the most common causes of fecal incontinence, other health issues and certain diseases can lead to an increased risk of bowel control problems.
Managing fecal incontinence
For day-to-day self-management of fecal incontinence, there are several products that are specially designed to absorb waste while controlling odor.