Overview

Bowel incontinence (or faecal incontinence), is when you have difficulties controlling your bowel movements. 

If the muscles in your intestine and the muscles around your bottom (called the anal sphincter muscles), are not working correctly, you may not be able to control your bowel movements properly. This can lead to farts, or liquid or solid poo leaking from your bowel either with or without your awareness or control.

Many people find it embarrassing to talk about their problem and may suffer for many years. Treatment can help so it’s important that you do get medical advice.  

Types of bowel incontinence

There are 2 types of bowel incontinence. 

• Urge incontinence is when you have a sudden urge to have a poo or fart but are unable to hold on until you get to a toilet, resulting in leakage.
• Passive incontinence is when you leak poo or fart without being aware that it is going to happen. 

Your can read more about bowel incontinence on the NHS website. 

Symptoms

Symptoms of bowel incontinence include: 

• poo leaking out, sometimes without your awareness
• runny or watery poo
• difficulty have a poo, or a feeling that your bowels haven't fully emptied   

Causes

Bowel incontinence is a common problem that can affect everyone and all ages. It can happen for a variety of reasons, including: 

• childbirth
• bowel (anal) surgery
• damage to the nerves or muscles in the bowel or rectum (end section of the bowel) that normally control opening your bowels to have a poo
• irritable bowel syndrome (IBS)
• X-ray radiotherapy treatment to the pelvis and bottom (anus)
• diet
• anxiety or stress
• infection
• trauma or injury
• multiple sclerosis
• constipation with diarrhoea
• diabetes 

Bowel incontinence may also happen for no known reason.

Treatment options

Once we recieve your referral, a pelvic floor nurse will contact you to discuss your symptoms. This will help guide the next stage of your care.

Depending on your needs, you may: 

• be referred to the bowel function clinic, where you'll be seen by a nurse or physiotherapist
• have an appointment with a doctor
• be referred for initial tests 

You may also see a consultant to discuss sacral neuromodulation (SNM) or posterior tibial nerve stimulation (PTNS). This is electrical stimulation to the nerves in your bowel, sphincter or leg that control bowel function.  

Surgery

People who have damage to the muscles around their bottom (sphincter), may be offered surgery to repair the sphincter (overlapping sphincteroplasty). 

Some people need surgery to have a stoma (their bowel brought through an opening in the tummy) created, and to use a stoma bag.

Surgery might improve incontinence, but it might need major operations. While results can be good, all major surgery has risks which need to be considered, and some results might not be permanent. These will be discussed with a colorectal surgeon.