What is fecal incontinence?
Fecal incontinence is the inability to control bowel movements, causing leakage of feces or difficulty controlling flatus. Many people who live with fecal incontinence also suffer from urine leakage. Living with both urinary and fecal incontinence is also known as double incontinence. Precise statistics for fecal incontinence and double incontinence are difficult to determine. This is mainly due to the taboos surrounding incontinence and fecal incontinence in particular. However, studies indicate that approximately 8% of the adult population has experienced some degree of fecal incontinence.
What causes fecal incontinence?
In this paragraph, let’s explore some of the many causes of fecal incontinence. Fecal incontinence occurs when the sphincter muscle is no longer able to hold stool. The condition can develop for many different reasons, including muscle or nerve damage, bowel diseases, and chronic constipation. Certain groups, such as older adults, children, and people with neurological or chronic illnesses, may have a higher risk of developing fecal incontinence. Below, we describe the most common causes in more detail to help you better understand how and why fecal incontinence can occur.
Damage to the sphincter muscle
The most common cause is damage or weakening of the anal sphincter muscle. In addition, damage to the nerves that control the anal sphincter muscle, and the pelvic floor can lead to reduced ability to sense the need to use the toilet. This damage can be caused by surgery, childbirth, or congenital disease.
Constipation, hemorrhoids, or rectal prolapse
Fecal incontinence may also be caused by constipation, hemorrhoids, or rectal prolapse. People with dementia, over 65, or with certain diseases, such as nerve damage, diabetes, and multiple sclerosis, have an increased risk of developing bowel incontinence.
However, many treatments are available to improve fecal incontinence and quality of life for those dealing with the condition, so it is important to seek help from health care professionals in a timely manner.
Fecal incontinence in children
Even though fecal incontinence occurs more often in older adults, it can also occur in children. Especially children and young adults with physical and/or mental disabilities may experience fecal incontinence. Children with a non-congenital brain disease or brain damage may struggle with fecal incontinence or double incontinence.
IBS (Irritable Bowel Syndrome), Colitis Ulcerosa, and Morbus Crohn
In addition to people with disabilities and elderly people, fecal incontinence occurs in people with bowel diseases. IBS (Irritable Bowel Syndrome) is a condition without a specific cause for bowel problems, including flatus and diarrhea. Some people also deal with fecal incontinence.
Colitis Ulcerosa and Morbus Crohn are sometimes connected to loss of bowel control. Regarding both Morbus Crohn and Colitis Ulcerosa (which is actually more widespread than Morbus Crohn), there is an inflammation in the small bowel, large bowel, and/or the rectum area.
Obstipation and overflow-diarrhea
Fecal incontinence can also result from obstipation. Obstipation is a severe form of constipation in which a person has difficulty emptying the bowel properly. In the long term, obstipation leads to hard feces and obstipation in the bowels. Sometimes, very soft, liquid feces can pass through. As soft stools are more difficult to control, loss of bowel control can occur. This kind of fecal incontinence is also called overflow diarrhea or paradox diarrhea.
Fecal incontinence can have many causes, and for some people, several factors may contribute at the same time. Understanding the underlying reason is an important first step, as it helps guide the choice of treatment and management. The good news is that fecal incontinence can often be improved with the right support and approach. In the next section, we explore the available solutions and how they can help manage symptoms and improve quality of life.
Solutions for fecal incontinence
The treatment of fecal incontinence depends on the underlying cause and the severity of the symptoms. While some people benefit from simple lifestyle adjustments or targeted exercises, others may need medical treatment, fecal incontinence products, or, in some cases, surgery. In this section, you will find an overview of the most common approaches to treatment for fecal incontinence.
Depending on the cause of fecal incontinence, there are several solutions.
Tips on how to treat fecal incontinence
Tip 1: Consult a physician or specialist
In cases of fecal incontinence, it is recommended to consult a physician or specialist who can recommend lifestyle changes, incontinence products, medication, surgery to repair the sphincter muscle, or, in severe cases, an ostomy.
Tip 2: Physiotherapy
As with involuntary urine leakage, fecal incontinence can be reduced with pelvic floor exercises and physiotherapy. Consult a physiotherapist.
Tip 3: Lifestyle adjustments
If obstipation is the cause, lifestyle adjustments can provide symptom relief. Consuming dietary fiber (i.e., cereals, vegetables, and fruit) and at least two liters of fluids per day can make a big difference. Furthermore, sufficient exercise and time for toilet visits can yield noticeable results.
If lifestyle changes do not yield results, medical treatment may be an option. A physician can prescribe a laxative to treat obstipation. Sometimes a damaged sphincter muscle can be repaired with synthetic materials, or a new sphincter muscle can be created using dynamic gracilis-synthetic constructs.
In some cases, fecal incontinence cannot be treated with surgery or medication, and the outcome may be a stoma, either temporary or permanent.
Tip 4: Choose a product for fecal incontinence
In addition to products for urinary incontinence, there are solutions specifically designed for fecal or double incontinence.
Residents or patients living with fecal incontinence may experience concern about leakage or unpleasant odors. This can affect confidence, limit mobility, and lead to social withdrawal. Choosing a product designed specifically for fecal incontinence can help provide secure containment and effective odor control, supporting greater comfort and discretion in daily life.
In some cases, a physician may also recommend additional supportive solutions, such as an anal tampon. These may be appropriate for individuals who experience frequent daytime fecal leakage but are not recommended in cases of overflow diarrhea.
Regardless of the approach, proper assessment and individualized guidance are essential when managing fecal incontinence. At ABENA, we believe continence care should always be based on knowledge and professional expertise. By combining the right products with the right approach, it is possible to reduce discomfort, minimize worry, and improve quality of life for both users and caregivers.