Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called bowel incontinence, fecal incontinence can range from an occasional leakage of stool while passing gas to a complete loss of bowel control.

Common causes of fecal incontinence include constipation, diarrhea, and muscle or nerve damage. The condition may be due to a weakened anal sphincter associated with aging. Fecal incontinence can also occur as a result of childbirth. Injury to the nerves and muscles of the rectum and anus while giving birth can cause a woman to lose control of her bowel movements.

• constipation
• Diarrhea
• Gas and gas pains
• Incontinence, bowel
• Incontinence, fecal
• Incontinence, urinary

Babies, of course, are incontinent until toilet-trained. Although fecal incontinence affects people of all ages, this condition is more common in women and in older adults of both sexes.

Fecal incontinence may be a source of embarrassment. It may cause you to stay at home and withdraw from social events. But don't shy away from talking to your doctor about it. Many treatments - some of which are very simple - are available that can improve, if not correct, incontinence.

Signs and symptoms

Most of us take for granted that we can control our bowels. We generally don't have "accidents" unless we have a short-lived bout of diarrhea.

But that's not the case for people with recurring, or chronic, fecal incontinence. They can't control the passage of gas or stools, which may be liquid or solid, from their bowels. And they often don't make it to the toilet in time to avoid an accident.

For some people including children, fecal incontinence is a relatively minor problem, limited to occasional soiling of their underwear. For others, the condition can be devastating due to a complete lack of bowel control.

Fecal incontinence may be accompanied by other bowel troubles, such as:

• Abdominal cramping
• Bloating
• constipation
• Diarrhea
• Gas and gas pains

Causes

Your body's digestive tract begins at your mouth and nears its end at your rectum, the lower portion of the large intestine. Your digestive tract contains a complex system of organs that convey the food you eat, convert it into energy and remove waste that your body can't digest.

As food waste passes through the upper portion of your large intestine (colon), your body absorbs nearly all of the water from the waste. The remaining residue, called stool, is usually soft but formed and comprises undigested foods, unabsorbed water, bacteria, mucus and dead cells.

Sphincter muscles, external and internal, in your anus — a short canal that's the outlet for your rectum — serve as the final valve. As your rectal walls stretch, they signal the need to release stool. As your sphincter muscles relax, your rectal walls contract to increase pressure. Sometimes, you have to exert pressure from your abdominal muscles, which put pressure on the outside of your colon and rectum. With this coordination of muscles and also nerves, stool is expelled through the anus.

Your digestive tract contains a complex system of organs that convey the food you eat, convert it into energy and remove waste that your body can't digest. Sphincter muscles, external and internal, ...

Critical to normal bowel function are:

The ability to hold stool requires the normal function of your rectum, anus and nervous system. In addition, you have to have the physical and psychological capabilities to recognize and appropriately respond to the urge to defecate. If something is wrong with any of these factors, fecal incontinence can occur.

A broad range of conditions and disorders can cause fecal incontinence, including:

• constipation

• Crohn's disease

• Diarrhea

• Hemorrhoids

• Inflammatory bowel disease

• Multiple sclerosis

• Stroke

Fecal incontinence in children
Fecal incontinence can occur at any age — even in children. Newly toilet-trained children simply may not make it to the toilet in time to defecate, soiling their pants. But the most common medical cause of fecal incontinence in the young is constipation, although the problem — known medically as encopresis — can also be due to an underlying condition, including mental retardation or other birth defects.

Constipation and impacted stools aren't uncommon in children. Toilet-trained children often get constipated simply because they refuse to go to the toilet — they're too busy playing, or they're too embarrassed to use a public toilet. The child holds in the stool, the stool hardens, and then the fear of passing the hardened stool keeps him or her from trying to pass it.

A child who is constipated may soil his or her underpants — and try to hide it from others. Soiling happens when liquid stool from farther up in the bowel seeps past the hard stool in the rectum and leaks out.

Risk factors

Fecal incontinence can occur at any age. But it's most common among people older than 65, who sometimes have to cope with a lack of bladder control (urinary incontinence) as well.

Fecal incontinence is more common in women than in men because the condition can be a complication of childbirth. Urinary incontinence also can be a complication of giving birth.

People who have long-standing diabetes or multiple sclerosis — conditions that can damage nerves that help control defecation — may be at risk of fecal incontinence. Fecal incontinence is also often an aspect of late-stage Alzheimer's disease, in which both dementia and nerve damage play a role. In addition, being physically disabled for any number of reasons makes it difficult to reach a toilet in time.

• Alzheimer's disease

• Incontinence, bowel

• Incontinence, fecal
• Incontinence, urinary
• Multiple sclerosis
• Urinary incontinence

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