Faecal incontinence

Overview

Faecal incontinence is the inability to control bowel movements, leading to the involuntary leaking of stool from the rectum. Common causes include a weak or damaged pelvic floor and sphincter muscles. Neurological problems such as a stroke or dementia can also cause faecal incontinence. Pelvic floor exercises or a change in diet can improve the situation.

Symptoms

• Involuntary leakage of bodily waste

Causes and treatment

Causes

• Faecal incontinence is a symptom rather than a diagnosis

Anatomical causes

• Weak pelvic floor muscles/perineal descent
• Damaged sphincter muscles
  • Difficult births
  • Prolapse of the womb or the rectum
  • Cancer and rectal surgery
  • Advanced haemorrhoids
• Decline in muscular strength in old age
• Chronic inflammation:
• Chronic bowel diseases (ulcerative colitis or Crohn’s disease)
• Abscesses
• Diarrhoea or constipation (overextension)
• Tumours

Neurological problems

• Central control failure
  • Dementia
  • Brain tumour
  • Multiple sclerosis
  • Stroke
• Break in nerve conduction in spinal cord
  • Malformations
  • Spinal cord injury
• Damage to pelvic floor nerves
  • After surgery
  • After radiation of the pelvic floor
  • Advanced diabetes mellitus

Other causes

• Stress
• Medication (e.g. laxatives)

Further treatment by your doctor / in hospital

Possible tests

• Anal examination
• Ultrasound (sonography)
• Measurement of anal pressure
• Colonoscopy with removal of tissue samples
• X-ray imaging using a contrast agent
• CT scan (computed tomography) or MRI (magnetic resonance imaging)

Possible therapies

• Therapy depends on the cause
• Change your diet
• Medication
• Physiotherapy
• Strengthening of sphincter and pelvic floor muscles
• Electrical stimulation / neurostimulation
• Surgery, if necessary
  • Treatment of haemorrhoids or rectal prolapse
  • Reconstruction of sphincter muscle

What can I do myself?

• Pelvic floor exercises
• High-fibre diet
• Sufficient exercise
• Drink enough fluids – especially if constipated
• Make a conscious effort to have bowel movements according to a fixed schedule
• Try out incontinence aids (pads, pants, etc.)
• Body hygiene (change underwear more frequently, shower every day)
• Skincare

When to see a doctor?

• Blood in stool
• Generally after several involuntary bowel movements
• Painful and severely reddened anus, possibly with fever

Further information

Selbsthilfe Schweiz (Self-Help Support Switzerland)
www.selbsthilfeschweiz.ch

Synonyms

faecal incontinence, stool incontinence