Bowel incontinence

Alternative names:

fecal incontinence; loss of bowel control; uncontrollable passage of feces

Definition:

The loss of bowel control (involuntary passage of feces). See also urinary incontinence. Fecal incontinence can range from an occassional leakage of stool with the passage of gas, to a complete loss of bowel control.

Considerations:

Among people over the age of 65, women more frequently experience bowel incontinnce with 13 out of every 1,000 women reporting loss of bowel control.

The most common cause of bowel incontinence ironically is constipation. Constipation, causes the muscles of the anus and intestines to stretch and weaken. The weakened muscles will prevent the rectal sphincter from tightly closing thus resulting in leakage of stool. Also, wekened intestinal muscles will further slow down the transit time of the bowels, making it difficult to pass stools and further worsening the constipation. Also, the chronic stretching of the anal and intestinal muscles can also make the nerves of the anus and rectum less responsive to the presence of stool in the rectum.

The ability to hold stool and maintain continence requires normal function of the rectum, anus, and the nervous system. Additionally, the person must possess the physical and psychological ability to recognize and appropriately respond to the urge to defecate.

Problems with incontinence should be reported to the health care provider. Incontinence is not a hopeless situation. Proper treatment can help the majority of people, and often the problem can be eliminated altogether.

Common causes:

• chronic constipation or impacted stool in the rectum leading to diarrhea and stool leakage around the impacted stool (see also encopresis)
• severe diarrhea that overwhelms the ability to control passage of stool
• stress of unfamiliar environment
• decreased awareness of sensation of bowel fullness
• nerve or muscle damage (from stroke, trauma, tumor or radiation)
• emotional disturbance (psychological)
• gynecological, prostate, or rectal surgery
• severe hemorrhoids or rectal prolapse
• colectomy or bowel resection surgery
• chronic laxative abuse

Note: There may be other causes of bowel incontinence. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for bowel incontinence, occurring alone or in combination with other problems.