Faecal incontinence in men is the accidental leakage of stool or gas when bowel control is reduced. It can happen because of pelvic floor weakness, anal sphincter problems, constipation, diarrhoea, nerve changes, or bowel conditions. Our Men’s Health Physiotherapy team assesses the cause and helps guide practical treatment.

Some men also notice related problems such as urinary incontinence, difficulty emptying, or bowel changes linked with constipation. Because bowel leakage can affect confidence, exercise, work, travel, and social activities, early assessment is worthwhile.

Common signs of faecal incontinence in men

Faecal incontinence symptoms vary from mild staining to more obvious leakage. Some men mainly lose control of wind, while others struggle with urgency, loose stool, or seepage after opening their bowels.

• Accidental leakage of stool or gas
• Faecal staining of underwear
• Urgency or not making it to the toilet in time
• Loose stools or frequent bowel motions
• A feeling of incomplete emptying
• Changes in routine, confidence, or social activity
• Associated bladder control symptoms

Quick summary

• Faecal incontinence in men can involve stool leakage, wind leakage, urgency, or seepage
• Common contributors include pelvic floor weakness, constipation, diarrhoea, nerve issues, and prior surgery
• Assessment looks at bowel habits, stool type, urgency, diet, medications, and pelvic floor control
• Physiotherapy may help through pelvic floor rehabilitation, bowel habit advice, and lifestyle changes

Common causes of faecal incontinence in men

Faecal incontinence usually happens when more than one factor affects bowel control. The rectum, anal sphincters, pelvic floor muscles, stool consistency, and nerve supply all need to work together well.

• Weakness or poor coordination of the pelvic floor muscles
• Anal sphincter injury or reduced sphincter strength
• Constipation with overflow leakage
• Loose stool or diarrhoea
• Reduced rectal sensation or urgency control
• Previous anorectal, bowel, or pelvic surgery
• Radiation therapy
• Haemorrhoids, fistulae, or rectal prolapse
• Neurological conditions such as Parkinson’s disease, stroke, or multiple sclerosis
• Bowel conditions such as irritable bowel symptoms or inflammatory bowel disease
• Medication side effects
• Reduced mobility or difficulty getting to the toilet in time

Why bowel leakage happens

Many men with faecal incontinence have a mixed pattern rather than one single problem. For example, constipation can lead to straining and pelvic floor overload, while diarrhoea can make urgency harder to control. In other men, the main issue is reduced anal sphincter strength, altered rectal sensation, or poor coordination between the pelvic floor and bowel emptying.

This is why assessment matters. The right plan for one man may focus on strengthening and male pelvic floor exercises, while another may need bowel habit retraining, stool consistency management, or medical review first.

How is faecal incontinence in men diagnosed?

Diagnosis starts with your history. A physiotherapist will usually ask about stool consistency, urgency, frequency, bowel routine, diet, fluid intake, medications, exercise, past surgery, prostate history, and how much the problem affects your daily life.

Assessment may include pelvic floor and abdominal examination, breathing pattern, posture, and when appropriate, an internal examination with your consent. If more information is needed, your GP or specialist may organise a bowel diary, anorectal testing, ultrasound, colonoscopy, sigmoidoscopy, or nerve studies. For a general medical overview, see Healthdirect’s faecal incontinence guide.

What treatment may help faecal incontinence in men?

Treatment depends on the cause. Conservative care is usually the first step and often combines bowel habit advice, stool consistency management, and pelvic floor rehabilitation.

• Education about your bowel problem and contributing factors
• Advice about fibre intake and stool consistency
• Fluid intake recommendations
• Exercise and activity advice
• Pelvic floor muscle retraining
• Bowel emptying strategies and toilet position changes
• Urgency control strategies
• Breathing and pressure-management advice
• Advice about when to discuss medications or stool-bulking agents with your doctor

Other treatment options

Some men also need GP, colorectal, or gastroenterology review. This may be important if symptoms relate to severe constipation, ongoing diarrhoea, rectal bleeding, significant pain, prolapse, inflammatory bowel disease, neurological disease, or suspected sphincter injury.

Medical treatment may include medication review, treatment of bowel disease, management of constipation or diarrhoea, transanal irrigation, biofeedback-based care, or surgical opinion when conservative treatment is not enough. Men after prostate or pelvic surgery may also benefit from pre and post prostatectomy rehabilitation when pelvic floor control is part of the picture.

When should you seek help?

You should arrange assessment if bowel leakage is recurring, getting worse, affecting confidence, or happening with urgency, constipation, diarrhoea, or bladder symptoms. You should also see your doctor promptly if there is blood in the stool, unexplained weight loss, severe abdominal pain, a major change in bowel habit, or new bowel leakage after surgery or illness.

Related information

• Men’s Health Physiotherapy
• Male Pelvic Floor Exercises
• Urinary Incontinence (Men)
• Constipation (Men)
• Pre & Post Prostatectomy Rehab

People also ask about faecal incontinence in men

Can pelvic floor exercises help faecal incontinence in men?

They may help when reduced pelvic floor or anal sphincter control contributes to leakage. However, not every man needs the same approach. Some need strengthening, while others need better coordination, urgency control, or bowel-emptying advice. Assessment helps match the treatment to the cause.

Can constipation cause faecal incontinence in men?

Yes. Constipation can lead to straining, incomplete emptying, or overflow leakage around impacted stool. In that situation, treating the constipation and improving pelvic floor coordination may be just as important as building strength.

Will faecal incontinence in men need surgery?

Not always. Many men improve with conservative management, especially when the main drivers are stool consistency, pelvic floor dysfunction, urgency, or bowel habit problems. Surgery is usually considered only when there is a structural problem or symptoms do not improve enough with non-surgical care.

Is faecal incontinence in men linked with urinary symptoms?

It can be. The bowel, bladder, pelvic floor, and pressure system work closely together. Some men notice bowel leakage alongside urinary urgency, post-prostate surgery symptoms, or reduced pelvic floor control, which is why combined assessment can be useful.

What to do next

If faecal incontinence in men is affecting your comfort, confidence, work, exercise, or travel, book an assessment with a physiotherapist who has an interest in men’s pelvic floor and bowel health. Early assessment can help identify whether the main issue is stool consistency, urgency, constipation, pelvic floor dysfunction, or another medical factor.

The right plan may include pelvic floor rehabilitation, bowel habit changes, lifestyle advice, and referral for medical investigation when needed.

References

1. Assmann SL, O’Connell PR, Valverde A, et al. Guideline for the diagnosis and treatment of Faecal Incontinence-A UEG/ESCP/ESNM/ESPCG collaboration. United European Gastroenterol J. 2022;10(3):251-286. doi:10.1002/ueg2.12213
2. Todd CL, Johnson EE, Stewart F, et al. Conservative, physical and surgical interventions for managing faecal incontinence and constipation in adults with central neurological diseases. Cochrane Database Syst Rev. 2024;10(10):CD002115. doi:10.1002/14651858.CD002115.pub6
3. Blackett JW, Bharucha AE. Fecal Incontinence in Adults: New Therapies. Am J Gastroenterol. 2025;120(9):2027-2041. doi:10.14309/ajg.0000000000003413