Faecal incontinence is the accidental leakage of stool or wind when bowel control is reduced. It can happen for several reasons, including pelvic floor weakness, urgency, loose stool, constipation, childbirth-related change, surgery, or nerve dysfunction. This page explains common causes, assessment, and how women’s health physiotherapy may help.

Although faecal incontinence can feel embarrassing, it is common and often manageable. Early advice can help you improve bowel habits, reduce leakage, and address related issues such as stress incontinence, constipation, or pelvic organ prolapse.

What is faecal incontinence?

Faecal incontinence is reduced control over bowel motions or wind. It may happen because the pelvic floor, anal sphincters, rectum, bowel habits, stool consistency, or nerve control are not working well together, and symptoms can range from mild staining to larger leaks.

Some women notice symptoms after pregnancy and childbirth, while others develop problems later due to constipation, bowel urgency, pelvic floor weakness, surgery, radiation therapy, or medical conditions affecting the bowel or nervous system. Some women also have features of urge faecal incontinence, where urgency is the main problem.

What causes faecal incontinence?

Faecal incontinence usually develops when more than one contributing factor is present. Common causes include pelvic floor weakness, anal sphincter injury, reduced rectal sensation, urgency, loose stool, constipation with overflow, and reduced mobility or delayed toileting.

• Pregnancy and childbirth-related muscle or nerve change
• Pelvic floor or anal sphincter weakness
• Constipation, straining, or faecal impaction
• Loose stool, diarrhoea, or irritable bowel patterns
• Surgery, trauma, radiation therapy, fistula, or haemorrhoids
• Neurological conditions such as multiple sclerosis or Parkinson’s disease
• Heavy lifting or chronic coughing that increases repeated pressure
• Reduced activity levels, limited mobility, or poor toilet access

Because bowel control also depends on stool consistency and routine, related problems such as constipation and bladder urgency can affect how severe symptoms feel day to day.

What symptoms can faecal incontinence cause?

Faecal incontinence can cause stool leakage, wind leakage, urgency, staining, and reduced confidence going out or exercising. Symptoms vary depending on whether the main issue is urgency, reduced sensation, loose stool, constipation, pelvic floor weakness, or a structural problem.

• Unintentional leakage of stool or wind
• Faecal staining on underwear
• Urgency or difficulty holding on
• Loose stool consistency or bowel unpredictability
• A change in usual bowel habits
• The feeling of incomplete emptying
• Bladder leakage or pelvic heaviness at the same time

How is faecal incontinence diagnosed?

Faecal incontinence is usually diagnosed from your history, bowel habits, symptom pattern, and a targeted pelvic health assessment. The main aim is to work out why leakage happens, what makes it worse, and whether bowel, pelvic floor, or medical factors are contributing.

Your physiotherapist may ask about stool type, urgency, constipation, diet, fluid intake, medications, childbirth, surgery, and daily activity. An assessment may include posture, breathing, abdominal function, pelvic floor coordination, and, when appropriate and with your consent, an internal pelvic floor examination.

Further investigation can sometimes include bowel diaries, ultrasound, anorectal testing, colonoscopy, sigmoidoscopy, or nerve studies depending on your presentation. For a broader public overview, Healthdirect also provides a useful summary of faecal incontinence.

How can physiotherapy help faecal incontinence?

Physiotherapy may help faecal incontinence by improving pelvic floor coordination, bowel habits, stool control strategies, and confidence with daily activities. Treatment is usually tailored to the reason for leakage rather than using the same exercise plan for everyone.

Your physiotherapist may recommend:

• Education about bowel function and trigger management
• Pelvic floor muscle retraining
• Breathing and pressure management strategies
• Bowel habit advice and toileting posture changes
• Diet and fluid guidance to support stool consistency
• Activity and exercise advice
• Management of straining and constipation risk
• A home program linked with pelvic floor exercises where appropriate

Many people improve with conservative treatment, especially when symptoms are linked to urgency, pelvic floor weakness, postpartum change, stool consistency, or poor bowel habits. If symptoms suggest a more complex medical cause, your physiotherapist may also recommend review by your GP or specialist.

Is surgery needed for faecal incontinence?

Surgery is not always needed for faecal incontinence. Many women improve with conservative treatment first, especially when the problem is linked to pelvic floor weakness, urgency, constipation, or lifestyle factors that can be changed.

However, surgery or medical procedures may be considered when symptoms relate to significant sphincter injury, prolapse, rectal issues, neurological disease, or when good conservative care has not helped enough. Treatment options can also include medication review, bowel-specific medical management, enemas, suppositories, or specialist referral.

When should you seek help for faecal incontinence?

You should seek help for faecal incontinence when leakage is happening more than once, affecting confidence, changing your routine, or occurring with pain, bleeding, major bowel changes, prolapse symptoms, or unexplained weight loss. Early assessment often helps you find the cause faster and start the right treatment sooner.

It is also worth booking if symptoms began after childbirth, pelvic surgery, radiation therapy, worsening prolapse, or if bowel urgency is becoming difficult to control. If symptoms are severe or sudden, speak with your doctor promptly.

Related articles

1. Urge Faecal Incontinence – a closer look at urgency-driven bowel leakage and what treatment may involve.
2. Constipation – constipation can contribute to leakage, straining, and poor bowel emptying.
3. Stress Incontinence – bladder leakage often overlaps with pelvic floor dysfunction.
4. Overactive Bladder (OAB) & Urge Incontinence – urgency can affect both bladder and bowel control.
5. Pelvic Organ Prolapse – prolapse can influence pelvic floor support and bowel symptoms.
6. Pelvic Floor Exercises – learn more about pelvic floor retraining and how it may support bowel and bladder control.
7. Faecal Incontinence (Men) – a related page discussing bowel leakage in men.

Faecal incontinence FAQs

Can pelvic floor exercises help faecal incontinence?

Yes, pelvic floor exercises may help when faecal incontinence is linked to weakness, poor coordination, or reduced support. The best results usually come from an individual assessment, because some people need strengthening while others need better timing, relaxation, bowel habit advice, or stool consistency management.

Is faecal incontinence common after childbirth?

It can happen after childbirth, especially if the pelvic floor or anal sphincter has been stretched or injured. Symptoms may appear soon after birth or later when other factors such as constipation, strain, menopause, or pelvic floor weakness add to the problem.

What is the difference between faecal incontinence and urge faecal incontinence?

Faecal incontinence is the broader term for loss of bowel control. Urge faecal incontinence is a subtype where you feel a strong need to open your bowels but cannot hold on long enough to reach the toilet.

Can constipation cause faecal incontinence?

Yes, constipation can contribute to faecal incontinence. Hard stool may block normal emptying, while softer stool can leak around it. Repeated straining can also affect the pelvic floor and make bowel control harder over time.

Do I need an internal examination?

Not always. Your physiotherapist will first discuss your symptoms, history, and goals. An internal examination is only suggested when it is relevant, helpful, and you give consent. It can provide useful information about pelvic floor strength, coordination, support, and symptom triggers.

Will faecal incontinence go away without treatment?

Some mild symptoms settle if the trigger improves, such as a short episode of diarrhoea. However, ongoing leakage usually needs assessment because untreated pelvic floor weakness, bowel urgency, constipation, or prolapse can continue to affect control and confidence.

What should I do next if I have faecal incontinence?

Start by paying attention to when leakage happens, how your stool is changing, and whether urgency or constipation is part of the problem. Then book an assessment so you can get a clear plan for bowel habits, pelvic floor retraining, and the right next steps.

What to do next

If faecal incontinence is affecting your routine, exercise, confidence, or social life, do not ignore it. A tailored assessment can help identify whether the main issue is urgency, constipation, pelvic floor weakness, stool consistency, or another contributing factor.

Book a women’s health physiotherapy appointment if you want a clear plan for symptom management, pelvic floor retraining, and practical day-to-day strategies.

References

1. National Institute for Health and Care Excellence. Faecal incontinence in adults: management. NICE Clinical Guideline CG49. 2007. Reviewed 2018.
2. Assmann SL, Keszthelyi D, Kleijnen J, 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
3. Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020;5(5):CD007471. doi:10.1002/14651858.CD007471.pub4
4. Dexter E, Walshaw J, Wynn H, et al. Faecal incontinence-a comprehensive review. Front Surg. 2024;11:1340720. doi:10.3389/fsurg.2024.1340720