Urge faecal incontinence is the sudden need to open your bowels followed by accidental leakage before you can get to the toilet. It is one of several concerns assessed through women’s health physiotherapy, and it can overlap with broader faecal incontinence symptoms.

Many people feel embarrassed by urge faecal incontinence, yet it is more common than many realise. Good assessment matters because bowel urgency, stool consistency, pelvic floor control, and anal sphincter function can all play a part. A physiotherapist may help identify the likely contributors and guide practical treatment.

What is urge faecal incontinence?

Urge faecal incontinence is the involuntary loss of stool or gas after a strong and difficult-to-delay urge to empty your bowels. In many cases, the problem is not just one structure. Pelvic floor muscle timing, anal sphincter strength, stool consistency, rectal sensitivity, bowel habits, and general health can all influence control.

Common symptoms of urge faecal incontinence

Symptoms vary from person to person. Some people leak only occasionally, while others feel worried every time they leave home or exercise. The main feature is urgency that feels hard to control.

What causes urge faecal incontinence?

Urge faecal incontinence may develop when the pelvic floor muscles and anal sphincters do not contract well enough, quickly enough, or in the right sequence to hold back stool. Pregnancy and childbirth are common contributors for women, although bowel conditions, surgery, medication effects, diarrhoea, constipation, and nervous system conditions can also increase risk.

Common contributing factors include:

• pregnancy and childbirth
• pelvic or anorectal surgery
• trauma affecting the pelvic floor or anal sphincters
• constipation and repeated straining
• loose stools or diarrhoea
• poor bowel habits or low physical activity
• neurological conditions such as Parkinson’s disease or multiple sclerosis
• bowel conditions such as IBS or Crohn’s disease
• chronic coughing or repeated heavy lifting
• some medications

How is urge faecal incontinence diagnosed?

Assessment usually starts with a detailed history. Your physiotherapist may ask about urgency, bowel frequency, stool consistency, straining, diet, fluid intake, medications, exercise, childbirth history, and how much the problem affects daily life. A bowel diary is often useful because patterns matter.

A women’s health physiotherapist may also assess pelvic floor muscle control, breathing pattern, abdominal support, and how well the anal sphincter and pelvic floor coordinate. In some cases, your doctor may suggest tests such as anorectal manometry, balloon expulsion testing, colonoscopy, or other anorectal investigations if your presentation needs further clarification.

Can physiotherapy help urge faecal incontinence?

Yes, physiotherapy may help many people with urge faecal incontinence, especially when poor pelvic floor control, urgency, straining habits, or lifestyle factors are contributing. Treatment often combines pelvic floor retraining, bowel habit advice, and practical changes rather than relying on one strategy alone.

Conservative management is also consistent with broader bowel care guidance, which commonly includes diet review, bowel routine advice, pelvic floor training, stool-bulking strategies, and selected medical support where needed. Healthdirect’s overview of faecal incontinence and NICE guidance on adult management both reflect this broader conservative approach.

Treatment for urge faecal incontinence

Treatment depends on the main drivers of your symptoms. A physiotherapist may recommend a program that aims to improve squeeze strength, improve fast contraction timing when urgency hits, reduce straining, and improve your confidence with bowel control.

Treatment may include:

• education about bowel control and urgency
• pelvic floor exercises and anal sphincter retraining
• bowel habit retraining and toilet positioning advice
• diet and fibre guidance
• fluid intake review
• exercise advice to support overall bowel health
• strategies to reduce constipation or loose stool triggers
• coordination retraining and, where appropriate, referral for further medical review

If stool consistency is a major issue, symptoms may also overlap with constipation or urgency presentations such as overactive bladder and urge incontinence. These related patterns are worth assessing because bowel and bladder symptoms often influence each other.

When should you seek professional help?

You should seek help if bowel leakage is recurring, getting worse, affecting your confidence, changing your exercise habits, or causing hygiene and skin issues. Early assessment is also sensible if symptoms began after childbirth, surgery, or a clear change in bowel habits.

Medical review is particularly important if you notice unexplained weight loss, rectal bleeding, severe pain, new neurological symptoms, or major bowel habit changes. A physiotherapist can work alongside your GP or specialist when further investigation is needed.

Related women’s health physiotherapy pages

• Women’s Health Physiotherapy
• Faecal Incontinence
• Constipation
• Stress Incontinence
• Overactive Bladder (OAB) & Urge Incontinence
• Women’s Health Physiotherapy Appointment FAQs

FAQs about urge faecal incontinence

Is urge faecal incontinence the same as general faecal incontinence?

Not exactly. Faecal incontinence is the broader term for accidental bowel leakage. Urge faecal incontinence is a subtype where the key problem is a sudden, strong urge that is difficult to delay. Some people mainly have urgency-related leakage, while others leak without much warning or have mixed symptoms.

What causes urge faecal incontinence after childbirth?

Childbirth may stretch or injure the pelvic floor muscles, anal sphincters, or nearby nerves. That can reduce bowel control and make it harder to respond quickly when urgency occurs. Symptoms may show up soon after birth or develop later, especially if combined with constipation, straining, heavy lifting, or ongoing pelvic floor weakness.

Can pelvic floor exercises help urge faecal incontinence?

Pelvic floor exercises may help urge faecal incontinence when weak or poorly coordinated pelvic floor and anal sphincter muscles are part of the problem. Technique matters, though. Many people benefit most when exercises are combined with bowel habit changes, stool management, and personalised coaching rather than generic squeezing alone.

Do I need surgery for urge faecal incontinence?

Not always. Many people improve with conservative treatment first, especially when stool consistency, bowel routine, pelvic floor timing, and lifestyle factors are addressed well. Surgery is usually considered only when symptoms remain significant, structural damage is more severe, or medical and physiotherapy options have not provided enough improvement.

Should I see a women’s health physiotherapist or my doctor first?

Either can be a sensible first step. A women’s health physiotherapist can assess pelvic floor control, bowel habits, and related movement factors. Your doctor may help screen for bowel disease, medication issues, or the need for further testing. In many cases, the best results come when both work together.

Can urge faecal incontinence affect bladder control too?

Yes. Bowel and bladder symptoms often overlap because they share pelvic floor support, timing, and pressure-management demands. Some people with urge faecal incontinence also have urinary urgency, leakage, or reduced pelvic floor coordination. That is one reason a broader pelvic floor assessment can be helpful.

What to do next

If urge faecal incontinence is affecting your confidence, exercise, work, or everyday routine, the next step is a proper assessment. A women’s health physiotherapist can help work out whether pelvic floor control, bowel habits, stool consistency, childbirth history, or another factor is driving your symptoms.

Early guidance may help you avoid guesswork and focus on the treatment strategies most likely to suit your situation.

References

1. 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.
2. Dexter E, Chapman AE, McCourtney JS, et al. Faecal incontinence—a comprehensive review. Front Surg. 2024;11:1340720. doi:10.3389/fsurg.2024.1340720.
3. Sjödahl J, Walter SA, Johansson E, Hallböök O. Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women: a randomized controlled trial. Scand J Gastroenterol. 2015;50(8):965-974. doi:10.3109/00365521.2015.1027266.