Faecal Incontinence

What is Faecal Incontinence?

Faecal incontinence is the inability to control your bowels leading to the uncontrollable leaking of faeces (stool / poo) or flatus (gas).

What Causes Faecal Incontinence?

Several factors can lead to faecal incontinence, including:

• Damage or weakness of the pelvic floor muscles, anal sphincters and associated nerves through:
  • Pregnancy and childbirth
  • Surgery
  • Trauma
  • Radiation therapy
  • Straining to make a bowel movement if you have a history of constipation
  • History of some heavy lifting
  • History of respiratory conditions resulting in constant coughing
  • Presence of fistula or haemorrhoids
  • Decreased mobility/lack of exercise
• Some medications
• Medical conditions that affect the nervous system, e.g.Parkinson’s disease and MS
• Medical conditions that affect the bowel, e.g. IBS and Crohn’s disease
• History of Diarrhea
• Blockage of the rectum/anus, e.g. rectal prolapse or faecal impaction
• Lifestyle – diet and fluid ingestion

What are the Symptoms of Faecal Incontinence?

The symptoms of faecal incontinence may include:

• Unintentional leakage of faeces (stool/poo) or flatus (gas) from the anus
• Unintentional faecal staining on clothing, e.g. underwear
• Loose stool consistency
• Change in stool appearance, e.g. colour
• Change in usual toileting routine/bowel movements
• Urinary incontinence

How is Faecal Incontinence Diagnosed?

Usually, a clinical diagnosis can be made using the information you have given based on your medical history, toileting habits, and lifestyle (diet, fluid ingestion, medication and exercise). Occasionally a physical exam may need to be performed. During this examination, your physiotherapist may need to perform an internal exam to assess the position of the organs in the pelvic cavity and the strength and ability of the pelvic floor muscles to activate and coordinate correctly. If further information is required, other tests and investigations can be performed, including using a bowel diary, imaging e.g.ultrasound, colonoscopy. sigmoidoscopy, nerve tests including EMG (electromyograph), as well as other anorectal and colorectal tests. However, these tests will only be performed if required based on your individual presentation.

What Treatments are Available for Faecal Incontinence?

There are many treatments for faecal incontinence that you can achieve through participation in physiotherapy. These treatments can include:

• Education
• Diet recommendations regarding fibre intake
• Recommendations regarding water / fluid consumption
• Recommendations regarding exercise
• Pelvic floor exercise program
• Adjustment of usual toileting habits
• The addition of stool bulking agents

Other Treatments:

A large proportion of people with faecal incontinence will have their symptoms improved or resolved with physiotherapy treatment. However, depending on the cause of your faecal incontinence, you may also need to follow up with your doctor for additional treatment if required, including:

• Medications review/ prescription
• Medical treatment for conditions that may put you at risk of faecal incontinence
• Enemas and suppositories if required
• Potential Surgery

Your physiotherapist will work closely with your doctor to ensure the best possible treatment outcome for you.

What Results Can You Expect?

A large proportion of people with faecal incontinence will have their symptoms improved or resolved with adjustment of lifestyle factors and a pelvic floor exercise program through physiotherapy treatment. However, if left untreated, the problem worsens gradually and may affect other areas, including the pelvic floor and bladder.

Will You Need Surgery?

There is a percentage of people who may not experience enough improvement with physiotherapy treatment alone. This often depends on the underlying cause of faecal incontinence, and as a result, some individuals may need to go on to have surgery to resolve their symptoms.

For more information please consult your physiotherapist with a special interest in pelvic floor conditions.

Related Articles

1. Faecal Incontinence (Men): This article discusses the causes, symptoms, diagnosis, and treatments available for men experiencing faecal incontinence. It emphasises the role of physiotherapy in managing the condition​​.
2. Diastasis Recti (Abdominal Separation): Readers can learn about a condition that may be relevant to those experiencing or at risk of faecal incontinence due to its impact on abdominal muscles​​.
3. Stress Incontinence: This article covers another form of incontinence, providing insight into its relationship with pelvic floor issues, which are also a concern in faecal incontinence​​.
4. Male Pelvic Floor Exercises: Offers insights into the benefits of pelvic floor exercises for men, particularly how they can help manage urinary and faecal incontinence, highlighting the importance of strengthening the pelvic floor muscles​​.
5. Constipation: Since constipation can lead to or exacerbate faecal incontinence by putting pressure on the pelvic floor muscles, an article focusing on this condition would be highly relevant.
6. Pelvic Floor Exercises: An article detailing exercises to strengthen the pelvic floor could provide valuable preventative and management tips for individuals with faecal incontinence.
7. Prolapse: Given the relationship between prolapse and faecal incontinence, due to the weakening of muscles in the pelvic area, an article on this topic would be pertinent.
8. Urge Faecal Incontinence: An article focusing on this specific type of faecal incontinence, exploring its causes, symptoms, and treatment options, would be highly beneficial for readers seeking more detailed information.