Fecal Incontinence (Bowel Incontinence) in Women

Fecal incontinence—also called bowel incontinence—refers to having a problem controlling your bowel movements. This causes stool (feces) to leak from your rectum because you can’t hold it in. Fecal incontinence can happen once in a while, such as when a small amount of stool leaks out when passing gas, or there may be complete loss of bowel control on a frequent basis.

This condition happens when the nerves and muscles that control the bowel don’t function they way they should. Normally, nerves tell muscles in the rectum and anus when to tighten and when to relax, so you can control when you release stool.

But certain conditions can affect the nerves and muscles that control this function, weakening the ability of the rectum and anus to hold stool. These conditions include diarrhea, constipation, aging, vaginal delivery during childbirth, or anal trauma or surgery. People who strain a lot or who have certain health problems may also experience malfunction in the nerves controlling this part of the body.

In addition, there are conditions including rectal prolapse (when the rectum drops down into the anus) or rectocele (when the rectum protrudes into the vagina) that can cause fecal incontinence.

Fecal incontinence can be stressful and embarrassing to deal with. But your healthcare provider is trained to deal with these issues and can help you manage the problem. It’s important to know that today there are a variety of effective treatments for fecal incontinence that can help improve or restore your ability to control this bodily function. These include lifestyle changes, medications, special exercises, and surgery.

Why Choose Cooper to Diagnose and Treat Fecal Incontinence

Cooper University Health Care has a comprehensive urogynecology program that is on the forefront of care for fecal incontinence in women. Our team of fellowship-trained urogynecologists offers a full range of today’s most advanced diagnostic and treatment services, delivered in a caring, sensitive manner:

  • We have the region’s only pelvic floor physical therapy (PT) program, a specialized form of rehabilitation that focuses on strengthening the pelvic floor, which helps control fecal incontinence
  • If surgery is necessary, we have the region’s only robotic surgery program for treating pelvic floor disorders and fecal incontinence—a minimally invasive approach that results in faster recovery, reduced pain and minimal scarring
  • We are involved in teaching the next generation of urogynecologists through a respected fellowship program—testament to the high level of clinical expertise available here
  • Our urogynecologists are on the forefront of research, giving you access to the latest knowledge and advances in treating fecal incontinence in women

Causes and Risk Factors for Fecal Incontinence in Women

There are many conditions that can affect the nerves and muscles that control the bowel. These include:

  • Diarrhea
  • Constipation
  • Aging (the anal sphincter muscles weaken as you grow older)
  • Vaginal delivery during childbirth, which can damage the nerves and muscles
  • Trauma to the vaginal or rectal area
  • Anal surgery
  • Hemorrhoids
  • Radiation treatment to the anal area (rectal wall tissue can stiffen after treatment)
  • Crohn’s disease (this also can cause rectal wall tissue to stiffen, so excess stool leaks out)
  • Irritable bowel syndrome (IBS) or ulcerative colitis
  • Rectal prolapse (when the rectum bulges into the anus) 
  • Rectocele (when the rectum protrudes into the vagina) 
  • Certain nerve-related diseases including multiple sclerosis, diabetes, stroke, and Alzheimer’s disease
  • Infections, including spinal cord or brain infections
  • Stress
  • Side effects from certain medicines
  • Pelvic floor dysfunction 

Symptoms of Fecal Incontinence in Women

Fecal incontinence or leakage may be a rare occurrence, or it may be chronic (happening frequently). Symptoms include:

  • Being unable to hold in gas
  • Leakage of stool during regular activities or exertion (such as exercise)
  • Being unable to get to the toilet in time when you feel the urge to go
  • Intestinal symptoms such as diarrhea, constipation or abdominal discomfort (cramping, bloating, stomach “gurgling”)

The only time that fecal “accidents” are considered normal is during episodes of severe diarrhea, so it’s important to see your doctor if you experience any of these symptoms.

Treating Fecal Incontinence in Women

Treatment for fecal incontinence depends on what’s causing the condition. It’s reassuring to know that a variety of effective treatments are available today for bowel incontinence. They range from simple lifestyle changes to medications to surgery and include:

  • Dietary changes: Increasing the amount of fiber in your diet can help manage diarrhea and constipation. Drinking plenty of fluids can also ease constipation. Avoiding certain foods that can cause diarrhea (spicy foods, fatty foods, dairy products if you are lactose-intolerant, products with artificial sweeteners) can also help.
  • Kegel exercises: This exercise involves repeatedly contracting and relaxing the muscles of the pelvic floor, which can strengthen the sphincter muscles and help you achieve better bowel control
  • Biofeedback therapy: This involves inserting a pressure-sensitive probe into the anus to register the strength of your anal sphincter, then you practice sphincter contractions and learn to strengthen your own muscles by viewing the scale's readout
  • Medications: There are medicines today that can help control bowel incontinence, and antidiarrheal medicines can help manage diarrhea
  • Bowel retraining: Setting a regular schedule for using the toilet can give you better control. This includes trying to move your bowels at the same time each day.
  • Sacral nerve stimulation: A small device is surgically implanted in the buttock to deliver low-level electrical impulses to the sacral nerves that regulate bowel activity
  • Injection of biomaterials: Silicone-based material is injected into the anal sphincter to narrow the anal canal, improving control
  • Surgery: There are several surgical options for treating conditions that can cause fecal incontinence, including minimally invasive, robotically assisted procedures such as:
    • In women with fecal incontinence due to anal sphincter damage caused by childbirth, a procedure called a sphincteroplasty may be performed to repair it
    • Specialized operations for treating pelvic organ prolapse  including rectocele and rectal prolapse 

Make an Appointment With a Fecal Incontinence Expert at Cooper

To learn more about the resources available for diagnosing and treating fecal incontinence in women at Cooper or to request an appointment, please call 800.8.COOPER (800.826.6737).