Regain Control: Definitions, Causes and Treatments for Fecal/Anal Incontinence

What is fecal/anal incontinence?

Fecal incontinence is the inability to control solid or liquid stool. Anal incontinence is the inability to control gas and mucous in addition to the inability to control stool. Symptoms can range from mild – occasionally leaking stool while passing gas – to severe – a complete loss of bowel control. No matter the severity of symptoms, it’s embarrassing to not be able to make it to the bathroom in time! For this reason, many individuals do not share their symptoms with a health care provider. Instead, they tend to withdraw from work and social activities for fear that they’ll have an accident outside of the comfort of their homes. They often suffer in silence, not knowing that help is available.

What causes anal incontinence?

While anal incontinence can affect all ages and both men and women, it most commonly affects middle-aged and older women. Approximately one out of thirteen women under the age of 60 and one out of seven women over the age of 60 has anal incontinence.

There’s often more than one underlying cause for anal incontinence. Some of them include:

  • Frequent diarrhea or constipation
  • Injury, weakness, or nerve damage to the sphincter muscles (the muscles that are responsible for continence)
    • The sphincter muscles can be injured during childbirth, past rectal surgeries, or other trauma
    • The sphincter muscles weaken with age
    • Certain medical conditions, like diabetes, can cause nerve damage to the sphincter muscles
  • Rectal scarring from ulcerative colitis or Crohn’s disease
  • Surgical removal of the rectum
  • Prolapse
  • Fistula


How is anal incontinence treated?

An appointment with your health care provider can help you determine the best course of treatment based on your individual health and medical history. The treatment plan will often be determined after a series of tests to determine the cause of your incontinence. Treatment may involve a combination of the following:

  • Dietary changes
  • Exercises to help restore muscle strength
  • Physical therapy
  • Medications that change the consistency of the stool or reduce the frequency of bowel movements
  • Surgery


At Virginia Women’s Center, our urogynecologist, Dr. Tovia Smith, and her staff work to find the best individualized treatment plan for women who are suffering from anal incontinence.


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