- Anal incontinence—Involuntary passage of stool and/or gas related to anal sphincter dysfunction.
- Overflow incontinence—Liquid stool moving around a mass of stool filling the rectum, which then leaks out of the anus.
- Passive incontinence—Passage of stool without sensation of needing to go to the bathroom.
- Urge incontinence—Inability to delay having a bowel movement.
- Structural defects in the anorectal area, which may be present at birth or acquired during life, that reduce bowel function
- Weak muscles in the rectum and pelvic floor, which can occur during aging, that reduce the ability to control bowel movements
- Constipation—back-up of stool increases rectal volume and decreases rectal sensitivity, causing liquid stool to leak out the anus
- Diarrhea—liquid stool is more difficult to hold
- Intestinal disease, such as inflammatory bowel disease can result in liquid stool, poor rectal function, or reduced rectal capacity
- Anorectal disorders, such as rectal prolapse, hemorrhoids, fistula, fissure or cancer, may interfere with bowel function
- Nervous system disorders—affect sensitivity and/or interfere with nerve signals between the anorectal region and the brain
- Trauma or surgery resulting in rectal scarring, which can interfer with anal sphincter tone
- Structural, muscular, or nerve deficits present from birth
- Disorders that affect nerve function, such as stroke or multiple sclerosis
- Taking medications that may affect anal sphincter tone, sensitivity, or cause diarrhea or constipation
- Intestinal diseases that can affect bowel health, bowel function, and bowel habits
- Infections that cause severe diarrhea, such as cholera
- Radiation therapy, which may cause scarring of the rectum
- Complications from medical procedures or anorectal surgery
- Trauma from vaginal childbirth
|Rectal Prolapse—The rectum falls through the anal opening.|
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- Fiber supplements
- Stool softeners
- Bulking agents that absorb water and form stool, such as fiber supplements
- Antidiarrheals, such as loperamide or diphenoxylate
- Medications to treat infection
- Medications to improve anal sphincter muscle tone
- Bile acid sequestrants that absorb excess bile salts before they reach the large intestine to reduce loose stools in people with previous surgery to remove the gallbladder or a section of the small intestine
- Bulking agents, such as collagen or stablized hyaluronic acid, can be directly injected into perianal area. These generally have short-term results and may need to be repeated.
- Surgical repair of the anal sphincter
- Inserting an artificial bowel sphincter that you can open and close as needed
- Colostomy for severe cases—disconnects the colon and brings the end through an opening in the abdomen called a stoma
- Radiofrequency energy delivery—Temperature-controlled radio energy is delivered during anoscopy to change the muscular structure of the anal canal. It is not clear how effective this treatment is over a long period of time.
- Vaginally-inserted balloon—A balloon placed in the vagina can be inflated as needed to increase pressure on the adjacent rectal area.
- Anal plugs—Some find success with this method, but they are generally not well-tolerated.
- Prevent constipation by eating a high-fiber diet and drinking plenty of fluids.
- Pay attention to your diet and avoid foods that trigger diarrhea.
- Treat chronic health conditions as advised.
- Try to maintain a regular bowel movement schedule.
- Talk to your doctor if you are having trouble with diarrhea or constipation.
International Foundation for Functional Gastrointestinal Disorders http://www.iffgd.org
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov
Canadian Digestive Health Foundation http://www.cdhf.ca
Canadian Society of Intestinal Research http://www.badgut.org
Fargo MV, Latimer KM. Evaluation and management of common anorectal conditions. Am Fam Physician. 2012;85(6):624-630.
Fecal incontinence. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/fecal-incontinence/Pages/facts.aspx. Updated November 25, 2013. Accessed September 25, 2015.
Fecal incontinence in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 28, 2015. Accessed September 25, 2015.
Garg, P, Song J, Bhatia A, Kalia H, Menon G. The efficacy of anal fistula plug in fistula-in-ano: a systematic review. Colorectal Diseases. 2010;12(10):965-970.
Rectal prolapse. American Society of Colon & Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/rectal-prolapse. Accessed September 25, 2015.
12/4/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Deutekom M, Dobben A. Plugs for containing fecal incontinence. Cochrane Database Syst Rev. 2009;(4):CD005086.
11/5/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Pannu HK, Glanc P, et al. ACR Appropriateness Criteria pelvic floor dysfunction. National Guideline Clearinghouse website. Available at: http://www.guideline.gov/content.aspx?id=48295#Section420. Accessed September 25, 2015.
7/21/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Paquette IM, Varma MG, Kaiser AM, Steele SR, Rafferty JF. American Society of Colon and Rectal Surgeons (ASCRS) clinical practice guideline on treatment of fecal incontinence. Available at: https://www.fascrs.org/sites/default/files/downloads/publication/clinical%5Fpractice%5Fguideline%5Ffor%5Fthe%5Ftreatment%5Fof%5Ffecal%5Fincontinence.pdf. Updated 2015. Accessed September 25, 2015.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014 -
- Update Date: 09/25/2015 -