Let’s Talk About It
What is Faecal Incontinence?
No-one likes to talk about incontinence, yet it’s one of the most common medical issues people face.
Faecal (or bowel) incontinence is the inability to control bowel movements. Severity can range from an occasional leakage of stool while passing gas, to a complete loss of bowel control.
Most adults who experience faecal incontinence only do so during an occasional bout of diarrhoea. However, some people have recurring or chronic faecal incontinence.
There are two typical types of incontinence:
- urge incontinence: the inability to resist the urge to defecate, often being unable to make it to the toilet in time, and
- passive incontinence: a lack of awareness of the need to pass stool.
For an otherwise healthy person, faecal incontinence can cause significant emotional and psychological distress.
The loss of dignity associated with losing control over your bodily functions can lead to embarrassment, shame, frustration, anger and depression. It’s common for people with faecal incontinence to try to hide the problem or to avoid social engagements.
It can also lead to additional physical issues such as skin irritation. For instance, repeated contact with stool can lead to pain and itching, and may cause sores that require further medical treatment.
Whatever the cause, the important thing is to seek medical advice. Treatments are available that can improve faecal incontinence and your quality of life.
What Can Cause Faecal Incontinence?
For many people, faecal incontinence results from poor bowel control, often due to:
- Muscle damage: injury to the rings of muscle at the end of the rectum (anal sphincter)
- Nerve damage: injury to the nerves that sense stool in the rectum or control the anal sphincter
- Rectal prolapse: occurs when the rectum drops down into the anus, or
- Rectocele (in women): occurs when the rectum protrudes through the vagina.
These conditions can be caused or made worse by a number of factors including:
- age (the incidence of faecal incontinence increases in middle-aged and older adults)
- lifestyle activities, such as: having babies, being overweight or obese, or heavy lifting (especially if the pelvic floor muscles are weak)
- constipation and/or long term straining
- some types of surgery, radiation therapy or medications (including antibiotics, and drugs for arthritis and diabetes)
- existing conditions, such as: hemorrhoids, enlarged skin tags, or fistula-in-ano
- existing illnesses or diseases, such as: Coeliac disease, Crohn’s disease, diabetes, multiple sclerosis or Parkinson’s disease
- physical disability resulting from spinal injuries, stoke, etc, and/or
- dementia (especially late-stage Alzheimer’s disease or dementia)
Incontinence can be linked to many other major health conditions. You should speak to your doctor if you have:
- regular bowel mishaps
- a change in your normal bowel habits
- pain or bleeding from the back passage
- a feeling that your bowel is never quite empty
- dark or black bowel motions, or
- weight loss that you can’t explain.
Faecal incontinence affects up to 20% of men and around 13% of women.
Faecal incontinence is one of the three major causes (along with decreased mobility and dementia) for admittance to a residential aged care facility.