Treatment of Fecal Incontinence
The first step in treating your fecal incontinence is to see a doctor. Your doctor will talk to you about the causes of fecal incontinence and how they can be treated. Simple treatments—such as diet changes, medicines, bowel training, and exercises to strengthen your pelvic floor muscles—can improve symptoms by about 60 percent.5 These treatments can stop fecal incontinence in 1 out of 5 people.5
Your doctor can recommend ways you can help manage and treat your fecal incontinence. Your doctor can also recommend ways to relieve anal discomfort and cope with your fecal incontinence.
You can play an active role in your treatment by talking openly and honestly with your doctor about your symptoms and how well your treatments are working.
How can I manage and treat my fecal incontinence?
You can help manage and treat your fecal incontinence in the following ways.
Wearing absorbent pads
Wearing absorbent pads inside your underwear is the most frequently used treatment for fecal incontinence. For milder forms of fecal incontinence—few bowel leakage accidents, small volumes of stool, or staining of underwear—wearing absorbent pads may make a big difference in your quality of life. Wearing absorbent pads can be combined with other treatments.
Changing what you eat can help prevent or relieve your fecal incontinence. If diarrhea is the problem, your doctor will recommend avoiding foods and drinks that make your diarrhea worse. To find out which foods and drinks make your fecal incontinence better or worse, your doctor may recommend keeping a food diary to track
- what you eat each day
- how much of certain foods you eat
- when you eat
- what symptoms you have
- what types of bowel movements you have, such as diarrhea or constipation
- when your fecal incontinence happens
- which foods or drinks make your fecal incontinence better or worse
Take your food diary to your doctor to talk about the foods and drinks that affect your fecal incontinence.
If constipation or hemorrhoids are causing your fecal incontinence, your doctor may recommend eating more fiber and drinking more liquids. Talk with your doctor or a dietitian about how much fiber and liquids are right for you.
Depending on the cause, over-the-counter medicines can help reduce or relieve your fecal incontinence. If diarrhea is causing your fecal incontinence, your doctor may recommend medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, Kaopectate). If constipation is causing your fecal incontinence, your doctor may recommend laxatives, stool softeners, or fiber supplements such as psyllium (Metamucil) or methylcellulose (Citrucel).
Your doctor may recommend that you train yourself to have bowel movements at certain times of the day, such as after meals. Developing regular bowel movements may take weeks to months to improve fecal incontinence.
Pelvic floor muscle exercises
Pelvic floor muscle exercises, also called Kegel exercises, can improve fecal incontinence symptoms. Tightening and relaxing your pelvic floor muscles many times a day can strengthen the muscles in your anus, pelvic floor, and rectum. Your doctor can help make sure you’re doing the exercises the right way.
How do doctors treat fecal incontinence?
How doctors treat fecal incontinence depends on the cause. Your doctor may recommend one or more of the following treatments:
Biofeedback therapy uses devices to help you learn how to do exercises to strengthen your pelvic floor muscles. This therapy can also help you learn how to
- sense when stool is filling your rectum if you have passive incontinence
- control strong sensations of urgency if you have urge incontinence
Biofeedback therapy can be more effective than learning pelvic floor exercises on your own. Ask your doctor about getting a biofeedback machine or device.
Sacral nerve stimulation
The sacral nerves control the anal sphincters, colon, and rectum. Doctors use sacral nerve stimulation—a type of electrical stimulation—when the nerves are not working properly. For this treatment, your doctor places thin wires under your skin near the sacral nerves, just above the tailbone. A battery-operated device sends mild electrical pulses through the wires to the sacral nerves.
Electrical stimulation of the sacral nerves helps them work properly. The electrical pulses do not hurt. You can turn the electrical stimulation on or off at any time.
If over-the-counter medicines to treat your fecal incontinence aren’t helping your symptoms, your doctor may prescribe prescription medicines that are stronger. These medicines may treat the causes of fecal incontinence, such as irritable bowel syndrome, Crohn’s disease, and ulcerative colitis.
For women with fecal incontinence, your doctor may prescribe a device that inflates a balloon inside your vagina. The balloon puts pressure on the wall of your rectum through the vaginal wall. Pressure on the wall of your rectum keeps stool from passing. After your doctor makes sure the device fits right, you can add or remove air from the device as needed to control the passing of stool.
Nonabsorbable bulking agents
Nonabsorbable bulking agents are substances injected into the wall of your anus to bulk up the tissue around the anus. The bulkier tissues make the opening of your anus narrower so the sphincters are able to close better.
Surgery may be an option for fecal incontinence that fails to improve with other treatments, or for fecal incontinence caused by injuries to the pelvic floor muscles or anal sphincters.
Sphincteroplasty. Sphincteroplasty—the most common fecal incontinence surgery—reconnects the separated ends of an anal sphincter torn by childbirth or another injury.
Artificial anal sphincter. This surgery involves placing a cuff around your anus and implanting a small pump under the skin so that you can inflate or deflate the cuff. Inflating the cuff controls the passage of stool. This surgery is not a common treatment because it may cause side effects.
Colostomy. Colostomy is a surgery in which the colon is brought through an opening in the abdominal wall, and stools are collected in a bag on the outside of the abdomen. Doctors may recommend this surgery as a last resort for the treatment of fecal incontinence. However, this surgery is rarely used to treat fecal incontinence because of the colostomy’s effect on quality of life.
Other surgeries. Doctors may perform other surgeries to treat the causes of fecal incontinence, such as
What should I do about anal discomfort?
Fecal incontinence can cause anal discomfort such as irritation, pain, or itching. You can help relieve anal discomfort by
- washing the anal area after a bowel movement
- changing soiled underwear as soon as possible
- keeping the anal area dry
- using a moisture-barrier cream in the area around your anus
- using nonmedicated powders
- using wicking pads or disposable underwear
- wearing clothes and underwear that let air pass through easily
Talk with your doctor or a health care professional about which moisture-barrier creams and nonmedicated powders are right for you.
How do I cope with my fecal incontinence?
Doing the following can help you cope with your fecal incontinence:
- using the toilet before leaving home
- carrying a bag with cleanup supplies and a change of clothes when leaving the house
- finding public restrooms before one is needed
- wearing absorbent pads inside your underwear
- wearing disposable underwear
- using fecal deodorants—over-the-counter pills that reduce the smell of stool and gas
- taking over-the-counter medicines to help prevent diarrhea before eating in restaurants or at social gatherings
As part of coping with your fecal incontinence, remember that fecal incontinence
- isn't something to be ashamed of—it's simply a medical problem
- can often be treated—a wide range of successful treatments are available
- isn't always a normal part of aging
- won't usually go away on its own—most people need treatment
What should I do if my child has fecal incontinence?
If your child has fecal incontinence and is older than age 4 and toilet trained, you should see a doctor to find out the cause. How the doctor treats your child’s incontinence depends on the cause.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
William E. Whitehead, Ph.D., University of North Carolina School of Medicine