Bowel incontinence, also known as fecal incontinence, is when you involuntarily pass stool or gas.

It means you do not have control over your bowels or bowel movements (pooping), and therefore solid or liquid stool (poop) leaks out unexpectedly or even unknowingly.

Not only is stool leakage embarrassing, but it can also be indicative of a larger problem, so it is important to visit your provider to get to the root of the issue and learn how to manage or treat it.

With that being said, let’s go over a few terms you may hear in relation to bowel incontinence.

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A variety of causes can bring on bowel incontinence. It can be life experiences such as surgery, childbirth, diet, or aging; it can also be related to gastrointestinal conditions, nerve damage, or muscle damage. Let’s take a closer look at each of the possible causes one by one:

Muscle Damage

• Anal sphincter damage: The anal sphincter is a muscle that controls the passage of stool. Damage to this muscle (which can occur during childbirth, surgery, or an injury) can lead to incontinence.
• Pelvic floor muscles: The pelvic floor supports the organs in the pelvis. These muscles can be weak, tight, or poorly coordinated—which is known as pelvic floor dysfunction. Weakness in these muscles can contribute to fecal and gas incontinence, especially in people who have had multiple pregnancies and vaginal births.

Nerve Damage

• Neurological disorders: Conditions such as multiple sclerosis, Parkinson’s disease, a spinal cord injury, or stroke can damage the nerves that control the anal sphincter or the sensation in the rectal area.
• Diabetes: Long-standing diabetes can cause nerve damage that affects bowel control.

Structural Changes or Obstructions

• Rectal prolapse: Occurs when a portion of the rectum protrudes through the anus, potentially causing incontinence.
• Rectocele: A bulging of the rectum into the vagina, which can complicate the control over bowel movements.
• Hemorrhoids: While primarily known for causing bleeding and discomfort, hemorrhoids can also interfere with the closure of the anal canal.

Functional Gastrointestinal Disorders

• Irritable bowel syndrome (IBS): IBS can cause episodes of diarrhea or constipation, both of which may lead to incontinence.
• Chronic constipation: Long-term constipation can lead to overflow incontinence, where liquid stool leaks past blockages of hard stool.

Other Causes

• Diarrhea: Watery stools are more difficult to hold than solid stools. Therefore, frequent cases of diarrhea can overwhelm the ability of the rectum to hold stool, leading to incontinence.
• Age: Muscle strength and nerve function in the anus and rectum can decrease with age, increasing the risk of incontinence.
• Surgery: Operations on or around the anus or rectum—such as for hemorrhoids, cancer, or inflammatory bowel disease—can lead to temporary or permanent incontinence.
• Childbirth: Especially after a difficult delivery or with the use of forceps, which can cause muscle or nerve damage.

Lifestyle Factors

• Diet: Consumption of certain foods and drinks can irritate the digestive system or increase gas production, contributing to incontinence.

While your primary provider may recommend dietary changes or medications to help alleviate symptoms of bowel incontinence, you should also consider physical therapy.

Pelvic floor physical therapy can be a fantastic solution for bowel incontinence, as a common cause can be attributed to muscle dysfunction. As mentioned previously, incoordination of the pelvic floor muscles or a lack of control of these muscles can create gas or bowel incontinence.

To help alleviate these issues, your physical therapist will help you regain awareness and function of these muscles. This will include treatments such as neuromuscular re-education and biofeedback.

Additionally, behavioral therapies and activities such as bathroom schedules can help you regain and maintain control of these muscles. Treating pelvic floor dysfunction isn’t just about retraining your muscles, but also identifying bowel habits that may contribute to your symptoms!

Your physical therapist will create an individualized exercise plan that best suits your needs. These exercises can help strengthen your muscles—not just for your pelvic floor, but also the surrounding supportive muscle groups—to allow better control and strength overall.

If you want to know more about physical therapy with Hive Therapy and Wellness, you can explore the following treatment methods:

• Exercise prescription
• Behavioral modifications
• Neuromuscular re-education
• Biofeedback
• Therapeutic activity