Bowel Incontinence (Stool Leakage)
Bowel (or stool) incontinence is loss of control of your bowels, allowing stool (poop) to leak out. The bowels are organs that move and hold stool until you’re ready to have a bowel movement. Even though bowel incontinence isn’t as common as bladder incontinence, it’s more common than most people think. People might not tell their doctor because they’re ashamed or embarrassed.
Bowel incontinence may also be called fecal or stool incontinence.
What causes bowel incontinence?
Common causes of bowel incontinence in people with cancer include:
- Tumors in or near the colon, rectum, or anus
- Radiation or surgery near the bowel or rectum
- Damage to the muscles or nerves in the bowel
- Constipation and diarrhea
- Rectal prolapse (when the rectum drops outside the body)
Types of bowel incontinence
There are two types of bowel incontinence:
- Urge incontinence is when you feel like you have to move your bowels (poop), but you can’t hold it long enough to get to a toilet.
- Passive incontinence is when you don’t get any feeling that you have to poop. You have no control over when you lose your bowels.
Symptoms of bowel incontinence
The symptoms of bowel incontinence usually depend on the type and cause of incontinence.
Some common symptoms include:
- Not being able to control gas or stool.
- Soiling yourself before you realize you need to go to the bathroom
- Urges to move your bowels that you can't control.
- Leaking liquid stool or mucus, also known as soiling.
Call 911 or go to the emergency room
- If you have bleeding from your rectum that won’t stop
- If you have sudden, intense belly pain that won’t stop
Treatment for bowel incontinence
Bowel incontinence can last a short or long time depending on what's causing it. This can make daily life hard to manage and affect your mental wellbeing.
Bowel routine
Bowel training involves creating a daily schedule of times you’ll try to have a bowel movement (even when you don’t feel like you need to). You’ll keep track of your bowel movements, if you were able to make it to the bathroom in time, and what you ate or drank beforehand.
Pelvic therapy and biofeedback
Pelvic floor (Kegel) exercises can strengthen the muscles that support the bowel, rectum, and anus. Therapists or nurses trained in pelvic therapy can help you create a plan that is best for you.
Biofeedback uses sensors placed near the anus to show on a screen which pelvic muscles are being exercised. Pelvic therapy done with biofeedback often works better than the exercises alone.
Medicines
Anti-diarrheal medicines can help with some types of bowel incontinence. If you have constipation, taking fiber supplements or stool softeners can help. If your bowel incontinence is related to a treatable condition such as Crohn’s, getting the condition under control will often help relieve incontinence as well.
Always check with your doctor before starting any new medicines or supplements, even if they’re over the counter.
Surgery
Surgery might be an option if bowel incontinence is related to damaged pelvic muscles that can be repaired (such as for hemorrhoids or rectal prolapse).
Tips for managing bowel incontinence
Avoid things that can make incontinence worse
- Alcohol, tobacco, caffeine, and artificial sweeteners can irritate your bowels and make incontinence worse.
- Dairy, spicy foods, sugar, and fried or high-fat foods can also cause or worsen incontinence. Avoid the ones that cause problems for you.
Track your bowel movements
- Use a bowel diary to keep track of your bowel movements, stool, leakage, and other symptoms. Download a free printable bowel diary from the National Association for Continence.
Foods and fluids
- Many people with bowel incontinence have loose stools or diarrhea. If so, add soluble fiber to your diet such as fruits and vegetables.
- Don’t limit your fluid or food intake unless you have been directed by your doctor. This can lead to other problems like dehydration.
Take care of your skin
- If you wear incontinence products, make sure you change or replace them as soon as possible once they are wet. Stool can irritate the skin. There are also creams and lotions to help prevent skin breakdown.
- Use wet wipes (without alcohol or perfumes) to gently clean yourself. Avoid excessive wiping. Apply a moisture barrier cream (such as zinc) to the area around the anus.
Find support
Bowel incontinence can make you feel alone and affect your mental wellbeing. Even though it’s not often talked about, many people struggle with bowel incontinence. Ask about support groups or online forums where you can talk with people who are going through something similar.
Talk to your doctor or cancer care team
If you have:
- New or worsening incontinence
- Cramping, discomfort, or pain when going to the bathroom
- Skin changes or irritation such as redness, sores, or swelling
- Blood in your stool when you go to the bathroom
Ask your doctor or cancer care team what symptoms you should call about right away versus what can wait until office hours. Make sure you know who to contact when the office is closed.
- Written by
- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
American Society of Colon & Rectal Surgeons (ASCRS). Fecal incontinence. Updated 2021. Accessed December 20, 2023. https://fascrs.org/patients/diseases-and-conditions/a-z/fecal-incontinence#
Lembo AJ and Spivak AR. Fecal incontinence in adults: management. UpToDate. UpToDate Inc; 2023. Updated November 2023. Accessed December 20, 2023. https://www.uptodate.com/contents/fecal-incontinence-in-adults-management
Lembo AJ. Patient education: fecal incontinence. UpToDate. UpToDate Inc; 2023. Updated February 2022. Accessed December 20, 2023. https://www.uptodate.com/contents/fecal-incontinence-beyond-the-basics
Robson KM and Lembo AJ. Fecal incontinence in adults: etiology and evaluation. UpToDate. UpToDate Inc; 2023. Updated August 2022. Accessed December 20, 2023. https://www.uptodate.com/contents/fecal-incontinence-in-adults-etiology-and-evaluation
Last Revised: April 22, 2024
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