Fecal Incontinence: The Bottom Line on Why and What to Do

Fecal incontinence, also called bowel incontinence or accidental bowel leakage, is the unintended passing of solid stool, liquid stool or mucus. It may result from diarrhea, constipation, muscle injury, nerve damage, childbirth, surgery or another medical condition. Treatment depends on the cause and may include diet changes, medication, bowel training, pelvic floor therapy, biofeedback, neuromodulation or surgery.

Medically Reviewed: August 8, 2026
Reviewer: Fatima Khan, MD

Fecal incontinence causes and treatment options

Bowel leakage can be difficult to talk about, but it is a medical condition, not a personal failing. It is also more common than many people realize. If it is affecting your daily life, you do not have to simply live with it. Identifying the type and cause is the first step toward finding the right treatment.

Table of Contents

What is fecal incontinence?

Fecal incontinence is the accidental passing of bowel contents from the anus. This may include solid stool, liquid stool, or mucus. Some people experience only occasional staining, while others have more frequent or complete bowel movements they cannot control.

Other terms for fecal incontinence include:

  • Bowel incontinence
  • Accidental bowel leakage
  • Anal incontinence
  • Stool leakage

Fecal incontinence is not the same thing as diarrhea, although diarrhea can cause or worsen leakage. It is also possible for constipation to cause leakage when liquid stool moves around hardened stool in the rectum.

What are the different types of fecal incontinence?

The two most commonly discussed types are urge and passive fecal incontinence.

Urge fecal incontinence

You feel the need to have a bowel movement but cannot hold it long enough to reach a toilet. Urge leakage may be related to loose stool, reduced rectal capacity, muscle weakness, muscle coordination, or nerve problems.

Passive fecal incontinence

Stool or mucus leaks without you noticing it or without a clear sensation that you need to use the bathroom. This may be associated with changes in sensation, nerve function, or the muscles that keep the anus closed.

Some people have features of both types. Others experience fecal seepage after a bowel movement or leakage related to incomplete emptying. Because these patterns can have different causes, describing exactly what happens can help a healthcare professional determine the appropriate evaluation.

How common is fecal incontinence?

Fecal incontinence affects women and men of many ages, although it becomes more common with age. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that it affects approximately 7% to 15% of adults who live outside hospitals or nursing homes.

The true number may be higher because many people feel embarrassed and do not mention bowel leakage to a healthcare provider. Women may develop symptoms following pregnancy or vaginal delivery, but fecal incontinence is not exclusively a women’s condition. Men can also experience it because of bowel disorders, nerve problems, surgery, aging, or other causes.

What causes bowel leakage?

Fecal incontinence is a symptom with several possible causes. More than one factor may be involved.

Diarrhea

Loose or watery stool fills the rectum quickly and is more difficult to hold than formed stool. Diarrhea is a common risk factor for bowel leakage and may be related to an infection, medication, irritable bowel syndrome, inflammatory bowel disease, food intolerance, or another digestive condition.

Constipation

Large or hardened stool can stretch and weaken the rectum. Liquid stool may then leak around the blockage. Repeated straining may also affect the nerves and muscles involved in bowel control.

Muscle injury or weakness

The anal sphincter and pelvic floor muscles work together to help maintain bowel control. The pelvic floor is also involved in urinary continence, which is why weakness in these muscles can contribute to both bladder and bowel leakage. These muscles may be injured or weakened by vaginal childbirth, pelvic or rectal surgery, trauma, or age-related changes.

Nerve damage or reduced sensation

Nerves help you sense when the rectum is full and control the muscles used to hold and release stool. Diabetes, multiple sclerosis, Parkinson’s disease, stroke, spinal cord injury, chronic straining, and other neurologic conditions may interfere with these signals.

Changes in the rectum or surrounding anatomy

Rectal prolapse, rectocele, hemorrhoids, inflammation, scar tissue, radiation treatment, and previous surgery may affect storage, sensation, emptying, or closure.

Childbirth

Vaginal delivery can injure the anal sphincter, pelvic floor muscles, or nearby nerves. The risk may be greater following a large baby, forceps-assisted delivery, vacuum-assisted delivery, significant tearing, or an episiotomy. Symptoms may begin soon after delivery or become noticeable years later as tissues and muscles change.

How is fecal incontinence diagnosed?

A healthcare professional will usually begin by asking about your symptoms, medical history, medications, diet, previous pregnancies, and any pelvic, anal, or rectal surgery. You may be asked about:

  • How often leakage occurs
  • Whether the stool is solid, liquid, or mucus
  • Whether you feel urgency before it happens
  • Whether leakage occurs without your awareness
  • Constipation, straining, or incomplete emptying
  • Foods, medications, or situations that trigger symptoms
  • Urinary leakage or other pelvic floor symptoms

Keeping a bowel diary for one or two weeks can make this conversation easier. Record the timing of bowel movements, stool consistency, urgency, leakage episodes, food, medication, and possible triggers.

Depending on your symptoms, the evaluation may also include a physical examination or tests that assess the anal sphincter, rectum, nerves, sensation, and muscle coordination. A primary care clinician may refer you to a gastroenterologist, colorectal specialist, urogynecologist, or pelvic floor physical therapist.

What are the treatments for fecal incontinence?

Treatment should address the cause of the leakage rather than follow a single approach for everyone. Many people begin with conservative, nonsurgical care.

TreatmentWhat it may addressWhen it may be considered
Diet and stool managementDiarrhea, constipation, or inconsistent stoolOften a first step
MedicationLoose stool, urgency, or constipationBased on the underlying bowel problem
Bowel trainingIrregular timing or difficulty anticipating bowel movementsAs part of conservative care
Pelvic floor physical therapyMuscle weakness, coordination, or controlWhen pelvic floor function contributes to symptoms
BiofeedbackMuscle coordination, strength, or rectal sensationUsually with professional guidance
Sacral neuromodulationPersistent symptoms that have not responded adequately to conservative treatmentAfter specialist evaluation
Sphincter repair or other surgeryStructural injury, prolapse, or another correctable conditionFor selected patients

Diet and stool management

Improving stool consistency can make bowel movements easier to control. A healthcare professional may recommend gradually adjusting fiber intake, drinking adequate fluids, and identifying foods that trigger loose stool, gas, or constipation. More fiber is not the right answer for every person, so changes should reflect your symptoms and underlying condition.

Medication

Medication may be used to reduce diarrhea, slow bowel movements, improve stool consistency, or treat constipation. Because either diarrhea or constipation can cause leakage, it is important to choose the right treatment rather than self-treating without understanding the cause. Ask a healthcare professional before beginning regular use of an antidiarrheal medicine, laxative, or stool softener.

Bowel training

Bowel training involves developing a more predictable routine for bowel movements, often after meals when the colon is naturally more active. The goal is to improve regularity and reduce unexpected urgency or leakage. A clinician can help tailor the timing and approach.

Can pelvic floor exercises help with bowel leakage?

Pelvic floor muscle training may help some people improve control, particularly when weak or poorly coordinated muscles contribute to their symptoms. These exercises are sometimes called Kegels, but effective bowel-control training may involve more than repeatedly squeezing the muscles.

When weakness is part of the problem, strengthening these muscles can improve the ability to hold stool and maintain continence. These are the same pelvic floor muscles that also contribute to bladder control, which is why pelvic floor strengthening is used in the management of both urinary and fecal incontinence.

The pelvic floor must be able to contract, relax, and coordinate with the anal sphincter and abdominal muscles. Exercising the wrong muscles or using an inappropriate technique may provide little benefit and can sometimes make pelvic floor symptoms worse. A pelvic floor physical therapist can evaluate strength, tension, endurance, sensation, and coordination and recommend exercises for your specific needs.

Pelvic floor therapy, biofeedback, and electrical stimulation

These terms are related, but they do not mean the same thing.

Pelvic floor physical therapy

Pelvic floor therapy is an individualized rehabilitation program. It may include muscle training, relaxation, breathing, bowel-positioning strategies, education, and changes in toileting habits.

Biofeedback

Biofeedback uses sensors to show whether you are contracting or relaxing the intended muscles. It can help improve muscle coordination and, in some cases, awareness of rectal sensations. Sensors may be placed externally or used internally, depending on the system and treatment plan.

Electrical stimulation

Electrical stimulation activates nerves or muscles using controlled electrical signals. Internal electrical-stimulation probes and other stimulation approaches have been studied for fecal incontinence, but the evidence is mixed. They are not interchangeable with pelvic floor exercises, biofeedback, or implanted sacral neuromodulation. A healthcare professional should determine whether any form of stimulation is appropriate.

Elitone uses external neuromuscular electrical stimulation (NMES) to automatically contract and strengthen the pelvic floor muscles. These are the same pelvic floor muscles involved in both urinary and bowel continence.

Elitone is FDA-cleared to treat stress urinary incontinence in women; it is not FDA-cleared as a treatment for fecal incontinence. However, when a healthcare provider recommends Kegel exercises or pelvic floor strengthening because weakness is contributing to bowel leakage, Elitone provides a way to repeatedly activate and strengthen those pelvic floor muscles without an internal probe. Ask your healthcare provider whether pelvic floor strengthening is appropriate for your symptoms.

Elitone stimulates weakened pelvic floor muscles to reduce bladder leakage. Easy. Effective. External

When are procedures or surgery considered?

If conservative treatments do not adequately improve symptoms, a specialist may discuss additional options. The right procedure depends on the cause, severity, previous treatments, and overall health.

Options may include:

  • Sacral neuromodulation: An implanted device sends mild electrical signals to nerves involved in bowel control.
  • Injectable bulking agents: Material is injected into the anal canal to add bulk and may help reduce leakage in selected cases.
  • Sphincteroplasty: Surgery repairs a damaged anal sphincter, often following a recognized muscle injury.
  • Repair of an underlying condition: Rectal prolapse, rectocele, hemorrhoids, or another structural problem may require treatment.
  • Other bowel-management or surgical procedures: These may be considered when symptoms are severe and other treatments have not worked.

Benefits and risks vary. A colorectal specialist can explain which options remain current and appropriate for your condition.

Can urinary and fecal incontinence occur together?

Yes. Some people experience both urinary and fecal incontinence. Bladder and bowel control involve some of the same pelvic floor structures and may share risk factors, including childbirth-related injury, pelvic surgery, muscle dysfunction, nerve damage, and aging.

However, urinary and fecal incontinence are not interchangeable. Urinary leakage may result from stress incontinence, overactive bladder, urinary retention, or another cause, while bowel leakage has its own range of digestive, muscular, neurologic, and structural causes. Each symptom should be evaluated and treated appropriately.

For women who experience both bowel leakage and urinary leakage, identifying the type of urinary incontinence is also important. Elitone treats stress and mixed urinary incontinence by strengthening the pelvic floor. It is cleared for urinary incontinence, not fecal incontinence. However, when pelvic floor weakness contributes to both symptoms, strengthening the pelvic floor may be part of the management plan recommended by a healthcare provider.

When should you talk to a doctor?

Talk to a healthcare professional if you experience bowel leakage, even if it occurs only occasionally. Seek care promptly if symptoms are new, worsening, affecting your daily activities, or accompanied by pain, bleeding, significant changes in bowel habits, unexplained weight loss, weakness, numbness, or loss of bladder control.

Before your appointment, note the frequency of leakage, stool consistency, urgency, triggers, medications, and whether you have difficulty emptying your bowels. Clear information can help your healthcare professional identify the cause and recommend appropriate next steps.

Fecal incontinence is common and can often be improved. Starting the conversation is the first step.

Frequently Asked Questions

Diarrhea means passing loose or watery stool. Fecal incontinence means losing control of stool or mucus. Diarrhea can cause fecal incontinence because loose stool is more difficult to hold, but the conditions are not the same.

Yes. Hardened stool can become lodged in the rectum while liquid stool leaks around it. Chronic constipation and straining may also affect rectal sensation, muscles, and nerves.

Yes. Vaginal delivery can injure the anal sphincter, pelvic floor muscles, or nerves. Some women notice leakage soon after childbirth, while others develop symptoms years later as age-related changes reveal or compound an earlier injury.

It may help when weak pelvic floor muscles contribute to bowel leakage. Pelvic floor exercises such as Kegels strengthen muscles involved in both bowel and bladder control. However, fecal incontinence can also result from nerve damage, stool consistency, structural problems, or overly tight or poorly coordinated muscles, so strengthening is not appropriate for every person.

A primary care clinician can begin the evaluation. Depending on the suspected cause, you may be referred to a gastroenterologist, colorectal surgeon, urogynecologist, neurologist, or pelvic floor physical therapist.

Treatment can often reduce the frequency or severity of leakage. The most effective approach depends on whether symptoms are related to stool consistency, constipation, muscle damage, nerve function, sensation, coordination, or an anatomical condition.

Elitone is FDA-cleared for urinary incontinence, not fecal incontinence. It uses external neuromuscular electrical stimulation to contract and strengthen the pelvic floor muscles. If your healthcare provider has recommended Kegel exercises or pelvic floor strengthening because muscle weakness is contributing to your bowel leakage, ask whether Elitone may be appropriate for helping strengthen those same pelvic floor muscles.

References

This article is intended for educational purposes and is not a substitute for individualized medical advice, diagnosis, or treatment.

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