What is faecal incontinence?

Faecal incontinence is when you have trouble controlling your bowel. This can mean accidentally doing a poo when you didn’t want to.

As many as 1 in 10 people have poor bowel control. Faecal incontinence is more common as people get older, but young people can experience faecal incontinence too.

What symptoms are related to faecal incontinence?

Symptoms of faecal incontinence can include:

• accidental leaking of wind (farting)
• needing to rush to the toilet to do a poo
• a small amount of leakage of bowel contents (faeces) into your underwear
• being unable to hold onto a poo (liquid or solid)

You may have symptoms rarely, sometimes, or more often.

Many people with faecal incontinence also have urinary incontinence (problems with bladder control).

What causes faecal incontinence?

Faecal incontinence often has several different causes. It can be related to:

• weak pelvic floor muscles (for example, due to previous pregnancy or surgery)
• complications from previous vaginal childbirth
• constipation
• diarrhoea
• other problems with your anus, rectum (back passage) or bowel

Other conditions that can increase your risk of faecal incontinence are:

• conditions that affect your nerves
• dementia
• inflammatory bowel disease
• haemorrhoids
• rectal prolapse
• previous surgery to your bowel, rectum or anus
• previous radiotherapy to your pelvis

You may also have faecal incontinence if you have mobility issues that make it hard to get to the toilet in time.

How is the cause of faecal incontinence diagnosed?

Your doctor will ask about your symptoms and examine you. They will ask about how often you have symptoms and how bad they are.

Your doctor may ask you to keep a diary of your bowel habits. You will list what you eat and drink and how often you poo or have an accident. They will want to know how much your symptoms impact your lifestyle and quality of life.

Your doctor may recommend examining your anus, back passage or bowel with a special instrument called an endoscope. Other tests will depend on your symptoms, exam and health in general.

Depending on the cause of the problem, your doctor might refer you to a specialist or a continence health professional.

When should I see my doctor?

If you are having trouble controlling your bowel, you should see your doctor.

It’s also important to see your doctor if you have any change in your bowel habits or notice blood in your stools (poo).

How is faecal incontinence treated?

Your treatment will depend on the cause of your faecal incontinence.

Your doctor will also consider all the factors that could be affecting your bowel function, including your:

• general health
• diet
• exercise level
• mobility

Self-care at home

There are some general things you can do to help if you have faecal incontinence.

It’s important to:

• have a good bowel routine
• eat enough fibre
• drink enough fluids

Always go to the toilet when you have the urge to poo. Try not to go ‘just in case’.

When you go to the toilet:

• Sit leaning forward with your elbows on your knees.
• Support your feet on a footstool if needed.
• Don’t hold your breath or strain.

You can also use continence products, such as pads and bedding protection, if needed. Talk to your doctor or nurse continence specialist about what’s available.

Medicines

Some medicines may be prescribed by your doctor to help with certain causes of faecal incontinence. These may include medicines to treat diarrhoea or constipation.

Ask your doctor if there are medicines that may help in your situation.

Other treatment options

Physiotherapy can help if the problem is caused or made worse by weak pelvic floor muscles.

In some cases, surgery may be recommended to help treat faecal incontinence.

Can faecal incontinence be prevented?

There are some things you can do to reduce your risk of faecal incontinence. These include:

• Drinking plenty of fluids every day unless your doctor tells you not to.
• Eating a healthy diet containing plenty of fibre.
• Making sure you’re not overweight.
• Doing enough physical activity.
• Quitting smoking and vaping.

Complications of faecal incontinence

Some of the complications of faecal incontinence include:

• local skin irritation
• problems with self-esteem
• anxiety
• depression

Talk with your doctor or continence nurse if you need emotional or psychological support. There are also support groups for people with incontinence — see below.

Resources and support

The Continence Foundation of Australia has information and support for people with incontinence, including:

• Easy to understand booklets.
• Resources for Aboriginal and/or Torres Strait Islander people.
• Incontinence information in other languages.
• Incontinence in Confidence, which offers advice and support for young people with incontinence.
• The National Public Toilet Map, which shows the location of more than 22,000 public toilet facilities across Australia.
• Information about caring for someone with incontinence.

You can call the National Continence Helpline on 1800 33 00 66.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.