Bowel incontinence

Last updated 28 March 2017 — Last reviewed 15 January 2014

Bowel leakage, also called bowel incontinence, can be a very embarrassing topic to discuss. Many women experience bowel leakage at some time in their life. What is normal, what are the causes, how is it diagnosed and what can you do to prevent and manage bowel incontinence?

What is bowel incontinence?

Toilet paper

Bowel incontinence is the accidental or involuntary leakage of faeces (also called stools or poo) or wind. This is commonly caused by constipation but may also be associated with diarrhoea, and can happen to anyone at any age.

What is the normal frequency for bowel movements?

Normal frequency of emptying the bowel when you are healthy could be anything from three times a day to three times a week.

What causes bowel incontinence?

Incontinence can result from having weakened muscles in the pelvic floor and around the anus. This could be as a result of having chronic or constant constipation, after having children and from some medical illnesses. 

Diagnosis

female pelvic floorEven though it is quite common, many women are embarrassed to talk to their doctor about bowel weakness or are unsure about what incontinence is.

If you are worried about leakage, try to tell your doctor what's happening no matter how trivial you think it is.

Bowel weakness can be diagnosed by:

Diagnostic approach What to expect
Medical history

Your doctor may ask you questions about:

  • how often you leak faeces
  • when the leakage of faeces occurs
  • whether there is any burning sensation
  • how often you have a bowel movement
  • whether you have constipation and how long this has been happening
  • your daily fluid intake
  • respiratory conditions that cause you to cough often
  • how often you lift heavy weights
  • any surgery that might have contributed to the symptoms
  • medications you are taking
Physical examination

The physical examination will assess:

  • the strength of your pelvic floor muscles
  • whether there is any bulging of the bowel into the vagina (prolapse), or rectocele (rectal prolapse)
  • whether there is any other form of prolapse
Anal manometry A test of your anal reflexes and sensations where a small balloon-like device is placed in the anus and then inflated.
Anal and rectal ultrasound An ultrasound is used to provide an image of the rectum, the sphincter muscles and surrounding tissue.

Preventing & managing

You can prevent and manage incontinence with a number of simple dietary and lifestyle actions.

Water Drink 6-8 glasses of water per day (more if the weather is hot or if you are exercising). Not drinking enough water makes stools hard, dry and difficult to pass, which increases the strain on the pelvic floor muscles.
Caffeine and alcohol Cut down on caffeinated drinks, carbonated beverages and alcohol as they can worsen symptoms by making you need to urinate soon after eating or drinking.
Food

To avoid constipation and the strain on the pelvic floor muscles:

  • eat each day:
    • 2 serves of fruit
    • 5 serves of vegetables
    • 5 serves of cereals/breads
  • replace refined grains such as white flour with wholegrains such as wholemeal flour
  • include legumes such as kidney beans and lentils
  • eat wholegrain cereals or oats for breakfast
  • try including seeds in your diet such as pumpkin, flax, sunflower
Physical activity Be physically active as this stimulates movement of the bowel: aim for 30 minutes of moderate physical activity most days of the week, preferably in the morning to get your bowels moving.
Pelvic floor exercises Do pelvic floor exercises regularly to strengthen your muscles.
Lifting

Lift in the correct manner to reduce strain on your pelvic floor

Coughing Quit smoking as chronic coughing associated with smoking can weaken your pelvic floor – for help call the Quitline on 13 7848 or visit quit.org.au  
Visit your doctor if you have ongoing respiratory problems that cause you to cough.

Toilet habits

  • Go only when you have the urge to go
  • Avoid the habit of going to the toilet 'just in case'
  • Sit down properly with your feet firmly supported to fully relax your pelvic floor and sphincter muscles
  • Don't strain 

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at January 2014.

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