Incontinence, bowel

Overview

Incontinence, bowel
Incontinence, bowel

Bowel incontinence is when you cannot control when you poo. See a GP if you think you have bowel incontinence as there are treatments that can help.

Check if you have bowel incontinence

You might have bowel incontinence if you cannot control when you poo. Symptoms of bowel incontinence include:

  • poo leaking out without you being able to stop it
  • feeling like you need to poo, but not being able to get to the toilet in time
  • not being able to get fully clean after going to the toilet
  • seeing streaks or stains of poo in your underwear

See a GP if:

  • you think you have bowel incontinence
  • you have any changes in your poo that are not getting better, such as having softer poo, diarrhoea or constipation that is not usual for you

Try not to be embarrassed. The doctor will be used to talking about these symptoms.

Ask for an urgent GP appointment or get help from NHS 111 Wales if:

  • your poo is black or dark red
  • you have bloody diarrhoea

How bowel incontinence is diagnosed

If a GP thinks you might have bowel incontinence they:

  • will talk to you about your symptoms
  • might ask to examine you by feeling your tummy (abdomen) and feeling inside your bottom with a finger (they'll be wearing gloves)
  • might ask you to give a poo sample

They might refer you to a specialist for more tests such as:

  • blood tests
  • colonoscopy (a test to check inside your bowels using a thin, flexible tube with a small camera inside it)
  • an ultrasound scan

Treatment for bowel incontinence

The treatment you have for bowel incontinence will depend on what's causing your symptoms and how severe they are.

Treatment from a GP

A GP might recommend:

  • a review of your diet and any medicines you take
  • medicines to make you poo less often or medicines to soften your poo (laxatives)
  • incontinence pads or pants
  • plugs that go inside your bottom

If these things do not help, they might refer you to a specialist service.

Treatment from a specialist service

A specialist incontinence service can:

  • review your diet and any medicines you take
  • recommend exercises to strengthen your pelvic floor and your bottom
  • recommend techniques to help empty the lower part of your bowels

If these things do not help, you might be referred for surgery.

Surgery for bowel incontinence

You may have surgery if other treatments have not helped or your symptoms are severe.

Surgery can include:

  • repairing your muscles in your bottom that control when you poo (anal sphincter)
  • making a new anal sphincter using muscle taken from your thigh
  • putting an artificial sphincter in your bottom, so you can control when you poo
  • putting a small device under your skin in your bottom that uses electrical pulses to help you control when you poo
  • having a small tube (catheter) put into your tummy through a small hole to flush water through, which helps empty your bowels
  • making a small opening in your tummy (stoma) to attach a pouch to collect your poo

The surgeon will explain the risks and benefits of the operation, and what will happen.

Support if you have bowel incontinence

Support from charities

There are national charities that can offer support and information about bowel incontinence.

Bladder & Bowel Community

Information and support for people with bladder and bowel conditions.

Bladder & Bowel UK

Information and support for people with bladder and bowel conditions.

Get a RADAR key

RADAR keys unlock lots of accessible public toilets in places like cafés, restaurants and shopping centres.

It might help to get one, so you can easily access a toilet when you're in public. You can usually get one from a charity.

Causes of bowel incontinence

Bowel incontinence can happen for lots of reasons and is common. Try not to be embarrassed.

You may get it for reasons such as if you:

  • eat certain foods or drinks, for example spicy foods or drinks with caffeine in them
  • have weaker muscles around your bottom – this can happen as you get older or because of things like hormonal changes or childbirth
  • have a health condition that affects your digestive system such as constipation, irritable bowel syndrome (IBS) or Crohn's disease
  • have a health condition that makes you less aware of when you need to poo, such as dementia, a learning disability, a stroke or damage to the nerves in your spine

It can be a result of more than one of these things.

Children can also get bowel incontinence. Sometimes they avoid going to the toilet, which means their poo hardens and runny poo leaks out, or they do not make it to the toilet in time.

Treatment

There are lots of treatments for bowel incontinence that can help reduce the impact it has on your life.

Don't try to deal with it by yourself. The best treatments depend on what the underlying problem is, so see a GP to help find out the cause.

Incontinence products

Continence products can help stop you soiling your clothes. They may be available on the NHS, or you may have to pay for them.

Products that can help include:

  • foam plugs you put in your bottom to prevent leaks
  • pads you wear inside your underwear
  • a special key (Radar key) that can help you access public toilets

Continence products can be useful as a short-term measure, but they don't deal with the underlying problem and aren't a long-term solution on their own.

Dietary changes

If your incontinence is linked to constipation or diarrhoea, you may be advised to make some changes to your diet.

For example, you can help reduce constipation by:

  • eating more high-fibre foods like fruit, vegetables, beans and wholegrain foods (such as wholemeal bread)
  • drinking plenty of fluids, especially water

You can help reduce diarrhoea by:

  • cutting down on high-fibre foods
  • avoiding alcohol and caffeine (such as tea and coffee)
  • avoiding products that contain a sweetener called sorbitol

Medicines

You may sometimes be prescribed medicine to reduce incontinence, such as:

  • loperamide to relieve diarrhoea
  • a laxative to ease constipation

These medicines can also be bought from pharmacies, but they're not always suitable if you have incontinence - only try them on the advice of a doctor or continence specialist.

If laxatives don't help your constipation, medicine that you put into your bottom to clear your bowels (an enema) may be recommended.

Pelvic floor exercises

If other treatments haven't helped, you may be referred to a specialist continence service for further treatments, such as pelvic floor exercises.

These are exercises, taught by a physiotherapist or specilist nurse, that can help strengthen the muscles used to control the opening and closing of your bowels.

Read more about pelvic floor exercises for incontinence on the Bladder & Bowel Community website

Sometimes a technique called biofeedback may be used with pelvic floor exercises. You place a small device in your bottom while doing the exercises and it tells you how well you're doing them.

Bowel retraining

A treatment called bowel retraining may sometimes be recommended by a continence specialist.

This is a treatment programme that involves things like:

  • making changes to your diet to reduce constipation or diarrhoea
  • creating a regular routine for going to the toilet – for example, always going after meals
  • learning ways to help you empty your bowels – for example, having a hot drink or changing how you sit on the toilet

Surgery

Surgery for bowel incontinence will only be considered if other treatments don't help.

The aim of surgery is usually to help you have better control over the muscles in your back passage (anus).

Several procedures can be done, including:

  • an operation to repair damaged muscles in your anus (sphincteroplasty)
  • placing a small electronic device under your skin that helps the muscles and nerves in your anus work better (sacral nerve stimulation)
  • injecting a substance (such as silicone) into the muscles in your anus to help make them stronger (injectable bulking agents)

Very occasionally, a procedure called a colostomy may be considered. This is where your bowel is diverted through a hole made in your tummy so your poo can be collected in a bag.



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 04/06/2025 11:01:05