Bowel incontinence, or faecal incontinence, is when you have problems controlling your bowels.

It can be very upsetting and embarrassing, but it's important to get medical advice if you have it because treatment can help.

Signs and symptoms

Bowel incontinence can affect people in different ways.

You may have a problem if:

• you have sudden urges to poo that you cannot control
• you soil yourself without realising you needed the toilet
• you sometimes leak poo - for example, when you fart
• it happens every day or from time to time - a one off "accident" when you're ill with diarrhoea isn't usually a problem
• it's affecting your daily life - for example, it stops you socialising

You may also have other symptoms, such as constipation, diarrhoea, farting or bloating.

When to get medical advice

See a GP if you have difficulty controlling your bowels. Don't be embarrassed about talking to someone about it.

Remember that:

• it's not something to be ashamed of
• it's common and GPs are used to seeing people with it
• it's not something you have to put up with
• it probably won't get better on its own
• it can be treated

Treatments for bowel incontinence

Treatment can help improve incontinence and reduce the impact it has on your life. The best treatment for you depends on what's causing the problem.

Treatments for bowel incontinence include:

• incontinence products - such as pads you wear in your underwear or small plugs you put in your bottom
• changes to your diet - such as avoiding foods that make diarrhoea worse
• medicines to reduce constipation or diarrhoea
• exercises to strengthen the muscles used to control your bowels - called pelvic floor exercises

Surgery may be considered if other treatments do not help.

Causes

There are lots of possible causes of bowel incontinence. Often it's caused by a combination of problems.

Causes of bowel incontinence include:

• severe or long-lasting constipation or diarrhoea
• irritable bowel syndrome (IBS)
• inflammatory bowel disease - such as Crohn's disease
• severe piles (haemorrhoids)
• childbirth or surgery damaging the muscles or nerves you use to control your bowels
• conditions that can affect the nerves in your bottom - such as diabetes, a stroke or spina bifida

Don't try to self-diagnose the cause of your problems. Get medical help so the underlying cause can be identified and treated.

More information

For more advice, information and support, see:

• Bladder and Bowel Community - including more on treatments, ways to cope and patient stories

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.