Faecal incontinence refers to the leakage of stools. The quantity of leakage may range from smearing on underwear through to complete loss of bowel control. 

There are many different reasons as to why this may occur, and the treatment of faecal incontinence will depend on what is causing it. 

Faecal incontinence can often be better managed. Establishing a regular bowel habit can help – this is often achieved through bowel retraining. Adjusting diet and fluid intake can assist. Some people will benefit from the use of medicines such as laxatives, stool softeners, suppositories, and enemas or medicines to slow the gut. An accurate assessment of bowel function is required to determine the most appropriate form of treatment.   

Types of faecal incontinence include: 

Constipation and Overflow

Constipation can result in a build-up of hard stools in the rectum. If the hard stools remain in the rectum liquid stools may develop behind the blockage. The liquid stools move past the hard stools, resulting in bowel actions that may be explosive. The loose stools may also lead to faecal incontinence. This is referred to as constipation with overflow.  

Neurogenic (nerve damage) faecal incontinence

Damage to the nervous system may affect the ability to recognise when the bowel is full and needs to be emptied. This can include damage to the central nervous system in conditions such as dementia, multiple sclerosis or following a stroke. Damage to the peripheral nervous system damage such as following a spinal cord injury may also affect bowel control.  

Urge incontinence (this may be associated with diarrhoea) 

Faecal urge incontinence occurs when the need to get to the toilet (urge) does not allow for the person to reach the toilet in time. Some neurological conditions can also be associated with faecal urge incontinence. 

It may be associated with diarrhoea due to tummy upset, gastroenteritis, excessive fibre in the diet or laxative consumption when the gut produces a large volume of loose, liquid stools. Faecal urge incontinence may also be a problem following removal of all or part of the large bowel (colon) as the ability to absorb liquid in the bowel is reduced. 

It is much more difficult to “hold on “when stools are liquid and moving through the gut quickly and can lead to inability to reach the toilet on time resulting in faecal urge incontinence. 

This condition may respond to dietary changes to make stools firmer. This will often mean that the gut works a little slower and can be contained in the rectum more easily. Firmer stools also tend to decrease the strong urge sensation that can occur with looser, liquid stools. 

Reducing stress can also assist to make the gut more relaxed. 

Anal incontinence (inability to control passing gas or wind)

Anal incontinence is the term used to describe the involuntary passing of gas (wind) from the back passage. Whilst it is normal and healthy to pass gas it can be embarrassing if this occurs without warning or when it is not controlled. 

Dietary changes to reduce the intake of foods and drinks linked to an increased risk of excessive gas production may help. Pelvic floor muscles exercise may also assist. Please contact us for more information. 

Bowel disease 

Inflammatory bowel conditions such as Crohn’s disease and ulcerative colitis can result in faecal incontinence.  

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Kylie – parent of a child that wets the bed 

Kylie rang our service as she was concerned about her five-year-old daughter, Mia, who was wetting the bed. Kylie had tried limiting Mia’s drinks in the late afternoon and evening and was also getting up at night to wake Mia and take her to the toilet.

Our advisor explained that it may take children until they around 5 ½ years old before they gain bladder control during sleep. Kylie was advised to encourage Mia to drink well throughout the day and was cautioned against cutting out drinks in the afternoon and early evening. Kylie was discouraged from waking Mia at night to take her to the toilet. Kylie was provided with information on obtaining a referral from Mia’s doctor to a bedwetting clinic if Mia continues to wet the bed past 5 ½ years of age.

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Anastasiya’s story

“As a mum of two young children, I have experienced the joys of two pregnancies and postpartum recoveries. I was shocked after the birth of my first child to discover that my pelvic floor muscles had become weak. I sought advice from Bladder and Bowel Health Australia and learnt the importance of exercising these muscles. This knowledge helped, and because I was better informed second time around, I have now fully restored the dignity of my body and truly enjoyed the changes - and my motherhood. Thank you, Bladder and Bowel Health Australia, for informing young families about bladder and bowel health issues.” 

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Doreen – carer of her husband who has dementia 

Doreen was becoming exhausted caring for her husband Tom, who has dementia. Tom was not always making it to the toilet on time and needed his trousers to be changed several times a day. Every day Doreen was also washing bedlinen and the four towels that Tom was laying on at night as he was soaking through his pull-up pants. 

Tom was receiving a high-level Home Care Package, and Doreen was able to arrange with their provider for some of Tom’s package to be allocated to funding continence assessment and management.  

Our advisor went to Tom’s home and conducted a thorough continence assessment. A continence management plan was developed with input from Doreen, and appropriate incontinence aids and linen protection were organised. Doreen is relieved that Tom’s incontinence has reduced, and her washing load has lessened. Doreen is now confident that she can continue caring for Tom in their home. 

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Gary – experiencing leakage after his recent prostate surgery 

Gary met with one of our Bladder and Bowel Health advisors, as he was concerned about his urine leakage that was persisting after his radical prostatectomy five weeks earlier.   

Gary discussed his concerns with the advisor and was reassured that he was making good progress towards regaining bladder control. This reinforced the information he had received from his urologist. Gary was encouraged to switch to a smaller incontinence pad rather than continuing to wear the pull- up incontinence pants he had worn since his surgery. The advisor arranged some smaller pads for him to trial and provided details on where he could buy them close to his home. 

Gary was encouraged to drink plenty of fluid (particularly water) and to increase his fruit and vegetable intake to avoid constipation. Gary was uncertain if his pelvic floor muscles were working properly and he was referred to a pelvic floor physiotherapist. Gary left the clinic in a brighter frame of mind, confident that he was improving and had clear strategies to further support his recovery.