Causes of Fecal/Bowel Incontinence and Constipation
A broad range of conditions and disorders can lead to fecal or bowel incontinence. Here are some of the most common ones.
Constipation
It may seem contradictory, but in fact, chronic constipation can lead to incontinence. Impacted stool — a mass of hard, dry feces that’s too large to pass — can weaken the walls of the rectum and/or damage the nerves that control defecation. In addition, looser, more watery stool can leak out around the blockage.
Diarrhea
Loose stool is much harder to control than solid stool, so patients who suffer frequent bouts of diarrhea are more likely to have incontinence. Certain foods or infections can cause diarrhea and aggravate symptoms.
Muscle damage
Damage to the external or internal sphincter is a frequent cause of fecal incontinence. Like urinary incontinence, this can occur during vaginal childbirth, especially if the doctor must use forceps or perform an episiotomy. Symptoms sometimes don’t show up until years later. The weakness of pelvic floor muscles or the anal sphincter as you age can also cause incontinence.
Nerve damage
If the nerves that sense when it’s time to go to the bathroom or the ones that control the anal sphincter are damaged, incontinence can occur. This can also happen during childbirth, in people who have suffered a stroke or spinal cord injury, or in those with diabetes, multiple sclerosis or any other disease that attacks the nerves.
Reduced elasticity
Inflammatory bowel diseases like Crohn’s disease can irritate the lining of the rectal wall, interfering with its ability to hold stool. Previous surgery or radiation (such as for rectal cancer) can also scar or damage the rectum.
Other conditions
Rectal prolapse (a condition where the rectum drops and protrudes into the anus) or rectocele, when the rectum protrudes through the vagina, can lead to incontinence. Hemorrhoids that prevent the anal sphincter from closing properly can also cause leakage.
