A healthy living blog from Marshfield Clinic Health System

Straight talk about bowel control problems

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If you’ve experienced fecal incontinence (bowel control problems) that result in leakage of fecal matter, you know how embarrassing it is.

If you’ve experienced fecal incontinence—bowel control problems that result in leakage of fecal matter (yes, poop)—you know how deeply embarrassing and concerning the problem is. Before we discuss ways to treat bowel control problems, let’s look at some of the issues known to cause them.

Bowel incontinence is most often caused by damage to the anal sphincters. Those are the pursed muscles around the opening to the anus. Some of the most common causes of damage to these muscles are anal surgery, rectal radiation, and vaginal childbirth. Thanks to that last cause, women are nearly twice as likely as men to experience bowel control problems.

Other causes include:

  • Chronic diarrhea
  • Chronic constipation (very loose stool can escape)
  • Irritable bowel syndrome
  • Crohn’s disease
  • Ulcerative colitis
  • Nerve damage from diabetes, multiple sclerosis, or spinal cord injury
  • Cognitive impairment (such as stroke or advanced Alzheimer’s disease)

It’s actually common to experience more than one cause of bowel control problems. A doctor isn’t always able to pinpoint the cause, so don’t be discouraged if yours can’t. There are treatments to try even when you can’t get to the bottom of what’s wrong with your bottom.

Dietary Changes

Fiber-rich foods can help with both constipation and diarrhea. Increasing fluid intake can also help with fecal incontinence caused by constipation.


Your doctor may recommend that you start an exercise regimen to strengthen your sphincter muscles. There are also exercises to improve your awareness of when it’s time to get to a toilet. Exercise options include biofeedback, bowel training, posterior tibial nerve stimulation (PTNS), and a device called a vaginal balloon.


Anti-diarrheal medications can be used to treat diarrhea-caused fecal leakage. There are also over-the-counter bulking agents like Metamucil for constipation-induced loose stool leakage.


If a mechanical issue, such as rectal prolapse, hemorrhoidectomy, and sacral nerve stimulation is present, currently one of the most effective treatments is a surgically implanted device called InterStim. Less common treatments include sphincter replacement (a sphincter prosthetic), injectable collagen, dynamic graciloplasty (a sort of transplant using your own thigh muscle), or rarely as a last resort, a colostomy.

You can’t get treatment if you don’t seek treatment, so don’t be afraid to be completely frank with your doctor if you experience bowel control problems. Establishing a trusting relationship with a provider you feel comfortable with is the key to resolving these issues once and for all. Contact us to schedule an appointment with one of our women’s health providers to discuss bowel control or other concerns you may have. You may be surprised just how comfortable your experience can be.

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