Bowel incontinence is not a condition in itself. It is a symptom of an underlying problem or medical condition, such as muscle or nerve damage or dementia.
Bowel incontinence results from the inability to evacuate, hold on to or respond to the need to release stools appropriately. This can result in either chronic constipation or recurring diarrhoea.
It can sometimes be caused by damage to the anal sphincter following childbirth or as a complication of bowel surgery. Damage to the nerves connecting the rectum to the brain can also lead to incontinence in people after a stroke or who have multiple sclerosis or diabetes.
Incontinence can be a symptom of conditions such as Irritable Bowel Syndrome (IBS), Crohn’s disease, ulcerative colitis or diverticulitis. People with Alzheimer’s or other forms of dementia may lose the ability to control their bowels, even though there is no physical damage. Incontinence can also occur if you have mobility problems or find it hard to remove clothes quickly.
Constipation happens when hard bowel motions form and lodge in the rectum. This hard mass becomes difficult to pass. You might have to strain more than usual, stretching and weakening the muscles of the rectum and may also find you are unable to completely empty your bowels.
If you are chronically constipated, small pieces of faeces might be passed or liquid stools (which look like diarrhoea) might leak out around the solid stool.
Older people are more likely to have constipation than younger people. This is due to a range of factors, including diet, lack of exercise, medication and practicalities such as being unable to get to a toilet or putting off going. However, it is not an inevitable part of ageing and needs to be properly investigated and diagnosed.
It is normal to experience diarrhoea every now and again. However, conditions such as Crohn’s disease, IBS and ulcerative colitis can cause recurring diarrhoea. This leads to bowel incontinence, as it is more difficult for the rectum to hold liquid stools.
For a more detailed overview of how your bowel works, please visit our How the bowel works page.
For more information about the bowel and associated incontinence please visit our Common bowel problems page.