Bowel incontinence isn’t a condition in itself, and is a symptom of something else, often linked to a medical condition or physical change. It happens when the bowel can’t store, control, or release stool in the usual way. This can lead to constipation, diarrhoea, or a mix of both.

Common causes include:

• Muscle or nerve damage – for example, to the anal sphincter following childbirth or bowel surgery.
   
• Nerve problems – such as those caused by a stroke, multiple sclerosis, or diabetes, which can affect signals between the brain and the bowel.
   
• Digestive conditions – including Irritable Bowel Syndrome (IBS), Crohn’s disease, ulcerative colitis, or diverticulitis.
   
• Cognitive conditions – such as Alzheimer’s disease or other forms of dementia, where control may be lost even without physical damage.
   
• Mobility difficulties – being unable to get to the toilet in time or remove clothing quickly can also lead to leaks.
   

Constipation

Constipation happens when bowel motions become hard and difficult to pass. You may need to strain more than usual, which can stretch and weaken the rectal muscles. Sometimes, even after going to the toilet, the bowel may not empty completely.

If constipation is long-term (chronic), small pieces of stool may be passed unexpectedly, or looser stools may leak around a blockage, which can be mistaken for diarrhoea.

Older adults are more likely to experience constipation due to factors such as diet, reduced physical activity, certain medications, or delaying going to the toilet. However, it’s really important to remember that constipation is not an inevitable part of ageing, and it should always be investigated and treated.

Diarrhoea

Occasional diarrhoea is common, but some conditions, like IBS, Crohn’s disease, and ulcerative colitis, can cause it to happen regularly. Liquid stools are harder for the bowel to hold, which can lead to leaks.

If you experience constipation, diarrhoea, or any changes to your usual bowel habits, it’s important to speak to your GP. Identifying the cause is the first step towards finding the right treatment.

You can find more information here:

• Common Bowel Problems
   
• How the Bowel Works
   
• Everyday Ways to Manage Bowel Problems
   
• Where to Get Help