Faecal incontinence

If you’re experiencing faecal incontinence, you can’t control your bowel movements. In other words, you can’t get to the toilet in time – or don’t even know you need to go. This means your stools might leak unexpectedly.

Having control over your bowel movements requires your nervous system, rectum and anus to be functioning normally. So, if you have faecal incontinence, it’s crucial to find out what’s wrong. Causes of faecal incontinence can include:

• Damage to the anal sphincter (as a result of a serious tear in childbirth, for example)
• A weak pelvic floor
• Previous surgery, including rectal, anal, prostate or gynaecological surgery
• Long-term constipation causing the anus to weaken
• Stools building up in the rectum
• The over-use of laxatives
• An overgrowth of bacteria in the small intestine (called SIBO)
• Irritable bowel syndrome (IBS)
• Stress or anxiety.

There are many potential causes of faecal incontinence, ranging from mild to severe. In order to diagnose faecal incontinence to help find out what’s going on, we can run one or more of the following tests:

• Endoanal ultrasound – to image the muscles back passage and surrounding tissue, and assess their structure.
• Anorectal manometry – which tests the strength of the muscles in your back passage and rectum
• Pudendal nerve function test – which looks at the nerves in your pelvic floor which control your muscles in your back passage
• Whole-gut transit – a non-invasive test which looks at how long it takes for faeces to pass through your bowel
• Defaecography – which investigates any problems you may have when trying to open your bowels
• Carbohydrate malabsorption breath test – which finds out if you have certain food intolerances (lactose or fructose)
• Small intestinal bacterial overgrowth (SIBO) breath test – which finds out if you have an overgrowth of bacteria in your small intestine (called SIBO)