Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
Fecal Incontinence
Fecal incontinence, sometimes called accidental bowel leakage, is the involuntary loss of gas or stool. It can range from occasional difficulty controlling gas to more frequent leakage of liquid or formed stool. Even at the milder end, it affects how you go about your day and whether you feel comfortable leaving the house.
This is one of the most underreported conditions I see. Most providers don’t routinely ask about it, and most patients don’t bring it up on their own. If this is something you’re dealing with, it’s a medical condition with real treatment options, and it’s worth talking about.
How Common is It?
More common than most people realize. Studies estimate that fecal incontinence affects somewhere between 7 and 15% of women living in the community. That number is likely even higher, because so many women never mention it to their doctor.
Types of Fecal Incontinence
I generally think about fecal incontinence in two categories:
- Urge leakage — you feel the urge to go but can’t make it to the bathroom in time.
- Passive leakage — stool leaks without you being aware of it. You might notice soiling after the fact.
Some women experience both types, and the distinction matters because it helps guide what’s going on and how we approach treatment.
What Causes It?
There’s usually more than one factor involved. The most common causes I see:
- Childbirth injury. Vaginal delivery can damage the anal sphincter muscles or the nerves that control them. This is probably the single most common cause in my practice.
- Chronic diarrhea or loose stools. This is actually one of the strongest risk factors. If your stool consistency is off, even mild sphincter weakness can lead to leakage.
- Aging. The sphincter muscles naturally lose some strength over time.
- Prior anal or rectal surgery, including hemorrhoid surgery or other procedures in that area.
- Neurological conditions that affect the nerves controlling the rectum and anus.
- Diabetes, obesity, and inflammatory bowel disease can all contribute.
- Medications that affect stool consistency or bowel motility.
- Low physical activity. Staying active helps maintain pelvic floor function.
Symptoms
Symptoms vary quite a bit from person to person:
- Difficulty controlling gas
- Leakage of liquid or formed stool
- A sudden, urgent need to have a bowel movement with little warning
- Discovering soiling without having felt anything
If any of these sound familiar, don’t sit on it, even if it only happens occasionally.
How I Evaluate Fecal Incontinence
When you come in for an evaluation, I’ll start by asking about your symptoms, your bowel habits, your obstetric history, and any prior surgeries. A focused physical exam is the next step. Depending on what I find, I may recommend additional testing like:
- Anal ultrasound to look at the integrity of the sphincter muscles
- Anorectal manometry to measure how well the sphincter muscles and rectum are functioning
Both are done in the office and help me figure out what’s going on so we can pick the right treatment.
Treatment Options
Most women with fecal incontinence improve with treatment. I walk patients through the full range of options so we can figure out the best approach together.
Lifestyle and dietary changes
This is where I start for almost everyone. Adjusting your diet to improve stool consistency makes a bigger difference than most people expect. I’ll also talk with you about regular bowel habits and toilet positioning.
Pelvic floor physical therapy
Pelvic floor PT strengthens the muscles that control your bowel. It works well, especially for milder cases. We have pelvic floor PTs in our office, and I can also refer you to therapists closer to home if that’s easier.
Medications
If loose stools are contributing to the problem, medications to firm up your stool or slow your bowel can help. These are simple, well-tolerated options that I use frequently.
Sacral neuromodulation
For women who haven’t improved enough with conservative treatments, sacral neuromodulation is something I offer. A small device stimulates the nerves that control your bowel. We do a trial period first so you can see if it works before committing to anything permanent.
Surgery
When there’s a clear structural problem, like a sphincter tear from childbirth, surgical repair may be the right call. Most patients don’t need surgery, but for the right situation it can make a big difference.
Living with Fecal Incontinence
While we work on treatment, there are things you can do day to day that help:
- Skin care. Keeping the area clean and dry prevents irritation and breakdown.
- Dietary awareness. Pay attention to which foods make things worse. Caffeine, fatty foods, and artificial sweeteners are common culprits.
- Staying active. Regular physical activity supports pelvic floor health.
- Emotional support. This condition takes a toll emotionally. If it’s affecting your mood or keeping you from going out and doing things, bring that up too.
When to Seek Help
If you’re dealing with any degree of bowel leakage, even if it seems minor, I’d encourage you to bring it up. Many women wait years before mentioning it, and that’s time spent dealing with something that’s very treatable.
References
- Whitehead WE, Borrud L, Goode PS, et al. Fecal incontinence in US adults: epidemiology and risk factors. Gastroenterology. 2009;137(2):512-517. doi:10.1053/j.gastro.2009.04.054
- Bharucha AE, Dunivan G, Goode PS, et al. Epidemiology, pathophysiology, and classification of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) workshop. Am J Gastroenterol. 2015;110(1):127-136. doi:10.1038/ajg.2014.396
- Bordeianou LG, Thorsen AJ, Hawkins AT, et al. The ASCRS clinical practice guideline for the management of fecal incontinence. Dis Colon Rectum. 2023;66(5):647-661. doi:10.1097/DCR.0000000000002796