Fecal incontinence, also called a bowel control problem, is the accidental passing of solid or liquid stool or mucus from the rectum. Fecal incontinence includes the inability to hold a bowel movement until reaching a toilet as well as passing stool into one’s underwear without being aware of it happening.

Fecal incontinence can be upsetting and embarrassing. Many people with fecal incontinence feel ashamed and try to hide the problem. However, people with fecal incontinence should not be afraid or embarrassed to talk with their health care provider. Fecal incontinence is often caused by a medical problem and treatment is available.

Who gets fecal incontinence?
Nearly 18 million U.S. adults—about one in 12—have fecal incontinence. People of any age can have a bowel control problem, though fecal incontinence is more common in older adults. Fecal incontinence is slightly more common among women. Having any of the following can increase the risk:

  • Diarrhea, which is passing loose, watery stools three or more times a day
  • Urgency, or the sensation of having very little time to get to the toilet for a bowel movement
  • A disease or injury that damages the nervous system
  • Poor overall health from multiple chronic, or long lasting, illnesses
  • A difficult childbirth with injuries to the pelvic floor—the muscles, ligaments, and tissues that support the uterus, vagina, bladder, and rectum

How does bowel control work?
Bowel control relies on muscles and nerves of the rectum and anus working together to

  • Hold stool in the rectum
  • Let a person know when the rectum is full
  • Release stool when the person is ready

Circular muscles called sphincters close tightly like rubber bands around the anus until stool is ready to be released. Pelvic floor muscles also help with bowel control.

What if a child has fecal incontinence?
A child with fecal incontinence who is toilet trained should see a health care provider, who can determine the cause and recommend treatment. Fecal incontinence can occur in children because of a birth defect or disease, but in most cases it occurs because of constipation.

Children often develop constipation as a result of stool withholding. They may withhold stool because they are stressed about toilet training, embarrassed to use a public bathroom, do not want to interrupt playtime, or are fearful of having a painful or unpleasant bowel movement.

As in adults, constipation in children can cause large, hard stools that get stuck in the rectum. Watery stool builds up behind the hard stool and may unexpectedly leak out, soiling a child’s underwear. Parents often mistake this soiling as a sign of diarrhea.