Fecal Incontinence - National Digestive Diseases Information ...

What causes fecalincontinence?Fecal incontinence has many causes,including• diarrhea• constipation• muscle damage or weakness• nerve damage• loss of stretch in the rectum• childbirth by vaginal delivery• hemorrhoids and rectal prolapse• rectocele• inactivityDiarrheaDiarrhea can cause fecal incontinence.Loose stools fill the rectum quickly andare more difficult to hold than solid stools.Diarrhea increases the chance of notreaching a bathroom in time.ConstipationConstipation can lead to large, hard stoolsthat stretch the rectum and cause the internalsphincter muscles to relax by reflex. Waterystool builds up behind the hard stool andmay leak out around the hard stool, leadingto fecal incontinence.The type of constipation that is most likelyto lead to fecal incontinence occurs whenpeople are unable to relax their externalsphincter and pelvic floor muscles whenstraining to have a bowel movement, oftenmistakenly squeezing these muscles insteadof relaxing them. This squeezing makes itdifficult to pass stool and may lead to a largeamount of stool in the rectum. This type ofconstipation, called dyssynergic defecationor disordered defecation, is a result offaulty learning. For example, children oradults who have pain when having a bowelmovement may unconsciously learn tosqueeze their muscles to delay the bowelmovement and avoid pain.Muscle Damage or WeaknessInjury to one or both of the sphinctermuscles can cause fecal incontinence. Ifthese muscles, called the external andinternal anal sphincter muscles, are damagedor weakened, they may not be strong enoughto keep the anus closed and prevent stoolfrom leaking.Trauma, childbirth injuries, cancer surgery,and hemorrhoid surgery are possible causesof injury to the sphincters. Hemorrhoids areswollen blood vessels in and around the anusand lower rectum.3 Fecal Incontinence