Bowel incontinence or ABL occurs when stool or gas unexpectedly leaks from your rectum.
Bowel incontinence, which may also be referred to as fecal incontinence, anal incontinence or Accidental Bowel Leakage (ABL), is when stool or gas unexpectedly leaks from your rectum. Sometimes you feel the urge to have a bowel movement, but can’t reach a bathroom in time.
The U.S. National Institutes of Health’s Bowel Control Awareness Campaign reports that more than 18 million Americans have bowel incontinence. As with urinary incontinence, bowel incontinence affects people of all ages, races, and both sexes. However, it is more common in women than in men, and it affects the elderly more often than younger adults (although it is not a normal part of aging).
In some cases, incontinence of gas can almost be a bigger challenge than incontinence of stool. Uncontrollable leakage of gas can sometimes cause a sound and/or odor that can’t be covered up, hidden, or managed with an absorbent product.
Some Causes for Bowel Incontinence
The following is a list of just some of the possible causes for bowel incontinence. This is in no way a complete list.
- Muscle and/or nerve damage due to childbirth (including complications with episiotomies)
- Surgery
- Spine or pelvic trauma
- Other trauma to the pelvic floor
- Constipation due to the “overflow” that can occur when hardened stool becomes backed up and unformed liquid stool seeps around the blockage
- Health conditions such as Crohn’s Disease or Ulcerative Colitis (Inflammatory Bowel Disease), Irritable Bowel Syndrome, or neurologic conditions such as Multiple Sclerosis (MS)
- Effects of medications or treatments: regular and long-term use of laxatives can cause the bowel muscles to weaken to the point that they lose control. Radiation to the pelvis and/or bowels can affect the ability of the rectum to store stool, leading to leakage.
- Diarrhea
Prevention
Good bladder and bowel health is an important part of taking care of your body. Some things that everyone can do to help prevent bowel incontinence include:
- Prevent constipation by making sure you get enough liquids and fiber each day
- If a health condition such as Crohn’s Disease or Irritable Bowel Syndrome is the cause, following your doctor’s recommendations for managing the condition can often help with the incontinence as well
- Reduce the risk of incontinence by avoiding routine episiotomies during childbirth
- Strengthen the muscles of the pelvic floor that help support the anal sphincter by routinely doing pelvic floor exercises (Kegels). Maintain adequate exercise for your whole body daily to help keep the bowels working regularly.
- Avoid prolonged failure to empty your bowels
Treatment and Management
Bowel incontinence or ABL can be very uncomfortable to talk about. However, it is important for the sake of your health that you speak with a knowledgeable medical professional. If your family doctor or general practitioner isn’t interested in treating bowel incontinence, you may want to make an appointment with a gastroenterologist. In some cases, you may be referred to a colorectal surgeon. Your exam will probably start with simply talking about your condition. The doctor will want to know how often you experience bowel incontinence, and when it has happened. He or she might also ask about family history. The doctor will also probably want to do a physical exam, and possibly additional tests. These questions and tests might be embarrassing, but there are treatment options your doctor may be able to recommend — but only after a thorough exam.
For a more thorough discussion on bowel incontinence, please read our Bowel Incontinence Fact Sheet.
Medical Reviewer: Carrie Carls, RN, BSN, CWOCN
Carrie Carls, BSN, RN, CWOCN, oversees pelvic floor retraining for urinary and fecal incontinence, performs urodynamics testing, treats painful bladder syndrome, and cares for wound and ostomy patients at Passavant Area Hospital in Jacksonville , Illinois . Her article, “Prevalence of Stress Urinary Incontinence in High School and College Age Female Athletes in the Midwest : Implications for Practice” appeared in the Journal of Urologic Nursing, February 2007. Her abstract, “Partial Thickness Wound Resulting from Use of a Penile Clamp to Control Urinary Incontinence in a Patient with Radical Prostatectomy” was presented at the Symposium of Advanced Wound Care in 2005. She teaches content in the areas of wound, ostomy, and continence care to baccalaureate nursing students at MacMurray College, and facilitates the West Central Illinois UOAA ostomy support group.