A loose stool is considered diarrhea

Faecal Incontinence - All About the Different Forms, Causes, and Treatment

Common causes of fecal incontinence are diarrhea or constipation, but also muscle or nerve damage. Muscle or nerve damage in particular often occurs in old age or after childbirth.

Alone there are around 5 million people in Germany of the symptoms of fecal incontinence affected. Many affected people remain silent out of shame, which is why the number of unreported cases is estimated to be much higher.

Women are 4 to 5 times more likely to suffer from faecal incontinence than men. This is caused by weakened pelvic floor muscles or injuries as a result of vaginal birth. Affected women also often suffer from urinary incontinence.

Whatever the cause, fecal incontinence can be embarrassing. But don't be afraid to speak to your doctor. Targeted treatment and various incontinence aids can improve fecal incontinence and your quality of life.

The three degrees of severity of intestinal incontinence

The extent of fecal incontinence is divided into three degrees of severity:

Severity I

Occasional and light soiling of the laundry as well as involuntary escape of gases from the intestines.

Severity II

Frequent and moderate soiling of laundry with involuntary escape of gases from the intestines, in addition to which there may be a loss of liquid stool.

Severity III

The complete loss of bowel control with involuntary discharge of stool and gases from the bowel.

Forms of fecal incontinence

There are several forms of fecal incontinence, the most common being

  • Urge incontinence
  • Flatus incontinence
  • Passive incontinence
  • Anal and rectal incontinence
  • Overflow incontinence
  • Dual incontinence

Urge incontinence

With urge incontinence, the person affected experiences a sudden urge to defecate that cannot be controlled. This form of incontinence is characterized by involuntary defecation.

Flatus incontinence

In the case of flatus incontinence, the person has the feeling of a full rectum, but cannot distinguish whether it is stool or gases due to a malfunction in the sensory mechanisms.

Passive incontinence

In the form of passive incontinence, the person concerned does not feel the urge to defecate; the nerve tracts do not send the information that the intestine is full to the brain.

Since they lack the feeling of a full bowel, these people cannot consciously control their bowel movements and stool unwittingly.

Anal and rectal incontinence

If the anal sphincters can no longer be controlled, one speaks of anal and rectal incontinence. This can be caused by injury to the sphincter muscles or damage to the nerves.

Overflow incontinence

Overflow incontinence is usually caused by constipation. Hardened feces cause a blockage in the intestines. Since only watery stool can pass these fecal stones, there is uncontrollable loss of stool.

Dual incontinence

One speaks of dual incontinence when the person concerned suffers from both intestinal and urinary incontinence.

Symptoms of fecal incontinence

Typical symptoms of fecal incontinence include:

  • Soiled underwear
  • Strong urge to defecate
  • Difficulty holding the chair
  • Involuntary escape of intestinal gases
  • Involuntary discharge of liquid stool
  • Involuntary loss of firm stool
  • The use of incontinence pads is necessary
  • Afraid of having uncontrollable bowel movements
  • Diarrhea

Causes of Fecal Incontinence

Faecal incontinence can have various causes, in many cases weakened muscles as well as muscle and nerve damage are the triggers. But constipation and diarrhea can also lead to temporary incontinence.

Muscle damage

Injury to the anal sphincter can make it difficult to hold a chair. Such injuries can occur during childbirth and are often caused by a perineal cut or forceps delivery.

Nerve damage

Injury to the nerves that feel the stool in the rectum and those nerves that control the anal sphincter can also lead to fecal incontinence. This nerve damage can have various causes, such as a vaginal delivery, constant and heavy strain during bowel movements (constipation), spinal cord injuries or strokes. But diseases such as diabetes and multiple sclerosis can also damage these nerves and thus lead to fecal incontinence.


Frequent and chronic constipation can cause the feces to solidify into a dry and hard mass. This impacted stool expands the muscles of the rectum and intestines until they are eventually weakened. The softer and sometimes watery stool from the upper digestive tract moves around the hardened stool and eventually comes out uncontrollably. Chronic constipation can also lead to nerve damage that leads to fecal incontinence.


Since normal or solid stool is easier to hold in the rectum than loose stool, diarrhea can cause temporary fecal incontinence.


With hemorrhoids, the veins in your rectum swell, this can prevent your anus from closing completely, which can cause stool to leak.

Surgical interventions

Surgery to treat hemorrhoids in the rectum or anus, as well as other surgeries in this area, can cause muscle and nerve damage, which subsequently leads to fecal incontinence.

Pelvic floor weakness

If the pelvic floor is weak, the entire pelvic floor can sink, which puts additional permanent pressure on the intestines. Due to the weakened muscles, it is often no longer possible for the person affected to hold the chair.

Bowel prolapse

When a bowel prolapses, parts of the bowel protrude from the anus. This incident is often triggered by a severe form of pelvic floor weakness.


In women, faecal incontinence can occur when the rectum sags through the vagina due to a weakening of the wall layers between the rectum and the vagina.


Depending on the cause of fecal incontinence, there are different options for treatment:


These can be antibiotics to treat inflammation or laxatives for acute constipation. Your attending doctor will prescribe the necessary medication to treat your illness.

Change of diet

Changing your eating habits can improve the symptoms of faecal incontinence because the choices you eat and drink will affect the consistency of your stool.

If you are constipated, drink plenty of fluids, and if you have diarrhea, eating a high-fiber diet can help.

Physical activity

If weak muscles are the cause of faecal incontinence, a targeted exercise program or doctor-prescribed therapy can help improve symptoms.


Faecal incontinence can vary in severity and be triggered by a variety of causes.

By adopting a healthier lifestyle and strengthening the pelvic floor muscles, symptoms can be alleviated.

The use of incontinence products can make it easier to deal with this disease in everyday life and thus lead to a higher quality of life.

You can find more information about the various incontinence aids here.