Causes of Fecal incontinence

Cause of Fecal incontinence: Fecal incontinence can have several causes:

damage to the anal sphincter muscles
damage to the nerves of the anal sphincter muscles or the rectum
loss of storage capacity in the rectum
diarrhea
pelvic floor dysfunction

Cause details for Fecal incontinence:

Muscle Damage

Fecal incontinence is most often caused by injury to one or both of the ring-like muscles at the end of the rectum called the anal internal and/or external sphincters. The sphincters keep stool inside. When damaged, the muscles aren't strong enough to do their job, and stool can leak out. In women, the damage often happens when giving birth. The risk of injury is greatest if the doctor uses forceps to help deliver the baby or does an episiotomy, which is a cut in the vaginal area to prevent it from tearing during birth. Hemorrhoid surgery can damage the sphincters as well.

Nerve Damage

Fecal incontinence can also be caused by damage to the nerves that control the anal sphincters or to the nerves that sense stool in the rectum. If the nerves that control the sphincters are injured, the muscle doesn't work properly and incontinence can occur. If the sensory nerves are damaged, they don't sense that stool is in the rectum. You then won't feel the need to use the bathroom until stool has leaked out. Nerve damage can be caused by childbirth, a long-term habit of straining to pass stool, stroke, and diseases that affect the nerves, such as diabetes and multiple sclerosis.

Loss of Storage Capacity

Normally, the rectum stretches to hold stool until you can get to a bathroom. But rectal surgery, radiation treatment, and inflammatory bowel disease can cause scarring that makes the walls of the rectum stiff and less elastic. The rectum then can't stretch as much and can't hold stool, and fecal incontinence results. Inflammatory bowel disease also can make rectal walls very irritated and thereby unable to contain stool.

Diarrhea

Diarrhea, or loose stool, is more difficult to control than solid stool that is formed. Even people who don't have fecal incontinence can have an accident when they have diarrhea.

Pelvic Floor Dysfunction

Abnormalities of the pelvic floor can lead to fecal incontinence. Examples of some abnormalities are decreased perception of rectal sensation, decreased anal canal pressures, decreased squeeze pressure of the anal canal, impaired anal sensation, a dropping down of the rectum (rectal prolapse), protrusion of the rectum through the vagina (rectocele), and/or generalized weakness and sagging of the pelvic floor. Often the cause of pelvic floor dysfunction is childbirth, and incontinence doesn't show up until the midforties or later. ¹

Underlying condition causes of Fecal incontinence: The list of possible underlying conditions (see also Misdiagnosis of underlying causes of Fecal incontinence) mentioned in various sources as possible causes of Fecal incontinence includes:

Diarrhea - a common cause of temporary fecal incontinence
Chronic constipation (type of Constipation) - the most common cause of fecal incontinence in children
Fecal impaction
Pregnancy and childbirth related conditions:
- Pelvic floor dysfunction
- Childbirth - can cause spincter muscle or nerve damage or pelvic floor dysfunction; sometimes childbirth-caused fecal incontinence does not occur immediately but later in the 40's.
- Forcep delivery
- Episiotomy
Abdominal conditions
- Inflammatory bowel disease
- Pelvic floor weakness
Rectal conditions
- Hemorrhoid surgery
- Straining bowel motions
- Anal sphincter muscle damage
- Anal sphincter nerve damage
- Rectal nerve damage
- Reduced rectal capacity
- Rectal surgery
- Rectal prolapse
- Rectocele - rectal protrusion into the vagina
- Rectal scarring
- Rectal tumor
- Rectal inflammation
- Reduced rectal sensation
- Reduced anal canal pressures
- Reduced anal squeeze pressure
- Reduced anal sensation
- Rectal cancer
- Rectal abnormality
- Anal abnormality
Nerve-damaging diseases - may affect the nerves of the rectal area or those controlling sphincter muscles.
- Spinal cord conditions (type of Neck conditions)
- Spinal cord injury
- Spinal cord compression
- Diabetes - nerve damage from diabetes
- Stroke
- Multiple sclerosis
- Epilepsy
- Brain tumor
- Spinal cord tumor
- Brain injury
- Peripheral neuropathy
- Diabetic peripheral neuropathy
- Dementia
- Parkinson's disease
Radiation treatment
Pelvic fracture
Anorectal surgery
Traumatic childbirth

Fecal incontinence as a complication: Other conditions that might have Fecal incontinence as a complication might be potential underlying causes of Fecal incontinence. The list of conditions listing Fecal incontinence as a complication in our database includes:

Fecal incontinence as a symptom: Conditions listing Fecal incontinence as a symptom may also be potential underlying causes of Fecal incontinence. The list of conditions listing Fecal incontinence as a symptom in our database includes:

Related information for causes of Fecal incontinence: Further relevant information on causes of Fecal incontinence may be found in the risk factors for Fecal incontinence and underlying causes of Fecal incontinence.

Footnotes:
1. excerpt from Fecal Incontinence: NIDDK

Last revision: May 30, 2003

Medical Tools & Articles:

Next articles:

Medical Articles: