Bowel Leaks: Learn More, Live Better

Of all the personal topics out there, fecal incontinence is one of the toughest to discuss. The condition is also known as bowel control problems or accidental bowel leakage (ABL). By any name, living with this condition is a pain in the backside (if you’ll forgive the pun), often causing distress and embarrassment. That’s why many people choose to keep the problem to themselves instead of talking about the issue with anyone—even their healthcare professionals.

We wrote this blog to encourage conversation and action. While we can’t solve your bowel problems in a single post, we believe that having plenty of support and information is good medicine. Read up, and feel free to share this with anyone you know who could benefit!

Bowel Leaks: Learn More, Live Better

The What and Why of Fecal Incontinence

According to the American College of Gastroenterology, “Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum.” The National Association for Continence describes it as “the inability to hold a bowel movement until reaching a bathroom.” ABL can range from an occasional leak while passing gas, to a complete loss of control over your bowels.

Some people experience the problem during a temporary bout of diarrhea. Others have a chronic (ongoing) condition where the urge to defecate comes on so quickly they are unable to get to the bathroom in time. This is known as urge incontinence. Still others experience passive incontinence, meaning they are not even aware that they need to pass stool.

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Many Medicaid programs cover incontinence supplies, including supplies for fecal incontinence, at no cost to the recipient. Check with the friendly team at HCD to find out the benefits covered under your Medicaid plan

Facts and Factors

For many people, going number two is not a simple matter. Several internal systems must be working together for a person to have a “normal” trip to the bathroom. For example, a person needs to be able to control the muscles that hold the stool in the rectum. He or she also needs to sense that stool is present in the rectum and have the physical and mental ability to recognize the need to go. And finally, the person must be able to keep the stool inside when a bowel movement is not convenient.

A person has a higher risk of bowel problems if they:

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Are over 65

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Are female

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Have nerve damage from conditions such as diabetes, Multiple Sclerosis, or back trauma

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Have dementia

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Have inflammatory bowel disease or irritable bowel syndrome

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Live with physical disabilities that make it hard to get to the bathroom in time

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Have a physical injury to the rectal area

What actually causes leaky bowels?

  • Muscle damage at the end of the rectum. This can sometimes occur after childbirth.
  • Nerve damage from straining during bowel movements, childbirth, stroke, or spinal cord injuries.
  • Chronic constipation that creates a hard, dry mass of stool that’s too large to pass. This can cause the muscles around the area to weaken and watery stool in the bowel to leak out.
  • Diarrhea which makes it harder to hold in loose stool.
  • Hemorrhoids, which are caused by swelling of the veins in the rectum. In this case, the anus may not close completely, allowing stool to leak out.
  • Insufficient storage capacity in the rectum. Radiation, surgery, or other conditions can make the rectum stiff and unable to stretch as it should.
  • Side effects of medication. If a medicine causes diarrhea, that can contribute to leakage.
  • Rectal prolapse, a condition where the rectum drops down into the anus, damaging nerves and muscles needed to successfully defecate.

Some people benefit from “retraining” their bowel. For example, trying to have a bowel movement at the same time every day.

Yes, You Can Treat Bowel Problems

The first step in treating a bowel problem is to know the underlying cause of your fecal incontinence. That means seeing a doctor and being totally honest about what’s going on. Be prepared to discuss your symptoms, when and where accidents happen, when and what you eat and drink, the type of bowel movements you have, and your patterns and activities. Some people even keep a food diary. Sharing this with the doctor can be a great source of information.

Senior couple visiting doctor

In most cases, ABL is light to moderate and can be treated with changes in lifestyle and habits, such as wearing absorbent pads inside your underwear. Many people combine absorbent pads with other treatments.

If the doctor finds that your pelvic muscles are weak, you may be asked to do strengthening exercises known as Kegels. Read more about how to do Kegels here. You may also benefit from “retraining” the bowel, which could include trying to have a bowel movement at the same time every day.

Sometimes increasing fluids, exercising, and consistent bowel habits can reduce or even eliminate the problem of bowel leakage. If you have constipation, high-fiber foods like whole grains, fresh vegetables, and beans can add bulk to your stool. If you have diarrhea, fiber supplements that bind the stool may be recommended. There are also over-the-counter medicines to treat both constipation and diarrhea. These should all be discussed with your provider.

Other treatments can include biofeedback, a therapy that can help you learn to control that sudden urge. Another approach uses radio frequency energy to strengthen the sphincter muscle. In a procedure known as sacral nerve stimulation, an implanted device improves communication between the bowel and the brain.

Other surgical procedures that may be recommended by your healthcare professionals include injecting a silicone-based material into the anal sphincter to narrow the anal canal. It’s also possible to repair a damaged sphincter. A colostomy is considered a last resort. It redirects stool through an opening in the abdomen, where it is collected in a special pouch that is regularly emptied and changed.


The first step to make things better is to know the underlying cause of your fecal incontinence. That means seeing a doctor and being totally honest about what’s going on.

This Is Tough. We Can Help.

Bowel incontinence is just plain difficult—not only the physical aspects but the emotional toll it takes as well. Get the help you need from your doctor and care team. Consider joining a support group—check with your doctor and online for one near you—or find someone in your community who also lives with fecal incontinence that you can talk with about the condition.

One way to reduce some of the stress is to make sure you’re signed up for convenient, discreet delivery of the absorbent products you’ll need to manage your fecal incontinence. HCD has a wide range of pads, liners, and underwear, as well as additional products such as wipes and skin care supplies. Not only do we deliver the supplies you need, but our specially trained customer care team totally get what you’re going through, eliminating some of the embarrassment of talking about the condition with a stranger. We make it easy to get started when you call us at 804-885-4101. Or, simply enter your phone number on the bottom left of the screen and a friendly HCD team member will give you a call.

Living with fecal incontinence? Let’s make life better together.

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Unless otherwise noted, the recommendations in this document were obtained from the sources indicated. Be advised that information contained herein is intended to serve as a useful reference for informational purposes only. HCD cannot be held responsible for the continued accuracy of or for any errors or omissions in the information. All trademarks and registered trademarks are the property of their respective owners.

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