Fecal Incontinence: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Fecal Incontinence?
A gastroenterologist, a doctor who treats digestive problems, often treats fecal incontinence. A colorectal surgeon, a surgeon for the colon and rectum, may help if surgery is needed. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is fecal incontinence?
Fecal incontinence has two main types, and the symptoms depend on the type.
With urge fecal incontinence, you know you need to pass stool but cannot control it before you reach a toilet.
With passive fecal incontinence, you pass stool or mucus from your anus without knowing it.
Fecal incontinence is not always a normal part of aging. It can often be treated.
Symptoms
Symptoms depend on whether the leaks are urge or passive. They can include:
- Not being able to hold stool until you reach a toilet when you feel the urge.
- Passing stool or mucus without knowing it.
- Streaks or stains of stool or mucus on your underwear, called soiling.
It can also cause anal discomfort, such as irritation, pain, or itching.
Causes and who gets it
Fecal incontinence has many causes, including digestive tract disorders and chronic diseases. Common causes include:
- Diarrhea. Loose, watery stools fill your rectum quickly and are harder to hold in than solid stools.
- Constipation. Hard stools stretch and weaken the muscles in your rectum over time. Watery stool then leaks out around the hard stool.
- Injured or weakened muscles around the anus or rectum, which may not keep the anus closed.
- Nerve damage from long-term straining to pass stool, brain injury, or spinal cord injury.
- Nerve diseases such as dementia, multiple sclerosis, Parkinson’s disease, stroke, or type 2 diabetes.
- Hemorrhoids, which can keep the anus from closing fully.
- Rectal prolapse, when the rectum drops down through the anus.
Vaginal childbirth sometimes injures the anal sphincters, the muscles that close the anus.
In children older than age 4, the most common cause is constipation with a large amount of stool in the rectum.
How doctors diagnose it
The first step in treating fecal incontinence is to see a doctor. Your doctor will talk to you about the causes of fecal incontinence and how they can be treated. You should see a doctor if your fecal incontinence is frequent or severe.
Treatment
The first step is to see a doctor. How doctors treat it depends on the cause.
Simple steps you can take with your doctor include:
- Absorbent pads inside your underwear, the most frequently used treatment.
- Diet changes. Your doctor may suggest a food diary to find foods that make it worse.
- More fiber and liquids, if constipation or hemorrhoids are causing it.
- Over-the-counter medicines, depending on the cause.
- Bowel training, which means having bowel movements at set times, such as after meals.
- Pelvic floor muscle exercises, also called Kegel exercises.
Your doctor may also suggest biofeedback therapy. It uses devices to help you learn exercises that strengthen your pelvic floor muscles. It can be more effective than learning the exercises on your own.
Another option is sacral nerve stimulation. A device sends mild electrical pulses to the sacral nerves. Bulking agents injected into the wall of the anus are another option.
Surgery may be an option if other treatments fail to help. Sphincteroplasty is the most common surgery. It reconnects the torn ends of an anal sphincter. An artificial anal sphincter is not a common treatment because it may cause side effects. A colostomy is a last resort.
When to see a doctor
You should see a doctor if your fecal incontinence is frequent or severe. Also see a doctor if it affects your quality of life or causes emotional or social distress.
If your child is older than age 4 and toilet trained, see a doctor to find out the cause.
Call 911 or go to the emergency room if you have a new loss of bowel or bladder control along with numbness or tingling between your legs, over your buttocks, or in your inner thighs, or severe or worsening leg problems. These can be signs of cauda equina syndrome, a squeezed bundle of nerves in the lower spine. It is a surgical emergency. Also call 911 for fainting, or for sudden weakness or trouble speaking.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your symptoms, medicines, and bowel habits, and order first tests. They can also help you arrange visits with a digestive or colorectal specialist.
Common questions
Is fecal incontinence a normal part of aging?
It is not always a normal part of aging. It can often be treated, and many successful treatments are available.
Will fecal incontinence go away on its own?
Usually not. Most people need treatment.
Can diarrhea cause fecal incontinence?
Yes, diarrhea can cause it. Loose, watery stools fill your rectum quickly and are harder to hold in than solid stools.
Can children have fecal incontinence?
Yes, children can have it. In children older than age 4, the most common cause is constipation with a large amount of stool in the rectum.
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases - Symptoms and Causes of Fecal Incontinence
- American Academy of Orthopaedic Surgeons - OrthoInfo - Cauda Equina Syndrome
- National Institute of Diabetes and Digestive and Kidney Diseases - Treatment of Fecal Incontinence
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
