Faecal Incontinence: You're Not Alone, and It's Treatable
Faecal incontinence, the involuntary loss of stool or mucus, affects an estimated 1 in 10 Australians, though under-reporting means the true figure is likely higher. It exists on a spectrum, from minor leakage to complete loss of control, and can result from causes including obstetric injury, pelvic floor dysfunction, neurological conditions, or anorectal surgery.
Despite the stigma surrounding it, faecal incontinence is a common, legitimate medical condition with effective treatment options: from pelvic floor physiotherapy and biofeedback to sacral nerve stimulation and, where needed, surgery. This means faecal incontinence is not something anyone has to simply live with.
Of all the bowel conditions we manage, faecal incontinence carries the greatest stigma. Many of our patients have been living with it for years before seeking help — mapping bathrooms before leaving the house, declining social invitations, quietly withdrawing from activities they once enjoyed. If this sounds familiar: faecal incontinence is common, it is a legitimate medical condition, and it is treatable.
What Is Faecal Incontinence?
Faecal incontinence is the involuntary loss of bowel contents (liquid stool, solid stool, or mucus) that the person did not intend to pass. It exists on a spectrum:
Minor leakage — occasional small amounts of stool or soiling after otherwise normal bowel movements
Urgency incontinence — an overwhelming urge to defecate that cannot be deferred long enough to reach a bathroom
Passive incontinence — stool or mucus passes without any awareness or urge
All forms are worthy of assessment and treatment. None are simply "something that happens when you get older."
How Common Is It?
Faecal incontinence affects an estimated 1 in 10 Australians; a figure widely considered an underestimate, as the condition is significantly under-reported. It affects both men and women across all age groups, though for different reasons. Women are more commonly affected in younger to middle adulthood, often due to obstetric causes; men more commonly in older adulthood.
What Causes Faecal Incontinence?
Normal continence depends on coordinated function of the anal sphincter muscles, pelvic floor, rectal sensation, and stool consistency. When any of these is affected, incontinence can result. Common causes include:
Obstetric Injury
Childbirth is one of the leading causes in women. Perineal tears, episiotomies, and the physical stretching of delivery can damage the anal sphincter or its nerve supply, sometimes with effects that don't appear until years later, particularly around menopause.
Anorectal Surgery
Surgeries involving the rectum or anus, including haemorrhoidectomy, sphincterotomy, and bowel resections, can affect sphincter integrity or nerve function.
Pelvic Floor Dysfunction
Weakness or incoordination of the pelvic floor muscles impairs the ability to retain stool. This is common and highly responsive to targeted physiotherapy.
Neurological Conditions
Conditions affecting bowel and sphincter nerve control, including diabetes, multiple sclerosis, and spinal cord injury, can cause or contribute to incontinence.
Loose or Liquid Stools
Even with an intact sphincter, loose stools are significantly harder to control. Treating the underlying cause of diarrhoea (whether IBS-D, bile acid malabsorption, or IBD) often substantially improves incontinence.
Assessment at Bowel Diagnostics & Therapy
We begin with a thorough, private consultation. Discussing this condition takes courage, and we meet that with sensitivity, professionalism, and non-judgment. Assessment may include:
Detailed history — symptoms, frequency, obstetric or surgical history, daily life impact
Anorectal manometry — measures sphincter strength, coordination, and rectal sensation
Endoanal ultrasound — imaging to identify any structural sphincter damage
Defecating proctogram — imaging to assess evacuation mechanics and rectal structure
Not all investigations are required for every patient. Assessment is tailored to your history and symptoms.
Treatment Options
Treatment depends on the underlying cause. Management options include:
Dietary modification — adjusting fibre and fluid to optimise stool consistency and reduce urgency
Pelvic floor physiotherapy — exercises and biofeedback to strengthen sphincter muscles and improve coordination
Biofeedback therapy — real-time feedback to help improve sphincter control and rectal sensation
Medications — to firm stool, reduce urgency, or address an underlying cause
Sacral nerve stimulation — a minimally invasive procedure with strong evidence for appropriate patients
Surgical options — for structural sphincter damage where other approaches have not provided sufficient improvement
Many patients experience meaningful improvement — and some achieve complete resolution — with non-surgical approaches. Our goal is to find the most effective, least invasive path forward for you specifically.
The Most Important Thing We Want You to Know
If you've been living with faecal incontinence without seeking help, whether due to embarrassment, assuming it was permanent, or not knowing where to turn, you don't have to manage this alone. You don't have to plan your life around it. And you don't have to accept it as inevitable.
A conversation with your GP about a referral to Bowel Diagnostics and Therapy is the first step, and it may be the most important thing you do for your quality of life.
Take the First Step Towards Better Bowel Control.
Gold Coast · Springfield · Greenslopes
Ask your GP for a referral to Bowel Diagnostics & Therapy,
or call our rooms directly on 1300 888 608
