Faecal Incontinence: Causes, Management and Where to Get Support
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There's a question people ask in a lower voice, or don't ask at all. As healthdirect puts it, you might find the idea of discussing bladder or bowel problems embarrassing.
That silence is the real problem, because faecal incontinence has causes. This article sits inside our wider guide to living well with incontinence. It covers what the condition actually is, what causes it, what the Australian care pathway looks like, and how to manage things day to day while the cause is being worked out.
What faecal incontinence is
Faecal incontinence is the accidental loss of stool or wind from the bowel. Continence Health Australia describes it as a common health condition affecting around 1 in 30 people in Australia, and healthdirect notes that it often has several different causes.
Bowel incontinence and faecal incontinence are the same thing. Continence Health Australia uses "bowel incontinence" on its consumer pages and describes it as the accidental loss of faeces or wind, which may include finding it hard to control when and where a person passes a bowel motion, or noticing stains in underwear. You'll hear both words used, sometimes in the same appointment.
The 1 in 30 figure is worth sitting with for a moment. It means this is not a rare or shameful outlier.
What causes faecal incontinence
healthdirect is clear that faecal incontinence often has several different causes, which is part of why a proper assessment matters more than guessing. It lists causes including weak pelvic floor muscles, for example after a previous pregnancy or surgery; complications from previous vaginal childbirth; constipation; diarrhoea; and other problems with the anus, rectum or bowel.
Beyond that core list, healthdirect names conditions that affect the nerves, dementia, inflammatory bowel disease, haemorrhoids, rectal prolapse, previous surgery to the bowel, rectum or anus, and previous pelvic radiotherapy. That list isn't a closed one, and two people with the same symptom can have completely different reasons behind it.
One cause on that list isn't a bowel problem at all. healthdirect includes mobility issues that prevent someone getting to the toilet in time. Somebody whose bowel works perfectly well can still have accidents if the walk to the bathroom takes too long, the doorway is too narrow for a frame, or there's no rail to get up from the seat.
Raise that one with a GP, because the fix is sometimes equipment. Continence Health Australia lists grab rails, toilet frames with a raised seat, and commodes among the equipment that helps with toileting.
Constipation, overflow, and a bowel that's too full
The link between constipation and bowel leakage catches people out, because it seems backwards. Continence Health Australia sets out the plain-English terms: faecal impaction is where a large, dry, hard stool gets stuck in the colon due to chronic constipation, and overflow faecal incontinence is losing control of the bowel because of constipation, where liquid stool leaks out around the hard impacted stool when the bowel can't hold any more.
So the leakage is liquid, but the underlying problem is a bowel that is too full rather than too loose. We've written separately about how constipation and bladder leakage are connected, and that article covers the bowel routine side in more detail than there's room for here.
The patterns people describe
Symptoms of faecal incontinence, per healthdirect, can include accidental leaking of wind, needing to rush to the toilet to open the bowels, a small amount of leakage of bowel contents into underwear, and being unable to hold onto a bowel motion, whether liquid or solid.
The wind one deserves a note of its own. It's on healthdirect's symptom list like everything else. It counts, and it's relevant.
If it's bladder leakage you're trying to make sense of rather than bowel, our guide to the different types of incontinence covers the urinary side.
When to get bowel symptoms checked
Some bowel symptoms need an appointment sooner rather than later. healthdirect advises seeing your doctor if you're having trouble controlling your bowel, and says it's also important to see your doctor if you have any change in your bowel habits or notice blood in your stools.
How quickly to act depends on what you're seeing. The two urgent lines below come from healthdirect's page on stool changes, and the routine one from its faecal incontinence page:
- Call triple zero (000) and ask for an ambulance if you see lots of blood in your stools.
- See your doctor right away if you have large amounts of blood in your stools, or your stools look black.
- Book a GP appointment if you're having trouble controlling your bowel, notice any change in your bowel habits, or notice blood in your stools.
Weight loss belongs on the list too. Cancer Council Australia says to talk to your doctor if you're losing weight without trying, have a persistent or unexplained change in bowel habits, or notice blood in or on your poo, especially if those symptoms are ongoing, get worse, or there is any bleeding.
None of this is meant to alarm anyone. It's meant to make sure that a symptom actually gets in front of someone who can look into it.
The Australian care pathway
The starting point is a GP. healthdirect says your doctor will ask about your symptoms and examine you, and may ask you to keep a diary of your bowel habits. Depending on the cause of the problem, it says, your doctor might refer you to a specialist or a continence health professional.
The National Continence Helpline on 1800 33 00 66 is a free service staffed by nurse continence specialists, and it's a genuinely useful first call if you're not sure how to raise the subject with a GP or what to ask for. Continence Health Australia runs it. It's confidential, and the nurses are experienced in continence care.
If the appointment itself is the hurdle, it helps to have the words ready. You don't need clinical language. "I'm losing control of my bowels and I'd like it looked into" is enough to open the conversation.
Notes help too. Keep them for a few days before you go: what happened, roughly when, what you'd eaten, and whether you felt the urge coming or only found out afterwards.
healthdirect describes treatment options including good bowel routines, adequate fibre and fluid, correct positioning on the toilet, medicines for diarrhoea or constipation, physiotherapy for weak pelvic floor muscles, pelvic floor exercises, and surgery in some cases. Which of those applies depends on the cause, and that's why the GP visit comes first.
Comfort First doesn't treat faecal incontinence and doesn't pretend to. Our products help with containment while the clinical side is being sorted out. If you want the detail on how to find the right clinician, we've covered finding and working with a continence nurse separately.
Absorbent products for bowel leakage
With bowel leakage, containment is part of the job.
Slips are the wraparound style.
Diarrhoea is on healthdirect's list of causes. A change kit in the car or the day bag takes the panic out of being away from home.
Bedding is the other thing to plan for. Disposable bed protection goes under the person rather than on them, as a second layer between the person and the sheets. Underpads Small are 30cm x 40cm and suit a chair or a small area, Underpads Regular are 60cm x 40cm, and the Maxi Bed Mat is 60cm x 90cm.
The slips and the pull-up pants are sized by waist measurement. Across their size runs, both cover waists from 60cm to 180cm.
For sizing, see our sizing guide, and our guide to choosing the right product covers matching a product to a level of leakage.
Cost is a fair question, and funding is a separate conversation from this one. If you're an NDIS participant or a carer, our guide to NDIS continence funding in Australia sets out how continence supports sit within a plan.
Skin protection, and where it stops
Skin is the part that quietly decides how well the day goes.
Body wipes aren't a luxury item in this context. Comfort First unscented bamboo body wipes are dermatologically tested.
There's a hard line here, and it needs stating plainly. If the skin becomes red or sore, Continence Health Australia's advice is to talk to a doctor straight away.
The part that doesn't show up in a care plan
There's a social side too, and healthdirect lists problems with self-esteem, anxiety and depression among the complications of faecal incontinence. In daily life it can look like the map of accessible toilets, the second set of clothes in the car, the invitations quietly declined, the holiday that never gets booked.
Say that out loud to your GP too, because it's part of the picture and it affects what a good outcome looks like. If you're the one providing the care rather than living with it, our guide to caring for someone with incontinence covers the routines and the practical side of daily support.
Faecal incontinence is common, it has causes, and those causes are worth finding. Start with a GP appointment, or call the National Continence Helpline on 1800 33 00 66 if you'd rather talk it through with a nurse first. Our broader guide to living well with incontinence has more on the day-to-day side.
If you're new to Comfort First, we can send a free sample while the cause is being addressed, so you can check fit and feel before committing to anything. One of our team will get in touch once afterwards, by phone or email, to hear how it went. We're in East Bendigo, and we're Australian owned and run.