Fecal incontinence (FI) affects up to 17 million people in the United States, according to the International Foundation for Functional Gastrointestinal Disorders. It’s also the second most common reason older adults make the decision to go into assisted living or long-term care facilities. Even though fecal incontinence is common, it can be embarrassing or upsetting for seniors to talk about, and it often goes unaddressed. The good news is that, in many situations, elderly fecal incontinence is treatable or manageable.
Fecal incontinence is the inability to control bowel movements. The condition can range from an occasional leakage of stool to a complete loss of bowel control in elderly adults.
Healthy bowel function is controlled by three body functions:
Malfunction of one or more of these may result in fecal incontinence, according to Dr. Satish Rao, a gastroenterology specialist at Augusta University Health in Augusta, Georgia. Nearly half of those with FI have “impaired rectal sensation,” which means they aren’t aware of the need to use the restroom, says Rao.
During the digestive process, feces moves from the large intestine to the rectum. In response, rectal walls stretch. This tells the brain it’s time for a bowel movement. Two anal sphincter muscles — an involuntary inner muscle and a voluntary outer seal — hold the stool in the rectum until a toilet is reached. Then a person relaxes to release the stool. If a signal is misinterpreted, the sphincter muscles are damaged, or the toilet isn’t reached in time, fecal incontinence may occur.
One or more of the following physical causes can result in fecal incontinence in the elderly:
There are a number of different reasons why an elderly person may experience incontinence. Being aware of what has caused the problem may give seniors some idea of how to manage it. However, it’s not always possible to pinpoint a single cause.
Our free tool provides options, advice, and next steps based on your unique situation.
In addition to the physical causes described above, the following factors often contribute to the loss of bowel control in seniors.
As you can see, older adults are at increased risk for fecal incontinence simply because of their age. In fact, it’s estimated that around 8% of seniors in the United States suffer from fecal incontinence.
If you or an elderly loved one is experiencing FI, talk to a doctor. Usually, a general practitioner will provide a referral to a specialist, who may ask questions about living arrangements, diet, and current and past bowel function, according to Rao.
A patient may also be asked to bring a record of fecal incontinence to their first visit or to create one between appointments. In this journal, they’ll likely record:
After asking questions, the doctor may do a physical examination. They’ll likely check for hemorrhoids, infection, or other abnormalities. They may look at the anus and perineum, the area between the anus and the genitals. Doctors may also schedule one or more of these common tests:
The type of test needed will depend on a number of factors. A doctor will consider a patient’s symptoms and past medical history before recommending a specific test.
Our advisors help 300,000 families each year find the right senior care for their loved ones.
Mild incontinence may be managed at home, but seniors with more severe symptoms can benefit from biofeedback training, prescription medication, or surgery. It’s important to note that fecal incontinence in elderly adults may have serious emotional effects. These can contribute to anxiety, depression, and even social isolation. Mental health is one reason that bowel control is so important for seniors.
After a diagnosis, a doctor may recommend any of the following treatments and lifestyle modifications as a first step.
Trying one or more of these may offer some relief. However, some cases may not respond to these treatments. For persistent incontinence, more aggressive treatments may be necessary.
Biofeedback exercises are a noninvasive therapy that can reduce incontinence symptoms in a large percentage of people. Through biofeedback therapy, patients learn to control body processes that are normally involuntary. Biofeedback exercises may require the assistance of a registered nurse or doctor with special training. Once learned, they can be continued at home independently.
During biofeedback therapy, a small electrode is placed in or near the anus. This sends signals to a computer. As pelvic muscles tighten and relax, an image on the screen or noise that fluctuates in volume responds. Based on this feedback, a patient can tell when their muscles are engaged, even if they can’t feel it. This feedback is used to learn muscle control.
If other treatment methods don’t work, surgery may help reduce FI. It could even eliminate symptoms in some cases. Common surgical options to discuss with a doctor include:
It’s important to remember that surgery is often a last resort. Also, not everyone is a surgical candidate. Each patient must work with their doctor to determine the best course of treatment for their unique situation.
If your elderly family member is experiencing fecal incontinence, simple planning can help avoid complications, such as odors, accidents, and skin rashes.
Understanding the many causes of fecal incontinence can help seniors explore lifestyle changes, medical treatments, and surgical interventions to manage their symptoms. Although discussing the topic may be difficult, open communication with family members and medical professionals can lead to solutions and greatly improve a senior’s quality of life.
Staller, K., Townsend, M., Khalili, H., Mehta, R., Grodstein, F., Whitehead, W., Matthews, C., Kuo, B., & Chan, A. (2017, February 14). Menopausal hormone therapy is associated with increased risk of fecal incontinence in women after menopause. Gastroenterology.
Ditah, I., Devaki, P., Luma, H. N., Ditah, C., Njei, B., Jaiyeoba, C., Salami, A., Ditah, C., Ewelukwa, O., & Szarka, L. (2014). Prevalence, trends, and risk factors for fecal incontinence in United States adults, 2005-2010.American Gastroenterological Association.
Lee, B. H., Kim, N., Kang, S. B., Kim, S. Y., Lee, K. H., Im, B. Y., Jee, J. H., Oh, J. C., Park, Y. S., & Lee, D. H. (2010). The long-term clinical efficacy of biofeedback therapy for patients with constipation or fecal incontinence. Journal of neurogastroenterology and motility.
Goos, M., Baumgartner, U., Löhnert, M., Thomusch, O., & Ruf, G. (2013). Experience with a new prosthetic anal sphincter in three coloproctological centres. BMC Surgery.
Ullah, S., Tayyab, M., Arsalani-Zadeh, R., & Duthie, G. S. (2011, April). Injectable anal bulking agent for the management of fecal incontinence.Journal of the College of Physicians and Surgeons–Pakistan.
The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.
Make the best senior care decision