Urgency and Faecal Incontinence


Bowel Control

The anal sphincter consists of an inner ring of smooth muscle which relaxes when the rectum is distended, and is surrounded by a ring of striated muscle, which is under conscious control.

Urgency occurs when the arrival of faeces in the rectum causes strong contractions and  precipitate anal relaxation. In that situation, continence can only be maintained by conscious contraction of the external anal sphincter.

Urgency is particularly common in patients with ‘irritable’ bowels, because the rectum is more sensitive to distension.  If the sphincter is weak, this may cause incontinence.

Causes of Incontinence

The most common cause of sphincter weakness and faecal incontinence is damage to the pelvic floor sustained during childbirth.  About  30% of women have a weak  sphincter after childbirth.

“Mild sphincter weakness may be of relatively little consequence in somebody whose stools are solid and whose bowel habit is regular, but in a person who has IBS and loose bowels and a lot of wind, the risk of incontinence may severely impair a normal social life.”

Faecal incontinence can also occur after spinal injury, stroke, in Multiple Sclerosis and in long standing diabetes.

In the elderly, faecal incontinence commonly accompanies faecal impaction. Rectal distension stimulates the secretion of mucus, which can seep through an insensitive and weak anal canal. 


Medical treatment of urgency and faecal incontinence usually involves treatment of diarrhoea in the first instance.  Many patients find that taking  a capsule of loperamide (Imodium) before they go out anywhere gives them confidence.  

Anal plug. Some people find the use of an anal plug can give them confidence, but do purchase this from a reputable medical supplier.

If incontinence persists even after treating the diarrhoea, ask you GP to refer you to a specialist regional unit for assessment of anorectal function.     

For more information about Faecal Incontinence and how to manage it, click on Embarrassing Problems.

Jane's Story

Jane's Story

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