A leaky butt means a person passes bowel movements, or fecal matter, when they do not want or mean to. While it can occur for short periods of time, some people experience it as an ongoing issue.

Fecal incontinence is common. However, it can be uncomfortable and may affect a person’s quality of life.

Gastrointestinal challenges, such as severe diarrhea, may temporarily cause fecal incontinence. This is usually short-lived. Chronic incontinence typically stems from another medical condition, such as a neurological disorder, chronic constipation, childbirth injuries, or hemorrhoids.

Read on to learn more about leaky butt (fecal incontinence).

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Bowel leakage means a person leaks fecal matter when they do not want to.

For example, this may happen when a person thinks they are only passing gas but instead passes fecal matter. It is also possible to have more significant bowel leakage, such as having an entire bowel movement without being able to control it.

Bowel leakage is a type of bowel incontinence. It can be acute, such as when a person has short-term diarrhea. A disease or injury may also cause incontinence that is chronic, or ongoing.

Many different issues can cause bowel leakage. They include the following:

  • Rectocele: When the front wall of the rectum bulges into the vagina, it can cause rectocele. This is often a complication of vaginal deliveries but can also occur following surgery or if a person frequently strains to have a bowel movement.
  • Nerve damage: Nerve damage to the anus or rectum can affect a person’s ability to hold a bowel movement. Type 2 diabetes and traumatic injuries are common causes of nerve damage.
  • Gastrointestinal problems: Acute infections and diarrhea can make it difficult to hold in a bowel movement. Chronic illnesses such as Crohn’s disease or irritable bowel syndrome may cause frequent diarrhea. These diseases may also cause straining that damages the muscles of the rectum.
  • Neurological disorders: Some neurological disorders, such as dementia, can affect a person’s ability to control their body and understand when and how to have a bowel movement. Others, such as multiple sclerosis, can cause nerve and muscle damage.
  • Traumatic injuries: Traumatic injuries may damage the nerves or muscles of the rectum. Vaginal deliveries, surgery to the anus or surrounding areas, and instrumental delivery during childbirth, such as the use of forceps, can increase the risk of such injuries.

Many different medical conditions can cause bowel leakage, though not all people with those conditions will develop incontinence.

The following factors can elevate a person’s risk:

  • surgery to the anus, rectum, or surrounding areas, since this can cause nerve injuries
  • neurological disorders such as dementia, multiple sclerosis, and stroke
  • vaginal childbirth, especially if a person experiences injuries during delivery
  • traumatic injuries to the rectum that may damage the muscles
  • chronic severe hemorrhoids
  • chronic constipation, especially in children
  • brain and spinal cord injuries
  • type 2 diabetes

Diagnosis begins with a medical history that may help identify potential causes and guide additional testing.

A doctor may look for signs of infection in people with chronic diarrhea.

A doctor may also take a stool sample.

Some other tests a doctor might recommend include:

  • MRI scans of the intestines, rectum, or anus
  • tests that look for muscular or nerve injuries during a bowel movement
  • bloodwork to look for certain underlying diseases, such as diabetes
  • tests of the nerve signals in the rectum

Bowel incontinence may worsen with time. Some potential complications include:

  • social challenges
  • infections from chronic skin exposure to bacteria
  • pain and discomfort
  • damage to the skin

It is not always possible to prevent conditions that can cause bowel leakage. Some strategies that may help include:

  • avoiding straining to have a bowel movement
  • managing incontinence to reduce the need to strain
  • asking a doctor about strategies to reduce incontinence after surgery or childbirth
  • treating or managing chronic medical conditions such as type 2 diabetes
  • remaining physically active

Treatment depends on the cause, so getting an accurate diagnosis is important. Some potential treatments include:

  • Medication: Certain medications, such as loperamide, can slow digestion and reduce incontinence from diarrhea or runny stool.
  • Managing chronic conditions: Treating chronic medical conditions such as diabetes can help prevent symptoms from worsening.
  • Bulking agents: Treatment such as cellulose can make the stool bigger and thicker, reducing incontinence.
  • Biofeedback: This can help a person regain some control when there is nerve damage or a physical injury.
  • Estrogen: In postmenopausal women, estrogen may be helpful.
  • Surgery: Surgery may repair some injuries to the sphincter or nerves.
  • Other treatments: Some other treatments, such as pelvic floor physical therapy, may offer relief.

Temporary bowel leakage can occur when a person has diarrhea or another gastrointestinal problem. Chronic bowel leakage, though, is a medical issue requiring treatment.

It is best to contact a doctor if a person experiences any of the following:

  • diarrhea causing bowel leakage for more than a few days
  • bowel leakage following surgery, childbirth, or an injury
  • bowel incontinence for any reason that has not responded to home treatment
  • incontinence treatment that stops working or causes severe side effects
  • worsening incontinence

Bowel leakage can be difficult to manage and may affect a person’s self-esteem, relationships, and mental and physical health. A number of treatments can help, but a person must first discuss the issue with their doctor.

Doctors regularly help people with incontinence, as it is a common problem, so there is no reason to feel embarrassment or hesitation.