Fecal Incontinence

What is fecal incontinence?

Fecal incontinence is the inability to control bowel movements, causing a child to repeatedly pass stool in inappropriate places. It is often related to constipation, though some children have fecal incontinence after surgery to correct an anorectal malformation or other condition in the rectal area.

Fecal incontinence that does not resolve with the usual therapeutic measures is called “intractable fecal incontinence.”

What are the symptoms of fecal incontinence?

The symptoms of fecal incontinence depend on what type of the condition a child has.

An urge to have a bowel movement that comes on so quickly a child can't make it to the toilet in time is "urge fecal incontinence." A child who frequently soils their underwear with stool without realizing it has "passive fecal incontinence."

What causes fecal incontinence?

Common causes of fecal incontinence include:

  • diarrhea
  • constipation
  • problems with muscles or nerves
  • Hirschsprung's disease
  • congenital malformations of the anorectal area, like imperforate anus
  • neuropathic conditions like spina bifida

How we care for fecal incontinence

The Boston Children's Hospital gastrointestinal (GI) motility team takes a holistic approach to treatment. We perform tests to understand how your child’s entire GI system is working, including the nerves in the intestines that are often responsible for incontinence. This allows us to develop an effective treatment plan. Because fecal incontinence can be accompanied by other conditions, such as urinary incontinence or constipation, we work closely with other specialists throughout Boston Children’s to ensure that we meet each child’s complex needs.