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What is anal incontinence?
Studies suggest that a noticeable share of adults experience some degree of bowel leakage, yet only a small fraction ever talk to a doctor about it. You are not alone, and there is help.
Two rings of muscle around the anus, the internal and external sphincters, along with the pelvic floor muscles and nerves, keep stool and gas in until you choose to let them out. When any part of this system is weakened or damaged, control can slip.
Incontinence ranges from occasionally leaking gas, to staining underwear, to not being able to hold back loose or solid stool. Doctors often describe it as:
- Urge incontinence: you feel the need to go but can't reach the toilet in time.
- Passive incontinence: leakage happens without you noticing.
Symptoms
- Not being able to hold back gas
- Staining or soiling of underwear
- Sudden urgency with leakage before reaching a toilet
- Leakage of loose stool, or sometimes solid stool
- Soreness or itching of the skin around the anus due to moisture
- Avoiding going out, travelling or social events because of fear of an accident
Causes and risk factors
- Childbirth injury to the sphincter muscles, sometimes years earlier
- Previous anal surgery (for fistula, fissure or piles)
- Long-term diarrhoea or irritable bowel
- Chronic constipation with overflow leakage, common in older people
- Nerve problems: diabetes, stroke, spinal injury, multiple sclerosis
- Rectal prolapse or large piles
- Ageing and weakening of the pelvic floor
When to see a doctor
Please see a doctor if you have any loss of bowel control that affects your daily life. See a doctor urgently if you have:
- Sudden loss of bowel control with back pain, leg weakness or numbness around the anus or groin (a possible spinal emergency)
- Blood in the stool or unexplained weight loss
- A new, lasting change in bowel habits
How it is diagnosed at Samrijo
- A detailed, private conversation about bowel habits, childbirth, surgeries and medicines. A bowel diary may be suggested.
- Examination to check muscle tone, skin and any prolapse.
- Proctoscopy and, if needed, colonoscopy to rule out other bowel causes.
- Specialised tests such as anal manometry or endoanal ultrasound, if needed, may be arranged at a partner centre.
- Blood tests at the in-house lab (for example, sugar and thyroid).
Treatment options
What to expect
First visit
A private conversation and examination. Many people feel relieved simply to talk about it. You may be asked to keep a bowel diary for one to two weeks.
Tests
Only the tests that are likely to change your treatment are suggested.
Treatment plan
Most plans start with diet, medicines and exercises. Progress is reviewed after a few weeks.
If surgery is advised
The benefits, risks and recovery (often a few days in hospital and several weeks of healing) will be explained in detail. Recovery varies from person to person.
Everyday tips that help
- Plan toilet visits for times when your bowel is usually active, such as 20–30 minutes after breakfast.
- Keep a food and bowel diary for two weeks to spot triggers. Common ones are very spicy or oily food, too much tea or coffee, milk products in some people, and artificial sweeteners.
- Aim for formed stools. Soluble fibre such as isabgol (psyllium), oats and bananas can help bulk up loose stools. Ask your doctor about the right amount.
- Stay near a toilet when trying new foods, and carry a small kit when going out (wipes, spare underwear, pads). Many people find that simply being prepared reduces anxiety.
- Practise pelvic floor exercises daily once you've been taught the correct method.
Protecting your skin
Repeated moisture can make the skin around the anus sore. Clean gently with water or unscented wipes (avoid harsh soap), pat dry, and use a barrier cream if advised. Cotton underwear and changing pads promptly also help. Tell your doctor if the skin becomes broken or very itchy.
Questions to ask your doctor
- What is the most likely cause of my leakage?
- Which tests do I really need, and what will each one tell us?
- How long should I try diet, medicines and exercises before we review progress?
- Would pelvic floor therapy or biofeedback help me, and where can I get it?
- If surgery is an option, what results can I realistically expect, and what are the risks?
Bring a list of your medicines and, if you kept one, your bowel diary. It helps the doctor understand the pattern quickly.
Why choose Samrijo Hospital
- Private, respectful consultations: a sensitive topic handled with care, in Hindi or English.
- Surgeon-led assessment by Dr. Arun Kumar Patel (MBBS, MS General Surgery).
- Conservative treatment first, with surgery only when it is likely to help.
- In-house laboratory for supporting tests.
Cost
Cost depends on the tests needed and whether treatment involves diet and medicines, therapy sessions or surgery, plus stay and insurance cover.
Call 93196 62944 for an estimate.
मल पर नियंत्रण न रहने (एनल इनकॉन्टिनेंस) का इलाज
जब गैस या मल अनजाने में निकल जाए और व्यक्ति उसे रोक न पाए, तो इसे एनल या फ़ीकल इनकॉन्टिनेंस कहते हैं। प्रसव के दौरान मांसपेशी में चोट, पहले हुई गुदा की सर्जरी, लंबे समय से दस्त या कब्ज़, डायबिटीज़ और उम्र के साथ मांसपेशियों की कमज़ोरी इसके आम कारण हैं। बहुत से लोग शर्म के कारण डॉक्टर को नहीं बताते, जबकि इसका इलाज संभव है।
Samrijo Hospital, बुराड़ी में पूरी गोपनीयता के साथ जाँच की जाती है। ज़्यादातर मरीज़ों में इलाज खान-पान में बदलाव, दवाइयों और पेल्विक फ़्लोर व्यायाम से शुरू होता है। मांसपेशी में स्पष्ट चोट हो या दूसरे इलाज से फ़ायदा न हो, तो सर्जरी पर विचार किया जाता है। हर मरीज़ का परिणाम अलग होता है।
अचानक कमर दर्द, पैरों में कमज़ोरी के साथ मल पर नियंत्रण खो जाए तो तुरंत अस्पताल आएँ। कॉल करें: 93196 62944।
Frequently asked questions
Is loss of bowel control a normal part of ageing?
No. It becomes more common with age, but it is not something you simply have to accept. Many people improve with simple changes, exercises and treatment of the underlying cause.
Who treats anal incontinence?
A general or colorectal surgeon usually leads the assessment, sometimes with a physiotherapist trained in pelvic floor exercises, a gastroenterologist or a gynaecologist, depending on the cause.
Can pelvic floor exercises really help?
Yes, for many people. Regular, correctly done exercises strengthen the muscles around the anus. Improvement usually takes several weeks of practice. A trained therapist can guide you.
When is surgery needed for incontinence?
Surgery is considered when there is a clear muscle injury (for example after childbirth) or when simpler treatments have not helped enough. Your surgeon will explain whether a repair may help in your case.
Can diet make a difference?
Yes. Loose stools are much harder to control than formed ones. Adjusting fibre, avoiding foods that trigger loose motions and, where advised, using medicines that firm the stool can help a lot.
What does treatment cost?
It depends on the tests needed and whether treatment is with diet, exercises, medicines or a procedure. Call 93196 62944 for an estimate.
मल पर नियंत्रण न रहना किसे कहते हैं?
जब व्यक्ति गैस या मल को रोक नहीं पाता और वह अनजाने में निकल जाता है, तो इसे एनल या फ़ीकल इनकॉन्टिनेंस कहते हैं। यह एक आम लेकिन इलाज योग्य समस्या है।
क्या इसके लिए हमेशा ऑपरेशन करना पड़ता है?
नहीं। कई लोगों को खान-पान में बदलाव, दवाइयों और पेल्विक फ़्लोर व्यायाम से ही काफ़ी फ़ायदा होता है। ऑपरेशन तभी सोचा जाता है जब मांसपेशी में चोट हो या दूसरे इलाज से फ़ायदा न हो।
Related treatments
This page is for general health information only. It is not a diagnosis or a substitute for a consultation. Every patient is different, so please consult a qualified doctor about your own condition and treatment. Medical disclaimer.