Is bowel incontinence something I just have to live with as I get older?

No. Although it is more common with age, it is not a normal, untreatable part of ageing. Most people improve with simple measures like diet changes, pelvic-floor exercises and treating the underlying cause, so it is worth seeing a doctor.

I am too embarrassed to talk about it — is it really that common?

It is far more common than people think and is very under-reported precisely because of embarrassment. Doctors, continence nurses and physiotherapists deal with it routinely and confidentially. Speaking up is the first step to effective treatment.

Could my “diarrhoea” actually be caused by constipation?

Yes — this is a common trap. Hard stool stuck in the rectum can allow watery stool to leak around it (overflow), which looks like diarrhoea. A doctor can check for this with a simple examination, and the treatment is quite different.

Usually not. Most people are managed successfully with diet, bowel-habit changes, pelvic-floor exercises or biofeedback and treating the cause. Surgery is reserved for selected cases where these steps do not give enough improvement.

Which doctor should I see?

Start with your GP, who can assess you and begin treatment or refer you. Depending on the cause you may see a colorectal surgeon, a pelvic-floor physiotherapist, or a continence service.

Faecal Incontinence in Singapore: Causes & Treatment

Written & reviewed by the BestDoctors.sg editorial team · Last updated 25 Aug 2026 · General information, not medical advice

Faecal incontinence is the involuntary or accidental leakage of stool (solid or liquid) or wind from the back passage. It ranges from occasional leakage of wind or a small stain to complete loss of bowel control. The most important message is that it is common, under-reported, and treatable — many people suffer in silence for years out of embarrassment, yet effective, confidential help is available and worth seeking. Continence depends on firm-enough stool, a rectum that can sense and store it, intact sphincter muscles and the nerves that coordinate them, and a problem with any of these can cause leakage.

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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

Sudden bowel incontinence with back pain, leg weakness or numbness, saddle numbness, or new urinary problems can signal a nerve emergency — call 995 or go to A&E. Black or bloody stool also needs urgent review. Do not let embarrassment delay care.

The two main patterns

Urge incontinence is a sudden, overwhelming need to go with an inability to reach a toilet in time, often from a weak or damaged sphincter, while passive incontinence or soiling is leakage without awareness, often from nerve or sensation problems or from stool pooling above a blockage. Constipation with overflow is a common and reversible cause — hard stool builds up and watery stool leaks around it.

Causes and risk factors

Childbirth injury to the anal sphincter or pelvic-floor nerves is a leading cause in women and can appear years later. Ageing and weakening of the pelvic floor, nerve damage or neurological conditions (diabetes, stroke, spinal problems, multiple sclerosis, dementia), severe or chronic diarrhoea (loose stool is harder to hold), chronic constipation with overflow, previous anal or pelvic surgery or radiotherapy, and conditions such as haemorrhoids or rectal prolapse all contribute.

Symptoms

People experience urgency, leakage of stool before reaching the toilet or without being able to stop it, passive soiling of underwear sometimes without feeling it, and an inability to control wind. There is often skin irritation or itch around the anus, and a significant emotional and social impact — avoiding going out, anxiety, and low mood — which is exactly why seeking help matters.

Red flags

Sudden-onset bowel incontinence together with back pain, leg weakness or numbness (including numbness around the buttocks or genitals) or new urinary retention or incontinence can signal a nerve or spinal-cord emergency such as cauda equina — seek emergency care immediately, calling 995 or going to A&E. Incontinence with black, tarry or bloody stool, or bloody diarrhoea, needs urgent review, and a new, sudden, unexplained change in bowel habit or incontinence with unintended weight loss should be seen promptly to exclude serious bowel disease.

How it is assessed and treated

Assessment covers the history (pattern, triggers, obstetric history, medicines, diet) and a physical exam including a digital rectal examination to check sphincter tone, sensation and for impacted stool, prolapse or masses. Further tests where needed include anorectal manometry, endoanal ultrasound to look for sphincter injury, and sometimes a colonoscopy if there are red flags or a change in bowel habit. Care usually starts with a GP and may involve a colorectal surgeon and multidisciplinary continence services or pelvic-floor physiotherapists. Treatment begins by addressing the underlying cause — controlling diarrhoea, treating constipation and overflow, and reviewing contributing medicines. Dietary and bowel-habit measures help: identifying and reducing trigger foods and drinks (caffeine, very spicy food, some sugar-free sweeteners), adjusting fibre to firm the stool, a regular toileting routine, good positioning, and a symptom diary. Pelvic-floor muscle exercises and biofeedback or bowel retraining are core, well-evidenced treatments, and medicines to firm the stool may be prescribed, with skin-care and continence products protecting skin and dignity meanwhile. Surgery — sphincter repair, sacral nerve stimulation, or rarely a stoma — is reserved for selected cases when conservative measures are not enough. Most people improve with conservative treatment.

Please do not suffer in silence

The single most important step is to tell a doctor, however minor or embarrassing the leakage seems. Faecal incontinence is far more common than people think and is under-reported precisely because of embarrassment, and doctors, continence nurses and physiotherapists deal with it routinely and confidentially. A useful thing to bring is a simple diary of when leakage happens and what you had eaten, which helps pinpoint triggers, and it is worth remembering that this is not an inevitable part of ageing to be endured — most people get meaningful improvement with straightforward measures. In the meantime, gentle skin care, barrier creams and discreet continence products protect the skin and help you stay active and confident while treatment takes effect. A women’s-health or pelvic-floor physiotherapist is often central to recovery, so ask your doctor for a referral if one is not offered.

When to see a doctor

See a GP for any recurrent or bothersome leakage of stool or wind, however minor, and promptly for a new change in bowel habit, bleeding, or if it is affecting daily life or mood. Seek emergency care (995 or A&E) for the red-flag combination of sudden incontinence with back pain, leg weakness or numbness, saddle numbness, or new urinary problems.

Related colorectal & digestive topics

Sources

SingHealth — Faecal Incontinence: singhealth.com.sg
NHS — Bowel incontinence: nhs.uk
NIDDK — Bowel Control Problems (Fecal Incontinence): niddk.nih.gov
MedlinePlus — Bowel incontinence: medlineplus.gov

General information only. This guide is general information about a colorectal or anal condition and is not a diagnosis or personalised medical advice. See a doctor or colorectal surgeon for assessment. Do not assume rectal bleeding, an anal lump, a non-healing sore, or a change in your bowel habit is “just piles” — these must be checked to exclude bowel or anal cancer. Seek urgent care for a painful, spreading anal swelling with fever, or severe abdominal pain with vomiting and not passing stool or wind (possible obstruction); call 995 for a high fever with rapidly spreading redness or severe illness.

Faecal Incontinence in Singapore: Common & Treatable