Faecal incontinence

Faecal incontinence is the inability to control wind or stool, ranging from occasional leakage to more significant accidents. It is common, and often linked to childbirth, pelvic floor weakness, nerve damage, or bowel conditions. Many people improve with bowel management, pelvic floor therapy, and medication, while surgery is reserved for clear cases.

What is faecal incontinence?

Faecal incontinence is the loss of control of wind or stool, ranging from occasional leakage to frequent accidents. It occurs when the sphincter muscles, pelvic floor, nerves or stool consistency are affected. It is common, affects both men and women, and is treatable in many cases.

Control of the bowel depends on the sphincter muscles, pelvic floor, nerves, and the consistency of the stool working together. A problem in any of these can cause leakage. The cause may date back to a difficult birth or surgery, or develop with ageing, diarrhoea, or prolapse.

What causes faecal incontinence?

Faecal incontinence is most often caused by injury to the anal sphincter during childbirth, pelvic floor weakness, nerve damage, or loose stools from conditions such as inflammatory bowel disease or IBS. Rectal prolapse, previous anal surgery and conditions of the brain or nerves are other causes.

Injury to the sphincter during childbirth
Nerve damage
Pelvic floor weakness and rectal prolapse
Loose stools from inflammatory bowel disease or IBS
Previous anal surgery
Conditions affecting the brain or nerves

What are the symptoms?

Faecal incontinence causes leakage of wind or stool, accidents before reaching the toilet, a sudden urgent need to open the bowels, and staining on underwear. Loose stools are harder to control than formed stools, so symptoms are often worse during bouts of diarrhoea.

Leakage of wind or stool
Accidents before reaching the toilet
Urgency
Staining on underwear
Difficulty controlling loose stools

When should I see a colorectal surgeon?

See a doctor if you leak stool or wind more than occasionally, because many causes of faecal incontinence can be treated. Go to an emergency department immediately if new loss of bowel control comes with leg weakness, numbness around the genitals or bottom, or difficulty passing or controlling urine. Seek prompt assessment for blood in the stool, weight loss, a change in bowel habit, or a prolapse that protrudes from the anus.

The warning signs below need prompt attention.

Sudden onset with weakness elsewhere
Blood in the stool
Weight loss or a change in bowel habits
Prolapse that protrudes

How is it diagnosed?

Faecal incontinence is assessed with a history, a bowel diary and an examination of the sphincter and any prolapse. Ultrasound of the anal muscles shows sphincter injury, and nerve and pelvic floor tests check how the muscles work. Colonoscopy is added when bowel disease is suspected.

A careful history and bowel diary
Examination of the sphincter and prolapse
Ultrasound of the anal muscles
Nerve and pelvic floor tests
Colonoscopy when bowel disease is suspected

How is faecal incontinence treated?

Treatment of faecal incontinence begins with bowel management, stool-bulking fibre, medicine to firm loose stools, and pelvic floor training with biofeedback. If these are not enough, options include sphincter repair for a defined injury, sacral nerve stimulation and treatment of any prolapse or bowel disease. Only a minority need an operation.

Bowel management and stool-bulking fibre
Medication to firm loose stools
Pelvic floor and biofeedback therapy
Sphincter repair for a defined injury
Sacral nerve stimulation or other advanced procedures
Treatment of prolapse or inflammatory disease

Is it covered by MediSave or insurance?

Dr Wong is a panel doctor under Alliance Medinet. Before your procedure, he can request pre-authorisation from Prudential and AIA, and the clinic writes in to other insurers in the same way. Prudential patients can claim when Dr Wong operates at Aptus Surgery (Paragon), a day surgery centre listed on Prudential's PRUPanel Connect. Pre-authorisation is decided by the insurer and is not a guarantee of payment. Eligible charges may be paid from MediSave within the limits for your procedure, and any uncovered balance is paid in cash.

How it works, step by step: fees, MediSave and insurance.

What is recovery like?

Conservative care Weeks to months
Pelvic floor therapy needs practice
After surgery 4 to 6 weeks
Further therapy may follow

What are the risks and complications?

Surgery for faecal incontinence may not fully restore control. Risks include infection and wound problems, and implant-related complications with sacral nerve stimulation. Medicines that firm the stool can cause side effects such as constipation.

Surgery may not fully restore control
Infection and wound problems
Implant-related complications in nerve stimulation
Side effects from medication

How much does it cost in Singapore?

The cost depends on the treatment you need and how complex it is. MOH publishes fee benchmarks for most surgical procedures, and Dr Wong's fees are guided by them. After your consultation the clinic gives you a written estimate before you decide. See fees, MediSave and insurance.

Medically reviewed by Dr Wong Nan-Yaw

MBBS (NUS), FRCS (Edinburgh). 33 years in medicine (since 1993), 23 years as an accredited specialist (since 2003) and 18 years in private practice at Mount Elizabeth (since 2008). Last reviewed 6 November 2026.

Frequently asked questions

Is it a normal part of ageing?

It becomes more common with age but is not inevitable and should not simply be accepted. Many causes can be treated.

Do I have to talk about it in detail?

It is treated in complete confidence. A clear history and a bowel diary help target the right treatment.

Can pelvic floor exercises help?

Yes, guided biofeedback and pelvic floor training are among the most effective first-line treatments.

References and further reading

Ulcerative colitis

Ulcerative colitis management and surgery by colorectal surgeon Dr Wong Nan-Yaw, with symptoms, treatment, cost and MediSave guidance.

Irritable bowel syndrome

Irritable bowel syndrome diagnosis and care by colorectal surgeon Dr Wong Nan-Yaw, with symptom management and when tests are needed.

Rectal prolapse

Rectal prolapse diagnosis and repair by colorectal surgeon Dr Wong Nan-Yaw, with abdominal and perineal options, recovery and cost.

See Dr Wong at Mount Elizabeth Medical Centre

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