Is Accidental Bowel Leakage a form of Pelvic Floor Dysfunction?

What is Accidental Bowel Leakage?

Accidental Bowel Leakage (ABL) — the unintentional loss of stool or gas — is a distressing but surprisingly common condition that affects nearly 6% of younger women and up to 15% of older women in the U.S. It is a form of pelvic floor dysfunction which leads to incontinence or unintended incidents of bowel leakage. These incidents may occur when laughing, exercising, coughing, etc. Leakage of fecal matter may also occur when intending to pass gas.

Though rarely discussed, ABL stems from a complex interplay between weakened pelvic muscles, nerve damage, and bowel irregularities, often linked to childbirth, surgery, aging, or chronic illnesses like diabetes or multiple sclerosis.

Women with ABL may experience sudden leakage of liquid or solid stool, or difficulty controlling gas. Diagnosis often includes physical exams, nerve tests, and imaging like ultrasound or defecography to assess damage to the anal sphincter muscles and surrounding tissue.

Treatment for ABL

Treatment is highly individualized, combining lifestyle changes with pelvic floor physical therapy and medical interventions. Simple shifts — increasing fiber, staying hydrated, and scheduling regular bowel movements — can significantly reduce episodes. Skin care and pelvic floor muscle exercises are crucial, while medications can help manage diarrhea. For more persistent cases, options include nerve stimulation implants, anal bulking agents, or even surgery.

Physical Therapy for ABL

Pelvic Health Physical Therapy offers a conservative treatment option for ABL. Interventions are geared towards improving pelvic floor muscle tone, strength and coordination. Common treatment options include but are not limited to manual therapy, therapeutic exercises, neuromuscular control exercises, nerve mobilization, therapeutic stretching, real-time ultrasound, biofeedback and toileting techniques.

Though often seen as taboo, ABL is both manageable and, in many cases, treatable. Open conversations with a healthcare provider are the first step toward reclaiming control — and confidence. We spend up to one hour with all of our patients in private treatment rooms.