You may not expect a condition like incontinence - which describes the involuntary loss of urine and/or faeces - to be linked with constipation, but the two can actually crossover.

Constipation is an extremely common gastrointestinal issue, with around 24% of Aussies reported to experience chronic constipation (constipation that persists for several weeks or longer) [1].

As for how it’s related to incontinence, constipation can unexpectedly cause and/or worsen incontinence symptoms and create a challenging cycle if it’s not dealt with properly.

In this article, we’ll delve deeper into the link between these two common conditions, exploring how constipation can lead to or worsen incontinence, along with how to best manage both conditions to improve overall health and quality of life.

Before exploring the connection between constipation and incontinence, let's get to know a bit more about each of these conditions.

Constipation is caused by infrequent bowel movements, accompanied by difficulty in passing stool. It can arise from diet factors (not eating enough fibre), lack of physical activity, stress or trauma, some medications, and medical conditions.

Incontinence is the involuntary loss of bowel or bladder control, causing an inability to contain faeces or urine. The level and type of incontinence will vary from person to person.

Constipation can affect both urinary and faecal incontinence.

The gastrointestinal (digestive) system and the urinary system share several connections within the body. When constipation occurs, the hard, stubborn stool can actually put pressure on the bladder. This pressure can then affect the function of the bladder and urethra in a few ways.

It can impact the bladder from being able to fill with urine properly, not being able to empty properly or cause it to contract when it’s not ready to. Each issue can then cause a sudden urge to urinate (urge incontinence). Some who already experience bladder leaks may notice they get worse when they’re constipated.

As for how constipation affects the bowel, it’s actually the most common cause of faecal incontinence (bowel leakage). It might seem counterintuitive that constipation can cause bowel leakage, so how does it happen?

A hard stool can cause a partial blockage high up in the bowel, so only watery stools can get around it. This can often be mistaken for diarrhoea. Sometimes these watery bowel movements cannot be controlled and leak without going to the toilet - this is faecal incontinence.

You can refer to the Bristol Stool Chart to identify what your stool looks like. It’s particularly helpful to then pass that information on to your doctor if you need to seek help for your constipation and/or incontinence.

In terms of what’s considered a healthy bowel movement, this will vary from person to person. However, a general rule of thumb is that a bowel movement should be soft but well-formed and easily passed. They can be passed between one to three times a day or three times a week to be considered normal. Speak to your doctor if you’re concerned.

Another way constipation can cause or impact incontinence is through the pelvic floor muscles.

Pelvic floor strength plays a huge role in bladder and bowel control, however, they can be weakened by straining due to constipation. When strained consistently over time, the pelvic floor will lose strength and so too can the bladder and bowel.

Constipation can also put pressure on nerves in the pelvic region which can disrupt the signals between the rectum, bladder and brain, leading to altered sensations of urgency to use the toilet.

You can see how the connection between constipation and incontinence can become an uncomfortable cycle.

For example, someone who already has incontinence may be hesitant to pass stool regularly for fear of leaking, but this then causes constipation.

Constipation can then cause watery stool that leaks around the hardened stool.