It's tough to discuss, while arguably tougher to live with. Here's when one man knew it was time to seek help, and what he's learned.
‘Here’s How I Knew I Had Fecal Incontinence’: One Patient Reveals When ‘Accidents’ Finally Called for a Diagnosis
Published on Aug. 01, 2025
Fecal incontinence, which clinicians may abbreviate to “FI,” occurs when stool passes unintentionally. For those who experience it, it can feel embarrassing, so people with fecal incontinence might not discuss it—but a doctor’s office is a good place to bring it up.
That’s especially true because it’s more prevalent than most realize. According to a Frontiers in Surgery review published in 2024, about 7% to 15% of people experience fecal incontinence, with older adults and women skewing more likely to experience the condition.
Stool leakage with fecal incontinence ranges from a watery to solid consistency, and fecal incontinence can significantly impact quality of life. However, it can be effectively treated.
Ahead, Mike M., from Cleveland, OH, shares how he first recognized symptoms of fecal incontinence a few years ago; how his diagnosis led to management of his condition with his healthcare team, including Cleveland Clinic colorectal surgeon Anna Spivak, DO; and Mike’s renewed quality of life.
“Here’s How I Knew I Had Fecal Incontinence”
By Mike M., as told to Jackie Newgent, RDN
I’m in my sixties and disabled. I have a partner. We have a dog, Chloe, and a cat, Shadow. I worked more than 30 years at a car dealership. I have an autoimmune disease and have had rectal cancer twice in my life, in 1998 and 2024. In all, I’m a four-time cancer survivor.
My fecal incontinence symptoms
It all started around 2019, but it wasn’t happening often and I didn’t think too much of it. Loose stool would just seem to suddenly creep out. I might have an accident coming home for lunch, or I’d be in a store, and it would happen. I’d be at a traffic light, and I just felt like I had to go.
It got to the point where I tried adult incontinence underwear, but for me they weren’t very comfortable. So, I’d carry a change of clothes and wipes with me. When it’s loose, [stool leakage] is just running down your legs into your shoes. You find you need to clean wherever you walk, because it’s coming out of your pants and hitting the floor. Maybe you’ve got to clean the car seat, immediately put your clothes in the washer, and take a shower. It’s demoralizing.
To help, initially I tried Imodium. I tried Metamucil and eating more fiber, hoping it would make my stool more solid and less urgent. But I’ve learned that the condition grows progressively worse over time. In 2022, it started to disrupt my life.
Seeking care for fecal incontinence
I talked to the physician assistant in my oncology office about my symptoms since my first rectal cancer. I’d undergone 38 radiation treatments, which put my body through a lot, to say the least.
My PA talked things over with my oncologist. When I’d had my prostate removed, the surgery took almost eight hours. Because of all the scar tissue in that region, they referred me to a colorectal surgeon for treatment of fecal incontinence with the thought of a colostomy.
But the surgeon was worried. He really didn’t want to perform the colostomy surgery because he didn’t know what they were going to find. He referred me to Dr. Spivak, suggesting something else could help—something, he hoped, that would be less invasive.
So, I saw Dr. Spivak, and at that point, I was so worried after what the surgeon had said and all the problems that could arise. I was resigned, feeling like I just wanted to find a solution: I’m going to have a colostomy, I thought, because I can’t live this way anymore. My quality of life sucked! I couldn’t plan things with people, because you just didn’t know what would happen. I would just get so embarrassed.
I never knew that there was such a diagnosis as fecal incontinence, I just thought that’s the way my body was now. My colorectal surgeon is the one who said, Yes, this is a thing. This is definitely a thing.
The cause of fecal incontinence, for me
They don’t know with certainty if my fecal incontinence was due to rectal cancer treatment. I think with the radiation and surgery, you can only have surgery so many times in one area before it’s going to start weakening. I believe it’s more from all the times that they had to cut tumors out that really caused my bowel problems.
My fecal incontinence treatment
Dr. Spivak suggested a sacral nerve stimulation, or SNS, device. She explained that initially it’s a temporary type of implant, a trial for a week or two, and the battery is outside of you. And if there’s no improvement, they take it out. The Cleveland Clinic‘s website explained more: “Sacral nerve stimulation works by modifying the communication between your brain and your bowels … Blocking communication gives you more control over when you poop.”
Let’s give it a shot, I thought.
Within two weeks, I probably had just two accidents. I was amazed that it had gotten better with a device, not a colostomy. They implanted the permanent SNS in January 2024. Since then, I’ve had some accidents, but I’m able to go on my own.
The SNS device is like two phones, where you turn the device on, and then put the transmitter over where it’s implanted on my left lower side. You’ll feel a little buzz, and then you can turn up its tension. I do that on my own.
I praise Dr. Spivak for what she’s done.
Living with fecal incontinence
At first, fecal incontinence is something you feel so embarrassed and ashamed about that you don’t want to talk about it. But it gets to the point where you’ve got to talk about it, because otherwise, you’re just avoiding trying to have a better life.
My partner has been very, very understanding. Now, my outlook has completely changed—I’ve got this device inside me. I have a better outlook at everything in my future because now I feel this can be under control. Yeah, I might have an accident here and there…but a lot of people do. The good news is I don’t have that feeling in my head all the time that something bad is going to happen if I go out.
Today, I’m trying to eat more fruits and vegetables. I enjoy my home, hanging out with very good friends, and just enjoying life as it comes. You have to have a good attitude. If you don’t, then you might as well just give up.
Advice for others who may be experiencing fecal incontinence
Talk to your doctor. There’s help for this. Make sure you have a team of doctors around you that all talk, want you to have a better quality of life, and listen to you. I think that has been my biggest help along the way—knowing I have a team at the Cleveland Clinic around me.
I think people with this condition think colostomy is the only way. It’s possible that there are alternatives. Treatment can definitely be a life-changer and get you back to some type of normality in your life.
What to do if you suspect you have fecal incontinence
If you think you might have fecal incontinence:
- See your primary care provider (PCP) or gastroenterologist, even if you’re embarrassed.
- Track your symptoms, including timing and severity of episodes, triggers, and diet.
- Tell everything to your PCP, including your symptoms, medications, supplements, and medical history.
- Follow through. Proper treatment can improve fecal incontinence.
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