Hemorrhoids and Fecal Incontinence

Understanding the Relationship

Hemorrhoids themselves do not directly cause fecal incontinence, but prolapsing hemorrhoids can contribute to minor incontinence through mechanical obstruction and soilage rather than true sphincter dysfunction, as noted by the American Gastroenterological Association 1, 2
Anal cushions contribute 15-20% of resting anal pressure and play a role in maintaining continence, but symptomatic hemorrhoids represent pathologic enlargement of these normal structures 3
The American Gastroenterological Association notes that anal itching from prolapsing hemorrhoids is just as likely due to inadequate hygiene or minor incontinence as it is to the hemorrhoids themselves 1, 2

The American Gastroenterological Association emphasizes that when hemorrhoids are simply assumed to be the cause of incontinence, other pathology is too often overlooked 1, 2
A careful anorectal evaluation is warranted for any patient reporting both hemorrhoids and incontinence symptoms, as 20% of patients with hemorrhoids have concomitant anal fissures 4