How do you know if your sphincter is damaged?

September 23, 2025 •

5 min read

Studies show that millions of adults experience fecal incontinence, a key indicator for answering the question: how do you know if your sphincter is damaged? This authoritative guide will help you understand the common signs and symptoms and when to seek professional medical advice.

Quick Summary

Identifying sphincter damage involves recognizing changes in bowel control, such as accidental fecal leakage, difficulty holding gas, and new onset rectal pain. These symptoms, often caused by muscle or nerve injury, require medical evaluation for proper diagnosis and effective treatment options.

Key Points

Incontinence is a Key Symptom: The most direct sign of sphincter damage is a loss of bowel control, ranging from minor fecal leakage to an inability to hold gas.
Look for Bowel Changes: Pay attention to symptoms like sudden urgency, incomplete evacuation, or accidental soiling, which indicate compromised sphincter function.
Pain is a Warning Sign: Chronic or acute rectal pain, particularly with bowel movements, can be a symptom of sphincter injury, especially if combined with other issues.
Childbirth is a Major Cause: Traumatic vaginal delivery is a leading cause of sphincter damage, making it important for women to be aware of symptoms postpartum.
Seek Professional Medical Advice: Self-diagnosis is insufficient; a healthcare professional can perform specialized tests to accurately diagnose the extent of any sphincter damage.
Treatment Options Exist: Depending on the cause and severity, treatments can range from simple dietary changes and exercises to advanced surgical procedures.

What is the Anal Sphincter?

Your anal sphincter is a set of two ring-shaped muscles at the end of your rectum. The internal sphincter is involuntary, meaning it functions automatically, while the external sphincter is under your voluntary control. Together, they are responsible for regulating the release of gas and stool, a function known as continence. When these muscles or the nerves controlling them become damaged, a person can lose the ability to control their bowels, a condition known as fecal or bowel incontinence.

Common Symptoms of Sphincter Damage

Recognizing the signs of sphincter damage is the first step toward getting a diagnosis and treatment. Symptoms can vary in severity, from minor leakage to complete loss of bowel control. Ignoring these signs can lead to worsening conditions and significant emotional distress.

Changes in Bowel Control

This is often the most prominent and distressing symptom of sphincter damage. It can manifest in several ways:

Fecal leakage or accidental bowel movements: This can range from slight soiling of underwear to the involuntary passing of solid stool. It may occur when coughing, sneezing, laughing, or during exercise.
Difficulty holding gas: An inability to control the passage of gas is an early indicator that the external sphincter's function is compromised.
Urgency: A sudden, overwhelming urge to have a bowel movement with little or no time to reach a toilet. The sensation that was once a gentle cue becomes an immediate and pressing need.
Incomplete evacuation: A persistent feeling that your bowel movement was not complete, often caused by discoordination of the pelvic floor muscles.

Pain and Discomfort

Damage to the sphincter can cause chronic or acute pain in the rectal area. This is especially true if the damage is related to a tear or a disease like Crohn's.

Rectal or anal pain: This can be a dull ache or a sharp, knife-like pain, especially during or after a bowel movement.
Painful bowel movements: Straining due to constipation can aggravate existing sphincter damage.
Feeling of fullness: Some people report a feeling of swelling or like an object is stuck in their anus.

Other Less Common Indicators

While less common, some other signs can point toward an underlying sphincter issue:

Anal discharge: The leakage of mucus or other discharge from the anus can occur when the sphincter cannot close completely.
Visible tear or swelling: In some cases, a tear (fissure) or swelling can be observed around the anus.
Skin irritation: Persistent leakage can cause the skin around the anus to become irritated, itchy, or even develop sores.

Causes of Anal Sphincter Damage

Understanding the potential causes can help in prevention and effective treatment.

Obstetric Trauma

Vaginal childbirth is a leading cause of anal sphincter damage, especially in cases involving large babies, prolonged labor, the use of forceps or vacuum extraction, or a large episiotomy. The trauma can cause tears in the sphincter muscles, leading to incontinence. While some women recover completely, others experience persistent symptoms.

Surgical Complications

Certain surgical procedures in the anorectal region can inadvertently damage the sphincter muscles or the nerves that supply them. Examples include surgery for hemorrhoids, fistulas, or cancer.

Neurological Conditions

Nerve damage can disrupt the communication between the brain and the sphincter muscles, causing them to malfunction. Conditions that can damage these nerves include:

Long-standing diabetes
Multiple sclerosis (MS)
Spinal cord injuries
Stroke
Pudendal nerve entrapment

Chronic Strain and Disease

Repeated straining over a long period, often due to chronic constipation, can weaken and stretch the sphincter muscles. Conditions like inflammatory bowel disease (IBD), such as Crohn's disease, can also cause inflammation and damage to the sphincter.

Diagnostic Procedures

If you suspect sphincter damage, it is crucial to see a healthcare professional, such as a gastroenterologist or colorectal surgeon. They will perform a physical exam and may recommend further testing.

Physical Examination: A digital rectal exam can assess the tone and strength of your sphincter muscles.
Anal Manometry: This test measures the pressure of the anal sphincter muscles.
Endoanal Ultrasound: This procedure uses a small probe to create an image of the anal sphincter muscles, showing any tears or defects.
Electromyography (EMG): This test measures the electrical activity of the sphincter muscles and the nerves that control them.
Defecography: This is an X-ray study that evaluates how the pelvic floor and sphincter muscles work during a bowel movement.

Comparison of Normal vs. Damaged Sphincter Function


Feature	Normal Sphincter Function	Damaged Sphincter Function
Bowel Control	Full control over gas and stool	Accidental leakage, urgency, and inability to hold gas
Muscle Tone	Strong and consistent muscle tone	Weakened or irregular muscle tone
Sensory Awareness	Strong awareness of the need for a bowel movement	Reduced or altered sensation in the rectal area
Pain	Absence of persistent rectal or anal pain	Presence of chronic or acute rectal pain
Emptying	Complete and easy evacuation of the rectum	Sensation of incomplete emptying and straining

Treatment Options

Treatment for sphincter damage depends on the severity and cause. It can range from conservative management to surgical intervention.

Conservative Treatments:
- Dietary Adjustments: Increasing fiber and managing fluid intake can help regulate stool consistency.
- Pelvic Floor Exercises (Kegels): Strengthening exercises can improve muscle tone and control.
- Biofeedback: This therapy helps you learn to control your sphincter muscles better.
Medical Treatments:
- Medications: Anti-diarrheal or stool-bulking agents may be prescribed.
Surgical Options:
- Sphincteroplasty: A surgical procedure to repair a torn anal sphincter muscle, often performed after childbirth-related injury.
- Sacral Nerve Stimulation: An implantable device that sends mild electrical pulses to nerves controlling the bowel.
- Colostomy: A bowel diversion procedure, typically reserved for severe cases where other treatments have failed.

For more information on fecal incontinence, visit the Mayo Clinic website.

Conclusion

Understanding how do you know if your sphincter is damaged involves paying close attention to your body's signals, particularly changes in bowel control. If you experience fecal leakage, difficulty holding gas, or rectal pain, it is essential to consult a healthcare professional. With accurate diagnosis and appropriate treatment, many people with sphincter damage can significantly improve their quality of life. Don't let embarrassment prevent you from seeking the help you need.

Frequently Asked Questions

In some mild cases, especially with related nerve issues, the body may show some improvement over time. However, a significant tear or severe damage to the muscle typically requires medical intervention, such as physiotherapy or surgery, to achieve meaningful recovery.

Yes, anal sphincter injury is a relatively common complication of vaginal childbirth, particularly with first-time mothers, forceps delivery, or certain perineal tears. Many women experience short-term issues, but persistent symptoms warrant medical evaluation.

The earliest signs often include difficulty controlling gas, minor soiling, or a feeling of urgency to have a bowel movement that is different from your normal routine. These subtle changes can indicate the initial stages of sphincter dysfunction.

Specialists who deal with sphincter problems include gastroenterologists, colorectal surgeons, and pelvic floor physical therapists. A general practitioner is a good first point of contact, as they can provide a referral to a specialist.

Yes, chronic straining associated with severe constipation can stretch and weaken the anal sphincter muscles over time. It can also lead to nerve damage, which further contributes to incontinence issues.

During a digital rectal exam, a doctor will insert a lubricated, gloved finger into the rectum to assess the strength and tone of the sphincter muscles. They can feel for muscle defects, check for signs of tenderness, and evaluate overall muscle response.

Yes, pelvic floor exercises, commonly known as Kegels, can help strengthen the external anal sphincter and improve bowel control. These are often a core component of rehabilitation and are frequently paired with biofeedback therapy for best results.