How do you know if your sphincter muscle is damaged?

September 23, 2025 •

5 min read

According to the NIH, millions of adults in the U.S. experience accidental bowel leakage, a primary symptom that can signal damage to the sphincter muscle. Knowing how do you know if your sphincter muscle is damaged is a crucial step toward seeking an accurate diagnosis and effective treatment options.

Quick Summary

Potential damage to the anal sphincter muscle often presents with symptoms such as involuntary leakage of gas or stool, difficulty controlling bowel movements, or feeling an urgent need to use the toilet. These signs suggest a need for medical evaluation, as a proper diagnosis is necessary to determine the cause and best course of action.

Key Points

Involuntary Leakage: The most significant symptom of a damaged sphincter is the inability to control the passage of stool or gas, ranging from minor soiling to major accidents.
Urgency and Soiling: A sudden, uncontrollable urge to defecate and persistent soiling after bowel movements are key indicators of a weakened muscle.
Causes Vary: Damage can result from childbirth trauma, chronic constipation and straining, pelvic surgery, or underlying neurological conditions.
Diagnostic Testing: Doctors use specialized tests like manometry and endoanal ultrasound to accurately diagnose sphincter damage and its extent.
Multiple Treatment Options: Treatment can include conservative approaches like physical therapy and lifestyle changes, or more invasive options like surgical repair for severe cases.
Early Medical Consultation is Vital: Due to the sensitive nature of the symptoms, many people delay seeking help, but early diagnosis is essential for the most effective treatment outcomes.

Understanding the Anal Sphincter Muscles

The anal sphincter is not a single muscle but a pair of muscular rings that help control the release of stool and gas. The internal anal sphincter is an involuntary, smooth muscle that maintains constant pressure to prevent leakage. The external anal sphincter is a voluntary, striated muscle that you consciously contract to hold back a bowel movement. When one or both of these muscles are weakened or injured, the coordinated function of continence is disrupted, leading to various issues.

Key Signs and Symptoms of Sphincter Damage

Symptoms of a damaged sphincter muscle can range from mild to severe and may develop gradually over time. Pay close attention to these indicators, which are often the first clues that something is wrong with your bowel control:

Fecal Incontinence: This is the most telling symptom. It can manifest as occasional, minor leakage of stool or mucus, or as a complete and involuntary loss of bowel control. Leakage may occur with physical activity, coughing, or sneezing.
Difficulty Controlling Gas: The inability to control the release of gas is another key sign. This can be embarrassing and disrupt daily life.
Urgency: Feeling a sudden, overwhelming, and unpreventable urge to have a bowel movement is common. This can leave little to no time to reach a toilet.
Soiling: Finding that you have not been able to get completely clean after a bowel movement is often a sign of weakened sphincter muscles that cannot close properly.
Rectal Pain and Discomfort: While not always present, pain or discomfort in the rectal area can indicate underlying damage. This may be associated with inflammation or issues arising from chronic straining.
Alternating Bowel Habits: Some people with sphincter damage experience a cycle of constipation and diarrhea, which can exacerbate leakage problems.

Common Causes of Sphincter Muscle Damage

Sphincter damage can be caused by a variety of factors, from major events to long-term habits. Identifying the potential cause is an important part of diagnosis.

Childbirth and Obstetrical Trauma

For women, vaginal childbirth is one of the most common causes of anal sphincter injury. This is especially true for those with:

Larger babies
Assisted delivery using forceps or vacuum extraction
Third- or fourth-degree perineal tears
Episiotomy during delivery

Chronic Straining and Constipation

Persistent straining during bowel movements can weaken and stretch the pelvic floor muscles and nerves over time. This chronic pressure can eventually lead to sphincter damage or dysfunction, even without a major traumatic event.

Surgery and Trauma

Surgery in the anal or rectal area can cause damage to the sphincter muscles. Examples include surgeries for hemorrhoids, anal fissures, or cancer. Other forms of trauma, such as accidents or injuries to the pelvic region, can also be a factor.

Neurological Conditions

Damage to the nerves that control the sphincter muscles can lead to incontinence even if the muscles themselves are physically intact. Conditions like diabetes, multiple sclerosis, or a spinal cord injury can all affect these nerves.

Diagnostic Procedures for Sphincter Damage

If you suspect a damaged sphincter, a healthcare provider, such as a gastroenterologist or colorectal surgeon, may perform several tests to confirm the diagnosis and assess the extent of the damage.

Anal Manometry: This test measures the pressure and strength of the anal sphincter muscles at rest and during voluntary squeeze. A small catheter with a balloon on the end is inserted to assess rectal sensation and muscle function.
Endoanal Ultrasound (EAUS): Considered a gold standard for assessing anatomical integrity, this internal ultrasound provides detailed images of the sphincter muscles, allowing doctors to see tears or defects.
Magnetic Resonance Imaging (MRI): An MRI can provide high-resolution images of the pelvic floor and sphincter complex, helping to identify structural damage that may be missed by other methods.
Electromyography (EMG): This test measures the electrical activity of the muscles and can help determine if nerve damage is present.

Treatment Approaches for Sphincter Damage

Treatments for sphincter damage range from conservative therapies to surgical intervention, depending on the severity and cause.

Lifestyle and Diet Changes: Dietary adjustments, including increasing fiber and fluid intake, can help manage bowel consistency and reduce straining, which eases pressure on the sphincter.
Physical Therapy and Biofeedback: Pelvic floor physical therapy uses exercises (like Kegels) to strengthen the external anal sphincter. Biofeedback therapy, often used in conjunction, helps patients learn to better control and coordinate their pelvic floor muscles.
Medications: Anti-diarrheal drugs or bulk-forming laxatives may be prescribed to manage stool consistency.
Surgical Repair (Sphincteroplasty): For a significant muscle tear, surgery may be necessary. This procedure, called a sphincteroplasty, involves stitching the torn muscle ends together to improve strength and function.

Symptom Comparison: Damaged vs. Weakened Sphincter


Symptom	Damaged Sphincter (Tear)	Weakened Sphincter (Aging/Neuropathy)
Leakage Severity	Often more significant and sudden, especially after childbirth or trauma.	Can be gradual, often starting with minor soiling or leakage of gas.
Urgency	Can be very strong and difficult to control, with little warning.	May be a frequent, but not always urgent, sensation.
Pain	Can be accompanied by rectal pain, especially if caused by a recent injury or tear.	Less likely to have significant pain unless other issues are present.
Onset	Acute onset following a specific event like childbirth or surgery.	Gradual onset over years, common with aging or chronic straining.
Diagnostic Findings	Endoanal ultrasound or MRI will show a structural defect or tear in the muscle.	Manometry may show lower resting and squeeze pressures, but imaging may not show a tear.

Seeking Professional Guidance

Dealing with bowel control issues can be stressful and embarrassing, but it's important to remember that it is a common medical condition with treatable causes. Ignoring symptoms can lead to worsening incontinence and a decreased quality of life. If you notice any of the signs of a damaged sphincter, consult a healthcare professional. A thorough examination and proper diagnostic tests can accurately identify the problem and lead to an effective treatment plan. For authoritative information on incontinence and pelvic floor disorders, you can visit the International Foundation for Gastrointestinal Disorders website. Their resources offer valuable insight into managing and understanding these conditions. Early intervention is key to restoring confidence and improving your overall well-being.

Frequently Asked Questions

A damaged sphincter usually involves a physical tear or structural defect in the muscle, often resulting from trauma. A weak sphincter may not have a tear but has lost its strength and function over time, often due to aging, nerve damage, or chronic overuse.

Yes, Kegel exercises can be part of the treatment for a damaged sphincter. They can help strengthen the surrounding pelvic floor muscles and improve overall function. However, if there is a significant tear, they may not be enough, and medical supervision is recommended.

For concerns about sphincter damage, you should consult a specialist such as a gastroenterologist, a colorectal surgeon, or a urogynecologist, especially one who specializes in pelvic floor disorders.

No. While childbirth is a common cause for women, sphincter damage can also be caused by chronic constipation, anal or rectal surgery, pelvic trauma, and certain neurological diseases like multiple sclerosis or diabetes.

Doctors diagnose sphincter damage through a physical exam and specialized tests. Common tests include anal manometry to measure muscle pressure and endoanal ultrasound to visualize the muscle structure for tears.

Minor damage may improve over time, especially with targeted exercises and lifestyle changes. However, significant tears or nerve damage often require medical intervention and sometimes surgery to repair effectively.

Yes, non-surgical options include dietary changes to manage stool consistency, medications, and physical therapy with biofeedback to help retrain and strengthen the muscles.