I'm Chris Norton. I'm professor of nursing at King's College London

and a nurse consultant at St Mark's Hospital.

Faecal incontinence or bowel incontinence is surprisingly common.

It affects about one adult in every hundred in this country.

People get really embarrassed by it. They don't like to talk about it.

People come to me with two main symptoms,

either urgency, having to run to the toilet and not making it in time,

or just a passive leakage from the bowel.

There are many different causes and types of bowel incontinence.

Probably the most common single cause is childbirth in women,

where the birth of the baby causes stretching of the muscles,

all the muscles down below, really,

and you can get bladder problems but you can also bowel problems,

which is far less often talked about or recognised.

Other possible causes, some people I see

have just got diarrhoea from any cause,

problems like irritable bowel syndrome.

Other people have had damage to the muscles around the back passage.

Others might have a nerve condition

or other medical problem that's causing it.

Sometimes it's drugs or diet that needs adjusting.

There are many different causes.

The main thing is to find what's going wrong for each individual

and then you can start to treat it.

Nearly everyone we see can be improved.

Most people can be cured completely.

Obviously, we can't guarantee that,

but for most people, significant improvement,

if not cure, is available.

Treatment depends on cause. Sometimes we need to do further tests.

Sometimes we look inside the bowel

to make sure there's no disease or inflammation going on.

But usually the causes are quite easily decided

and then we can start to treat it.

If it's weak muscles around the back passage,

then we do some exercises to strengthen the muscles there.

Often we'll do a programme of bowel retraining

to get the bowel into a regular habit

and enable you to hold on.

But we'll also look at diet, at what you're drinking, what you're eating,

any medicines you might need to help slow the bowel down

or speed it up and get it emptying better.

If those simple treatments don't work,

then sometimes more sophisticated treatments

involving computer retraining for your bowel

or even, in rare cases, an operation, but that isn't common.

I think once you pluck up courage to seek help,

often you're surprised by how quickly things can get better.

Obviously, losing control of your bowels is a socially devastating problem,

and once it's happened once, you lose your self-confidence.

The more you worry, the worse it gets, the worse it gets, the more you worry.

You get into a vicious circle.

I think just talking to someone who's seen it before,

who's going to give you some good, sensible advice about it

can break that circle, and it's a real first step in getting some help.