Frequent or constant fecal incontinence (soiling) in an adult male is not normal and typically indicates a serious underlying medical problem. It can involve physical, neurological, or even psychological causes.

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🔍 Most common causes:

1. Nerve damage (to the anal sphincter or rectum)
• Diabetes (can damage autonomic nerves)
• Spinal cord injury
• Multiple sclerosis
• Stroke
• Advanced dementia

2. Muscle damage
• Damage to the anal sphincter, from:
• Surgery (e.g. hemorrhoidectomy)
• Trauma (e.g. sexual injury or severe straining)
• Radiation to the pelvic area

3. Severe diarrhea
• Infections (C. diff, parasites)
• IBS-D (diarrhea-predominant)
• Inflammatory bowel disease (Crohn’s, ulcerative colitis)
• Bile acid malabsorption

4. Structural issues
• Rectal prolapse
• Hemorrhoids (severe, internal)
• Fistulas or congenital malformations

5. Cognitive or psychiatric impairment
• Dementia
• Severe depression
• Psychosis or neglect

6. Medication side effects
• Laxatives
• Metformin (especially in renal impairment)
• Certain antibiotics or cancer drugs

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🧠 Rare but important:
• Colorectal cancer (especially if bleeding or weight loss)
• Advanced Parkinson’s disease
• Cauda equina syndrome (a spinal emergency — needs immediate treatment)

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🚨 When it’s urgent:

If soiling is new, sudden, or accompanied by:
• Leg numbness or weakness
• Urinary incontinence
• Severe back pain
• Rectal bleeding or weight loss

That’s an emergency — could indicate spinal cord compression, tumor, or bowel obstruction.