Faecal incontinence and constipation are common conditions in women, and their prevalence increases with age. They have many aetiologies which overlap and range from the benign to the malignant. Bowel dysfunction rarely exists on its own, and is often accompanied by dysfunction of the bladder, prolapse and sexual dysfunction, with a knock-on effect on the psyche. Taking a comprehensive pelvic floor history is paramount. Investigations are dynamic, physiological and provide greater clarity and should be performed if they aid diagnosis or help with therapeutics. Treatments should be symptom-focused, informed, and expectations discussed in advance. Functional management is more effective if it combines multimodal treatment, involving pharmacotherapy, physiotherapy and psychotherapy. Corrective surgery is best undertaken where there is a proven symptomatic anatomical abnormality, or if function is affected as a consequence of this; otherwise, surgery on its own for functional colorectal disorders has poor outcomes.