Incontinence - The Complete Resource

Incontinence is the inability to control your bladder or bowel movements. Because of the difference in anatomy, women suffer from incontinence more often than men. In addition, urinary incontinence is more common than bowel incontinence. While it might not be preventable, there are ways to manage the inconvenience of incontinence. In this post, we discuss the types, causes, and management of bowel and bladder incontinence.

 

What is Incontinence?

Incontinence occurs when the pelvic and sphincter muscles weaken triggering a loss of bladder or bowel control. Normal aging is the main cause of the condition, but other factors like prostate surgery, narrowing of the urethra, urinary tract infections , pregnancy, childbirth, menopause, and nerve damage can increase the risk of incontinence.

Incontinence affects men and women alike, but some of the causes are unique to both.

Types of Incontinence

Incontinence is divided into two categories--urinary and fecal incontinence

• Urinary Incontinence

Your bladder is made of muscle. As you age or struggle with conditions that affect the ability of the muscle to control the flow of urine, you may suffer with one of the following four types of urinary incontinence:

Stress Incontinence

Stress incontinence is the inability to control urine flow in certain situations. The condition is triggered when pressure is exerted on the bladder when you sneeze, cough, or exercise. It’s common in women due to the changes that happen to the structures in the lower abdomen after childbirth. However, women are not the only ones who might struggle with stress incontinence. Complications from prostate cancer can increase the risk the in men.

Overactive Bladder

A healthy bladder signals your brain when you need to go to the bathroom. If you struggle with an overactive bladder, these messages to your brain might happen before the bladder is full. The mixed signals trigger abnormal contractions of the sphincter muscles leading to urine leakage.

The exact cause of the abnormality is not known, but diabetes, stroke, irritated bladder, urinary tract infections, and a damaged spinal cord are known to increase the risk. An overactive bladder is not dangerous, but it can be annoying and sometimes embarrassing to manage in public. If you experience other symptoms, such as pain or burning when you urinate, you might have another condition going on, so be sure to call your primary physician to book an appointment.

Overflow Incontinence

Do you struggle with emptying your bladder completely when you urinate? If so, you might have overflow incontinence. It occurs when the bladder is unable to empty completely. The urine left in the bladder creates a perfect environment for the growth of bacteria which might lead to urinary tract infections.   A few of the causes include a blocked urethra, an enlarged prostate, weak bladder, injured nerves in the bladder, and medications like antidepressants.

Functional Incontinence

This type of incontinence happens if you’re unable to get to the bathroom due to arthritis, Parkinson’s disease, Multiple Sclerosis or other conditions that might slow you down.

• Fecal Incontinence

There are two types of fecal incontinence (FI). Passive incontinence occurs when you’re not aware of the need to use the bathroom and urge incontinence happens when you’re unable to get to the bathroom on time. 

FI is characterized by the inability to control bowel movements causing fecal matter to leak unexpectedly. It ranges from tiny leaks of stool to complete loss of control.

Diarrhea, constipation, loss of storage capacity in the rectum, nerve and muscle damage associated with aging and childbirth can worsen the condition.

Risk Factors & Causes of Incontinence

Common factors like age, gender, weight, nerve damage, physical disability, and loss of neurological control can increase the risk of incontinence. However,  in some cases your incontinence might be caused by other health conditions.

• Pregnancy and Childbirth

Pregnancy and childbirth change your body. Some of these changes can place you at a higher than normal risk of urinary or bowel incontinence. A few of the changes include hormone levels, weight gain, weakened muscles, and change in the physical location of the bladder or rectum.

• Menopause

Estrogen is a hormone that helps keep the lining of the bladder healthy. After menopause, estrogen levels decrease, weakening the bladder lining and causing  urinary incontinence.

• Enlarged Prostate

An enlarged prostate occurs in older men, and it can be triggered by benign prostatic hyperplasia. This condition blocks the flow of urine in the bladder, and can also cause infections of the urinary tract and kidneys.  

• Hysterectomy and Urinary Tract Obstruction

During a hysterectomy, your surgeon removes all or part of your uterus. Other reproductive organs, such as the cervix and ovaries may be removed as well. The procedure can damage the pelvic floor muscles leading to incontinence. 

If the flow of urine is obstructed by a tumor, stone, or other change in the structures of the bladder and urethra, you might experience urine leakage.

• Neurological Disorder

Conditions like Parkinson’s disease, Multiple Sclerosis, stroke, spinal or brain injury can interfere with the control of the bladder. If loss of control occurs, urinary incontinence is common.

• Muscle and Nerve Damage

An injury to the sphincter muscles can make it difficult to hold fecal matter properly. Muscle and nerve damage can occur after childbirth, spinal cord injury, stroke, some surgeries, or diabetes.

Symptoms and Complications of Incontinence

The symptoms of incontinence will depend on the type and cause. Some general signs to look for include burning or pain in the pelvic area, urine leakage when pressure is exerted on the bladder like when laughing or sneezing, constant dribbling of urine, inability to control fecal matter, involuntary leaks of stool, persistent constipation, gas, bloating, or diarrhea.

• Potential Complications

Without proper management, incontinence can lead to several complications:

Emotional Distress

Loss of control of the bladder can lead to shame, frustration, anger, embarrassment, and depression. Emotional stress might cause you to disengage from society and avoid social situations.

Talk to a trusted friend or family member to seek support.  

Skin Irritation

Stool and urine are damaging to your skin, and may cause burning, infection, and bacterial growth. Symptoms of skin complications i nclude itching, redness, patches of inflammation, lesions, and tenderness.

Cleaning the skin with harsh soap can cause inflammation and dryness. Use a soap free of perfumes and chemicals for your irritated skin. Be sure to use soft linens when washing and moisturize your skin with petroleum-based products.

Treatment of Incontinence

Treatment depends on the type, severity, and underlying cause of incontinence. Sometimes, a combination of therapies will be used. Below are a few of the treatments your doctor may suggest.

• Medication

Some medicines like anticholinergics, alpha blockers, or topical estrogen may be prescribed to manage urinary incontinence. You may also use bulk laxatives, anti-diarrheal drugs, and bulking agent injections to treat fecal incontinence.

• Dietary Changes

Your diet will determine the consistency of stool. It’s recommended you increase fluids and fiber intake to soften and add bulk to the stool--this works great to resolve diarrhea.

• Exercise

An exercise program created by your physician or a physical therapist can help to restore muscle strength. Some of the workouts include biofeedback - a technique used to train body control using electrical sensors.

Pelvic floor exercises are used to strengthen the pelvic muscles and control urination. Kegel exercises can improve the symptoms of stress and urge incontinence.

These exercises are different for men and women.

Pelvic Floor Exercises for Women

Step 1: Fold a towel into a right roll and position between your legs, while sitting on a stool.

Step 2: Repetitively squeeze the pelvic floor muscles by lifting and squeezing the muscles around the urethra. 

Step 3: Repeat on a daily basis, lifting and holding for several seconds at a time.

Pelvic Floor Exercises for Men

Step 1: Find the pelvic muscle by lifting and squeezing the muscles around the urethra. If you can stop or slow the flow of urine, you've found it!

Step 2: Repetitively squeeze the pelvic floor muscles in the same manner.

Step 3: Repeat on a daily basis, lifting and holding for several seconds at a time.

• Behavioral Techniques

There’s a few behavior techniques that can help retrain your bladder to function properly. Your doctor may suggest bladder training, double voiding, fluid management, and scheduled toilet use.  

• Electrical Stimulation

Electrical stimulation is done to treat stress incontinence. It’s ideal if you have severely damaged pelvic floor muscles and can’t perform Kegel exercises. The process involves sending a mild electrical current to the low back and pelvic muscles . The frequency and length of the stimulation will vary depending on the severity of the condition, but your doctor will advise on that.  

• Incontinence Bed Pads

Incontinence bed pads are an ideal way to keep mattresses fresh through the years. ( See Product )

Incontinence bed pads a small multi-layered sheets made of cotton to provide high absorbency. These pads are available in either washable or disposable versions.

Mattress protectors are easy to slip on and off for fast protection. ( See Product )

You can add an extra layer of protection using waterproof mattress protectors to keep your mattress clean and dry.

• Adult Diapers

Adult diapers keep you dry and comfortable during the day and night. To choose a suitable diaper brand, consider the size, absorbency level, and odor control.

Check out these adult diaper designs.

• Absorbent Underwear

Adult briefs are discreet, comfortable, washable, and provide all-day protection. The underwear are available in different designs. Consider fit, comfort, odor control, discretion, and absorbency. They are also designed specifically for men or women; click here for men's incontinence underwear and women's incontinence underwear .

• Protective Guards

Male guards are uniquely shaped to suit the male anatomy and provide comfort. They’re created with an absorbent polymer that locks in liquid, and they work with most of your undergarments.  

Living with Incontinence

Urinary incontinence is manageable with simple life adjustments like dietary changes and behavioral modifications. Start off by setting a bathroom schedule to train your bladder, and avoid triggers like caffeinated drinks and chili peppers. You can also limit your fluid intake a bit to help with incontinence. Try decreasing your intake to seven glasses per day. Don’t forget to do regular pelvic floor exercises to strengthen the muscles. If lifestyle changes don’t help, schedule an appointment with your primary doctor to get to the bottom of your incontinence issues.

Sources:

https://www.medicinenet.com/urinary_incontinence_in_women/article.htm#how_is_incontinence_treated

https://www.webmd.com/urinary-incontinence-oab/types-of-urinary-incontinence#1