Urinary/Fecal Incontinence

 

The Facts About Bladder and Bowel Control

If you have problems with bladder or bowel control, it’s probably not something you’re shouting from the rooftops. These conditions can be very distressing for adults and can have a big impact on quality of life. However, if you are aware of the reasons and causes for this problem and the different options you have to treat it, this might make you more comfortable about discussing it with a medical professional.

All You Need To Know About Urinary Incontinence

When doctors use the term “urinary incontinence,” they are basically talking about loss of bladder control, or urinating when you do not wish to. Sometimes this can be a matter of just a minor leak with a cough or a sneeze, and sometimes it can be a full-out wetting of your pants.

No one knows just how many people suffer with urinary incontinence mainly because people are embarrassed to talk about it and don’t report it to their doctors. However, it is estimated that this affects between a quarter and a third of all adults, so if you do have this problem, you are definitely not alone. It is a lot more common than many people think.

So What Exactly Is Happening?

There are several different kinds of urinary incontinence. If you just have a problem when you cough or sneeze or laugh too hard, this is called stress incontinence, or SUI. It is the most common form. However, some people have a problem with a constant, small amount of leakage that is caused when the bladder does not empty completely after you go to the bathroom. This is called overflow incontinence. For people who have urge incontinence (also known as overactive bladder or OAB), the problem is that their body does not give them enough warning before they need to go to the bathroom.

There are other conditions which can cause urinary incontinence as well. For example, if you have arthritis in your knees or hips your mobility may be impacted making it difficult to get to the bathroom in time. If you don’t get to the bathroom fast enough, you might have an episode of incontinence. This is called functional incontinence.

It might sound strange to try to classify incontinence, but it is very important. Once the doctor knows just why you are having this problem, they can help you learn ways to manage and cope with it.

Why This Happens

Urinary incontinence is so complicated because there are many underlying reasons for its cause. For many, it is simply a matter of the muscles of the bladder getting weaker and less able to hold its contents. For others, nerve damage from past surgeries or other diseases can be the culprit.

Not surprisingly, the reasons for this condition can be different for women than they are for men. For women, childbirth, hysterectomies or the onset of menopause can lead to weak muscles and nerves in your bladder region. For men one of the main culprits is prostate enlargement. An enlarged prostate can cause difficulty going to the bathroom and fully emptying your bladder.

Some reasons affect women and men both. Certain foods, beverages and medications can make this problem worse (see below for more details). Also, if you have a condition that affects your nervous system — like Parkinson’s disease or Alzheimer’s — loss of bladder and bowel control is common as the disease gets worse.

The Problem With Incontinence

The fact is, many adults think of urinary incontinence as an embarrassment or inconvenience but not necessarily a problem. The truth is it can have a serious impact on you and the way you live your life. Many people get embarrassed about their lack of control and will stop going out to lunch with friends or running errands. They become more socially isolated. This can lead to problems with depression and loneliness if it gets too bad.

Incontinence can also cause other medical problems. It can irritate the skin and lead to redness, irritation and pain, and even cause the skin to start to break down. It can also put you at risk for urinary tract infections (UTIs). If UTIs go untreated, they get serious enough to require hospitalization in order to clear them up. In other words, incontinence is serious business.

What You Can Do To Cope

The good news is if you have urinary incontinence, there are a LOT of different options to choose from to manage your condition. These options range from lifestyle changes involving diet, to medications, target exercises, devices and surgery. Let’s take a look at what can help:

  • Diet — Many people aren’t aware of this, but there are actually changes you can make to your diet to help reduce incontinence. Beverages with caffeine, alcohol or artificial sweeteners can make the problem worse. So can spicy foods. Just avoiding these in your diet can improve the problem.
  • Medication — Some medications can also cause incontinence or make it worse. If you are on medications called diuretics (water pills), this actually causes your body to produce and discharge more urine. Medications taken for blood pressure and other conditions can also be a problem. The good news is medications can also help. There are numerous drugs on the market today which can help ease the struggle with bladder control. Your doctor may prescribe Ditropan, Enablex or Flomax to name a few. Women experiencing menopause have the option of estrogen therapy in a vaginal cream or ring to increase the tone of bladder muscles if that is the cause of their incontinence.
  • Exercise — Gentle, regular exercise like walking can help improve general muscle tone. However, your doctor might prescribe target exercises which help strengthen muscles in the pelvic area and reduce incontinent episodes. The best-known technique for this is Kegel exercises. In order to perform it, simply contract the muscles used to urinate for 5 seconds (eventually working your way up to 10 seconds) before releasing them again. It is recommended that you do 10-20 repetitions of this, 2-3 times a day, to help improve bladder control.
  • Devices — There are a number of devices which can also help you. The simplest is wearing panty liners or incontinent pads in your underwear which can be disposed of if you have an accident. There are also devices available through your physician. For women, one option is called a pessary, which is placed in the vagina but helps to support the bladder and make it stronger. There are also inserts designed for both men and women which are placed around the urethra, the tube which leads from the kidneys to the bladder. Devices to electrically stimulate the nerves of the bladder are also sometimes used. In some cases, it is also necessary to use a catheter, a tube which is inserted through the urethra into the bladder and which drains urine from the bladder into a small bag strapped to your leg. This is usually only done as a last resort.
  • Surgery – Surgery is not right for everyone. However, if you are incontinent and medications and exercises have failed, it might be time to bring this subject up with your doctor. There are several different types of surgery which work on the bladder, the prostate or the muscles in the area to treat the problem.

The bottom line is although urinary incontinence can be a complicated condition, you have plenty of options to choose from to help treat it.

A Frank Talk About Fecal Incontinence

Most people think that urinary and fecal incontinence are related. However, you can have one problem without having the other and they can be caused by different conditions. That is why it’s always better to look at this problem separately.

Fecal Incontinence

If you have fecal incontinence (also called bowel incontinence), you lack control over your bowel movements and cannot always get to the bathroom in time before you go. Like urinary incontinence, this condition is very embarrassing to people who have it and they will often not discuss it with their doctors.

Some of the reasons for fecal incontinence are similar to the reasons for urinary incontinence. If you have weak muscles in the area — or your muscles or nerves have been damaged by disease or surgery — this puts you at a greater risk for this condition. A history of strokes or neurological diseases like the ones mentioned earlier also make it more likely that you will lose bowel control. For women, a difficult childbirth or having multiple children can increase the risk.

Again, there are different kinds of fecal incontinence. People with urge incontinence do not get enough of a warning to get to the bathroom in time. There is also a type called passive incontinence, where people are simply not aware that they are going to the bathroom until it is too late.

Why Fecal Incontinence Is Important

As with urinary incontinence, fecal incontinence can cause you to feel embarrassed or ashamed and to withdraw from others socially. It is hard to enjoy running errands, going to church or even eating out in a restaurant if you don’t know when you are going to have an accident. Social withdrawal can lead to emotional problems like depression or loneliness.

There are also potentially serious problems that can stem from fecal incontinence. For one thing, it can cause irritation and breakdown of the skin. For another, it can increase your risk for urinary tract infections if the bacteria from your stools migrate to your urinary tract. UTIs can be very serious and even mild ones can be very painful.

What To Do To Treat Fecal Incontinence

While this is a difficult condition, you still have options for treating it ranging from mild lifestyle changes to more invasive techniques like surgery. Let’s take a look at the different methods doctors have to help treat the problem.

  • Diet — Diet can play a very important role in your fight against bowel incontinence. The most important thing to remember is increasing your intake of fluids and fiber. This means striving for at least 8 8-ounce glasses of water a day along with 20-35 grams of fiber. Eating high-fiber foods like some fresh fruits and vegetables and whole grains (like wheat bread or oatmeal) can help you reach your fiber goals. Avoiding triggers like dairy, cured meats, fatty foods and some fruits like apples or pears can also make a difference.
  • Medications – You have several treatment options when it comes to medications. Some are simply over-the-counter treatments like Immodium to help slow down your stools. Many doctors will also suggest fiber supplements like Metamucil to boost the amount of fiber in your diet. In extreme cases, there are also injectable agents that doctors can administer to help bulk up your stool.
  • Exercise — The good news is that bowel training programs and exercises have been developed to help strengthen the muscles in your lower colon and rectum in order to regain bowel control. Your doctor can also teach you to do pelvic floor exercises that can be done 50-100 times a day to strengthen and tone muscles.
  • Devices — Some doctors will use electrical stimulation devices to help the muscles in the rectal area become more responsive. Biofeedback is also useful; it uses sensors to help signal to your body when you need to go to the bathroom and can help greatly reduce incontinent episodes. Other than that, the most common “device” to help this problem is adult briefs or incontinence pads, which can be disposed of afterwards in case of an accident.
  • Surgery — There are a number of surgical options which you can discuss with your doctor, depending upon the reason for your bowel incontinence. Usually this involves surgery on the lower colon, rectum or anus in order to strengthen the muscles involved and make it easier to hold your feces. However, in some cases, doctors may take a section of your colon or lower intestines out and reattach the ends so that it comes out through the abdomen. Stools will be stored in a small plastic pouch that is attached to your stomach. This is called a colostomy. This, however, is not done unless it is absolutely necessary.

Take Control Of Your Incontinence

In short, while bladder and bowel incontinence can be embarrassing or distressing for you, you do not have to suffer in silence. There are a number of ways — from simple lifestyle changes to surgery — to improve this condition and let you start enjoying life without worrying about accidents.