Incontinence refers to the uncontrolled passing of urine, stools or both. There are several types of incontinence: stress incontinence, urge incontinence, overflow incontinence, mixed incontinence and functional or environmental incontinence.
Among these types, it is urinary stress incontinence that is most common among people said to be suffering from 'incontinence'. One who is suffering from stress incontinence may leak some urine when coughing, laughing, sneezing, exercising or lifting heavy objects.
Women are prone to suffer from stress incontinence more than men because of childbirth and menopause. At childbirth, a prolonged vaginal labour may weaken the pelvic-floor muscles which control how the sphincter opens and shuts the urethra (a narrow passageway where urine passes out of the body). With menopause, a decline or lack of oestrogen also causes the pelvic-floor muscles to become weak.
Stress incontinence can be caused by a variety of reasons such as:
- urinary tract infection
- weakened pelvic floor muscles in women
If you suffer from urinary incontinence, you should see a health care professional for proper diagnosis and treatment. Correct diagnosis enables your health professional to determine the best treatment for your incontinence.
It is often necessary to submit blood and urine samples to laboratory testing. Other diagnostic tests which may be prescribed are more invasive and involve an examination of the bladder itself during a cystoscopic examination, post-void residual measurement and urodynamic test.
The right treatment for urinary incontinence depends on the underlying cause.
- Urinary tract infection: medication to treat the bacterial infection or inflammation may be prescribed.
- Obesity: a patient will be placed on a weight loss and exercise program
- Menopause: A therapeutic herbal treatment and diet modification can help. Hormone Replacement Therapy (HRT) or the application of a topical oestrogen cream may reduce the problem. However HRT carries its own dangerous side effects and other therapies should be a first consideration.
- Constipation: The patient may be advised to take in more high-fiber foods and liquids, or prescribed a herbal laxative.
- Weakness of the pelvic-floor muscles: the patient may be taught how to strengthen these muscles by exercise. For women, these are known as kegel exercises.
- In very severe cases of incontinence, surgery may be recommended to correct physical defects in the bladder.
Other treatments can include biofeedback, electrical stimulation, catheterization and implants.
On your own, you can deal with incontinence by making some lifestyle changes. Sometimes your daily habits may aggravate your condition, so examine your lifestyle for additional factors that contribute to your incontinence. The following are some ways to minimize incontinence.
- Go to the bathroom at frequent and regular intervals of 2 to 3 hours ("timed voiding"). Making constant trips to the bathroom keeps the bladder empty and helps you regain some control over it.
- Drink sparingly before bedtime if nighttime incontinence is a problem.
- Empty your bladder before going to bed. This helps keeps your bladder from filling by the time you wake up.
- Avoid food and drinks with diuretics like coffee, tea and caffeinated beverages. Caffeine acts as a diuretic and promotes excretion of urine. Coffee drinkers who are affected by incontinence should cut back on or eliminate coffee from their diets.
A more distressing though less prevalent form of incontinence is bowel incontinence, the loss of bowel control. Its severity can range from losing total control over bowel movements, to passing small amounts of faecal matter with wind. Bowel incontinence is most prevalent in women over the age of 65.
Causes of Bowel Incontinence
There are a great many causes of bowel incontinence, including:
- Long term use of laxatives
- Bowel surgery
- Weakened muscles caused by chronic constipation
- Prostate, rectal or gynecological surgery
- Decreased awareness of 'need to go'
- Emotional problems
- Severe diarrhea
- Muscle or nerve damage
Treatment of bowel incontinence
There are some very effective treatments for bowel incontinence, and finding the most appropriate begins with identifying the cause. In particular there are several ways of strengthening the pelvic and anal muscles to encourage normal bowel function.
Diet: With bowel incontinence, it is often the case that the rectal sphincter has become less able to handle large quantities of liquid stool, and a change in diet can alleviate this problem.
Medications: If the problem is a result of diarrhea, there are both over the counter medications and herbal remedies to help alleviate the condition. Long term use of prescribed medications is not recommended as they may be masking a more serious condition.
Surgery: A last resort for the most serious cases of bowel incontinence, surgery, where warranted can include rectal sphincter repair, artificial bowel sphincter, faecal diversion and gracilis muscle transplant.
People with impaired mobility, or who have a decreased ability to recognise the need to defecate, need special care, including 'timed elimination' programs.
Always seek the help of a health care professional if incontinence is affecting you, or someone for whom you care.