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Get The Facts

Incontinence & continence problems

Information Services
 
 

Medical

Incontinence & continence problems

This article looks at the different types of incontinence, its causes, diagnosis and treatments, and how a person's environment and physical health can be managed to minimize the problem.


Incontinence is the accidental or involuntary loss of control of either:

  • the bladder (urinary incontinence)
  • or bowel (fecal incontinence).

 

It is a potentially embarrassing inconvient condition, but often can be managed well and even cured. It affects about one in five people and is common amongst the elderly. Causes include  brain or nerve injury, infections and prostate enlargement. 

 

Urinary incontinence

Stress incontinence is when small amounts of urine leak while coughing, sneezing, laughing, straining or lifting and is usually related to changes in the pelvic floor muscles.

 

Urge incontinence occurs when a bladder contracts without warning and the person gets a sudden, strong urge to urinate. It is common in people with stroke, Parkinson's disease and other conditions.

 

Overflow incontinence occurs when the bladder does not empty properly and urine spills out without warning. It is common in men with an enlarged prostate but constipation can also contribute.

 

Reflex incontinence is when certain nerves in the spinal cord are damaged, the messages they send from the bladder to the brain are disrupted. When full, the bladder takes action and empties itself.

 

Functional incontinence occurs when older people or people with a physical disability cannot always reach the toilet in time.

 

Bowel Incontinence

Bowel incontinence is less common than urinary incontinence, but can still affect people of all ages. Poor diet, not enough to drink, and lack of exercise are key contributors to bowel incontinence so exercise, a healthy diet and good fluid intake, and regular exercise can help prevent it.

 

Causes of incontinence

Causes of incontinence can include:

  • neurological problems
  • urinary tract infection
  • prostate problems
  • diabetes
  • constipation
  • a chronic cough
  • medications
  • diet (e.g. too much fiber or spices).

 

Diagnosis of continence problems

Your doctor may order tests such as:

  • urinalysis to check for a urinary infection
  • bladder ultrasound
  • x-ray to detect severe constipation.

 

Your doctor might  refer you to a:

  • continence advisor (e.g. nurse, physiotherapist or medical specialist)
  • urologist (a specialist in urinary problems)
  • a urogynacologist (bladder problems related to gynaecological issues)
  • geriatrician (a specialist in aged-care).

 

Treatment & management of incontinence

 Treatments for incontinence include:

  • losing weight
  • bladder retraining
  • chronic constipation treatment
  • physiotherapy
  • medication
  • surgery.

 

Medication can be a cause, in which case your doctor may reduce the dose, spread the pills out over the day, or change the medication.

 

The environment can be a cause if a toilet is not easy to find or use, or clothing is not easy to remove. 

 

Diet, fluid intake and exercise are all key elements for managing incontinence well.

 

Aids and appliances such as absorbent pads and special pants are available that are designed to absorb urine or contain feces. Urinary incontinence in men can be managed through condom drainage. Urine can also be collected via a catheter - a tube inserted into the bladder. Other continence aids include absorbent bed sheets and chair covers, bed pans, commodes and non-spill urinals for use in bed or on car journeys.

References and further information

This is an excerpt from "For Those Who Care: A Practical Guide" published by BrainLink Services, a statewide service in Victoria dedicated to improving the quality of life of people affected by a brain injury. Ring 1800 677 579 or visit www.brainlink.org.au

 

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