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
- 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
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
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 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
- a chronic cough
- diet (e.g. too much fiber or spices).
Diagnosis of continence
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
- urologist (a specialist in urinary problems)
- a urogynacologist (bladder problems related to gynaecological
- geriatrician (a specialist in aged-care).
Treatment & management of
Treatments for incontinence include:
- losing weight
- bladder retraining
- chronic constipation treatment
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
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