Continence Care

Incontinence is a common problem and can have various causes, but it doesn’t have to get in the way of living your best life. Understanding the underlying cause and type of incontinence is vital to understanding the different treatments and products that are available.

 

Types of incontinence

The most common cause of incontinence is the weakening or damaging of the pelvic floor muscles. However there are other causes as well such as; neurological disorders, prostate problems and more practical problems such as poor accessibility of the toilet – for example (blindness or a physical disability). One thing that the different types of incontinence do have in common is that in most cases something can be done about it.

Stress incontinence – incontinence in physical exercise due to weakened pelvic floor muscles is also called stress incontinence or exercise incontinence. It is the most common form of incontinence. Stress incontinence is not related to psychological stress but more related to excessive pressure on the bladder. Stress incontinence is most common in women, especially during or after pregnancy or menopause, but this is not to say it doesn’t affect men too.  The causes of stress incontinence are different for men and women, but the consequences can be frustrating for anyone affected. The main way to prevent or relieve stress incontinence is to do pelvic floor exercises. In addition to this it is advised that you consult a doctor or health professional that can prescribe different medications or suggest specific treatment methods.

Pregnancy incontinence -  in many cases pregnancy is the main cause of incontinence in women. As a result of hormonal changes and the pregnant belly, the pelvic floor muscles can no longer receive pressure on the bladder. Hormonal changes ensure that the muscles in the Urethra and pelvic floor are stretched for the delivery of the baby, however this can also cause weakening of the pelvic floor muscles. With this form of incontinence leakage may occur if the pressure on the bladder becomes too great. Over time after delivery the muscle tissue with automatically regain strength and in most cases symptoms will be gone within 6 weeks while full recovery can take up to a year.

 

Urge incontinence – Urge incontinence is when a sudden urge to urinate arises which cannot be suppressed. This is sometimes caused by nervous disorders, stress, medication and excessive alcohol consumption. Urge incontinence can often be partnered with an overactive bladder. Unnecessary bladder contractions make the bladder feel full even with a small amount of urine in it. These contractions give people a strong urge to urinate. The solutions of urge incontinence depend on the cause, a doctor or healthcare professional should always help diagnose the type and cause of incontinence. The main solutions are bladder training pelvic floor exercises and potentially medication.

 

Overflow or drip incontinence – tis can occur when a person has trouble emptying their bladder entirely. Overflow incontinence often occurs as a result of damage to the nerves and muscles around the bladder, otherwise known as ‘drip incontinence’. An estimated 10 – 15% of people with incontinence suffer from overflow incontinence. Most cases of overflow incontinence are in older men, since this is often related to prostate problems that can arise from the growth of the prostate that goes along with aging. In women, swelling in the ovaries or prolapse of the uterus can cause overflow incontinence. Overflow incontinence can eventually lead to kidney problems, so consulting a doctor is highly important.

 

Functional incontinence – function incontinence is where the bladder works well, but because of a psychological or physical condition someone has difficulty reaching the toilet in time. Functional incontinence is sometimes known as drug-induced incontinence because certain medicines may cause it. Functional incontinence can often be prevented or solved by taking regular toilet visits, asking for help with clothing if needed and having the knowledge of where the nearest toilet is.

 

Overactive bladder – healthy adults empty their bladder 6-10 times a day. When you start needing to go more frequently, it could be a sign of an overactive or sensitive bladder. Sensitive bladder occurs both in men and women, but is most often diagnosed in elderly people. Generally, an overactive bladder develops from unnecessary bladder contractions, making the bladder feel full with even if it is not full. These contractions make a person feel an urgent need to urinate. Depending on the cause, there are many different solutions for an overactive or sensitive bladder. Visiting a health care practitioner is an important first step in finding a solution or relieving the symptoms of the overactive bladder. Keeping a daily urination diary is often the first step prescribed by the doctor. The diary keeps track of how often and how much a person urinates, and how much and at what times of the day a person consumes liquids. 

 

 

Fecal incontinence - Incontinence is generally associated with loss of bladder control, but incontinence can also mean leakage of stools. While faecal incontinence is more common in the elderly, adults and children can also be affected. Faecal incontinence is the inability to control bowel movements, causing incontinence or leakage of faeces or gas. Many of the people suffering from faecal incontinence also suffer from urine leakage, also known as double incontinence. Faecal incontinence occurs when the sphincter muscle is no longer able to hold the faeces. There are however many treatments available to improve faecal incontinence and quality of life, so it is important to seek help from health care professionals in time.

 

Light incontinence

It is always important to remember no matter what type of incontinence you are dealing with that you are not alone. Most forms of light incontinence can be improved through pelvic floor exercises. Here are a few symptoms you may be dealing with if you have weak pelvic floor muscles:

  • You can’t stop yourself from allowing small amounts of urine escaping the bladder
  • You are unable to stop yourself from holding on to urine until the urge has passed
  • Frequent visits to the bathroom as a precaution against uncontrollable urge to urinate
  • A heavy sensation in the lower abdomen
  • Coughing or sneezing causing urine to leak from the ladder
  • Once you have started to urinate you are unable to stop or slow down the flow until you have finished
  • Not partaking in certain activities because you are worried to leak urine

If you are able to identify with any or all of these symptoms, there is a strong change that you are suffering with light incontinence issues. It is reassuring to know that these small accidents can be corrected through strengthening the pelvic floor muscles and regular and correct exercise. Toning these muscles will in turn aid with bladder control.

 

Seeking treatment

Studies estimate that between 20-40% of people living with incontinence are too embarrassed to talk about it. In addition, on average people live with incontinence for up to seven years before seeking help or treatment. Seeking help can enable you to get your life back on track and stop preventing you from doing the things you love!

How to prepare for going to the doctor

The doctor is likely to ask you about your medical history including pregnancy and childbirth, any surgery history, illness or medical procedures, list of medications you take including over the counter vitamins and supplements, health problems you may be experiencing and information about your general lifestyle. It is also important to try and tach your bladder health and go with information such as; general toilet habits, diet including what and ho much you drink, nighttime visits to the bathroom, record your flow of urine in different situations, record accidents/leaks – what causes them and when they tend to occur.

 

Depending on your doctor and how specialized they are, the doctor may:

  • Ask you to keep a urination journal
  • Do a physical examination
  • Encourage bladder training
  • Refer you to s specialist in urinary disorders or bladder health

The doctor can help you with:

  • Determining the type of incontinence
  • Determining the cause of incontinence
  • Active guidance on products to use
  • Advice on diet, exercise and pelvic floor exercises
  • Write prescriptions or referrals to physical therapists or specialists who know ow to address a specific problem.