Incontinence and continence problems

Bladder and bowel control problems are common. Around four million Australians experience leakage from the bladder and bowel regularly – this is known as incontinence. Many others have bladder and bowel control problems such as frequency and urgency without leakage. Together these problems are often known as continence problems.

Although incontinence and continence problems have a considerable impact on a person’s quality of life, most people do not seek help. Embarrassment often prevents people talking about their bladder and bowel problems. Some people restrict going out and have little social contact outside their home.

There is no need to become a recluse! The good news is that for most people these problems can either be cured or at least better managed. You can lead a normal life and you no longer need to plan activities around the toilet.

All kinds of people are affected
Incontinence and continence problems affect people of all ages, cultures and backgrounds. Despite popular opinion, older people are not the only ones affected. Some incontinence facts include:

• 1 in 3 women who have had a baby experience loss of bladder control
• 1 in 5 children aged seven wet the bed
• 1 in 100 adults never achieve bladder control at night
• 1 in 20 adults experience bladder and bowel control problems.

• Leak urine with coughs, sneezes or exercise
• Leak urine on the way to the toilet
• Pass urine frequently
• Rush to the toilet (urgency)
• Get up twice or more at night to pass urine
• Wet the bed when asleep
• Feel their bladder is not completely empty
• Poor urine flow
• Strain to get the bladder to empty
• Frequent urinary tract infections.

• Leakage from the bowel with the urge to open their bowels
• Urgency with the urge to open their bowels
• Leakage from the bowel without the urge to open their bowels
• Leakage from the bowel on passing wind
• Unable to control wind
• Straining to empty their bowels.

• Stress incontinence – leakage of small amounts of urine with exertion. Causes include childbirth, being overweight and prostate surgery.
• Urge incontinence – leakage following a sudden urge to urinate. Causes include stroke, enlarged prostate gland and Parkinson’s disease.
• Overflow incontinence – leakage because the bladder does not empty well and overfills. Causes include multiple sclerosis and enlarged prostate gland.
• Functional incontinence – leakage of urine because a person was unable to get to or use the toilet due to a physical disability, a barrier in their environment or because of an intellectual or memory problem. Causes include dementia and poor mobility.

• Diarrhoea – passing loose bowel motions frequently and in a hurry. Causes include infection or bowel conditions such as Crohn’s disease and ulcerative colitis.
• Constipation – passing hard, dry bowel motions, which can be difficult to get out. Causes include not drinking enough fluid, eating a diet low in fibre and lack of exercise.
• Faecal incontinence – is an uncontrolled loss of a bowel motion. Causes include diarrhoea and constipation. It can also result from a problem in the lower bowel or anus, making it difficult to hold onto a bowel motion. Causes include childbirth and nerve problems such as multiple sclerosis.

• Adequate fluid intake of 1,500–2,000ml each day
• A diet rich in fibre to prevent constipation
• A pelvic floor muscle exercise program
• Bladder retraining program
• Toileting program
• Medication
• Incontinence aids such as pads, condom drainage or catheters.

• Drink plenty of fluid; at least 1.5–2 litres each day, unless your doctor advises you otherwise.
• Eat well to prevent constipation and to maintain healthy body weight.
• Exercise regularly to keep fit and to prevent constipation.
• Tone up your pelvic floor with pelvic floor exercises for good bladder and bowel control.
• Practice good toilet habits to prevent bladder and bowel control problems. Go to the toilet to pass urine only when you have the urge to go; don’t go ‘just in case’. Take time to completely empty your bladder and bowel. Use the correct sitting position on the toilet. When you have the urge to use your bowels, don’t delay going to the toilet.

• Your doctor
• National Continence Helpline Tel. 1800 330 066
• Victorian Continence Resource Centre Tel. (03) 9816 8266
• Local continence service – call the National Continence Helpline for the contact details

• Incontinence is common.
• It has many different causes.
• There are many things that can be done to manage incontinence.
• In some cases, incontinence can be cured.

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