Incontinence

Incontinence describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal or bowel incontinence). Some people experience incontinence every day, whereas others experience it from time to time.

Urinary incontinence ranges in severity from occasionally leaking urine when you cough or sneeze to having an urgent need to urinate that's so sudden you might not make it to a toilet in time.

Bowel or faecal incontinence means you are unable to control bowel movements which may include feeling little or no sensation when you need to open your bowels (known as passive incontinence, or you may feel that you need to go but the urge is so sudden you are unable to reach the toilet in time.

Urinary incontinence occurs when the normal process of storing and passing urine is disrupted which can happen for a number of reasons. There are several types of incontinence which have different symptoms and causes.

Incontinence can occur as a result of having long term health conditions, such as multiple sclerosis, diabetes or dementia. It is common in pregnant women and after childbirth due to the increased pressure put on the bladder and pelvic floor muscles. Incontinence is also more likely to occur as a person ages, due to things such as hormonal and menopausal changes in women and prostate problems in men.

Read more about what causes incontinence on the Continence Foundation website

Incontinence is usually defined as either urinary or bowel/faecal, but it is possible to have both types. Urinary incontinence is often further categorised into several types, including:

The main symptom of urinary incontinence is passing urine unintentionally, but the type of incontinence you have often relates to how much urine you pass during the course of a day.

If you are experiencing problems with going to the toilet or think you might be incontinent, speak to your GP. It can feel embarrassing to talk about these issues, but remember your GP is a professional and the symptoms you are experiencing are really common. Your GP may ask you lots of questions about your bladder and bowel habits and your lifestyle, for example, your diet. They may recommend you undergo some tests to find out what may be causing your incontinence and possibly carry out a physical examination.

Find out more about how incontinence is diagnosed on the NHS website.

Everyone experiences incontinence differently depending on what type they have, the severity of their symptoms, and if they are also living with another healthcare condition that causes their incontinence. For some people, incontinence will affect their day to day life quite significantly, but there are a number of ways to make daily routines easier when living with incontinence, including incontinence products and incontinence treatments.

Age UK offer an information leaflet with more details on how to live well with incontinence, including practical advice and tips.

You may also like to take a look at the Bladder & Bowel UK, who are a great source of information and support. They also supply the 'Just Can't Wait' card that can give you access to toilets not usually accessible to the public.

There are lots of incontinence products available to help you manage your condition, make going to the toilet easier and make you feel more comfortable and confident. If you are caring for someone who is living with incontinence, there are a number of products that can help you too.

At Healthcare Pro, we have a team of product advisors and Occupational Therapists available who are able to talk to you about your incontinence (or any other related healthcare conditions) and to help you find the right incontinence aids to meet your specific needs. Our range of products include incontinence management aids, toileting aids and products for carers.

Continence management: these incontinence products will help to protect your underwear, clothing and furniture from any leaks, keeping you dry and comfortable. Some people find that their skin sometimes becomes irritated from wearing pads regularly and having urine or faeces close to the skin, so you may also benefit from using specially formulated skincare. Discover how to fit your incontinence pads correctly and prevent leaks by visiting our blog.

Initially, for urinary incontinence, it is likely you will be advised to undertake:

If these treatments are unsuccessful, there are a number of surgical procedures that may be considered and your healthcare professionals will advise which is likely to be the most effective for you. The various surgical treatments for urinary incontinence can be found on the NHS website.

Procedures for bowel incontinence will likely include the non-intrusive treatments first, such as dietary changes and exercise programmes, moving on to surgical options if these do not have the desired effects. The various treatments for bowel incontinence can be found in more detail on the NHS website.

Most people with incontinence will be able to continue to work but this may cause some anxiety. Depending on the type of incontinence you have, you should be able to find the right incontinence products such as pads and pants to help you manage your condition during the day or night.

You may wish to discuss your continence condition with your employer, particularly if it is likely to affect your work or require time off.

Bladder and Bowel UK offer some great advice on incontinence and employment. Contact them on their confidential helpline on 0161 607 8219 (Mon-Fri 9am-4.30pm) or email bladderandboweluk@disabledliving.co.uk

There is not really a set incontinence diet that people follow, but eating a healthy diet and drinking enough of the right kind of fluids can improve some types of incontinence. Certain food and drinks can increase urinary incontinence because they make bladder muscles spasm, creating the urge to urinate, including:

Drinking six to eight glasses of fluid a day is recommended even if you have incontinence as reducing the amount of fluid you drink may actually decrease the capacity of your bladder.

For people with bowel incontinence, a healthy diet may have a positive effect. Generally, fibre intake can help with diarrhoea and constipation, whilst drinking enough liquid may also help prevent constipation. If you experience diarrhoea, it may be beneficial to avoid fizzy drinks or those containing caffeine, alcohol or milk.

Some people take incontinence supplements in the form of herbal medicines or minerals such as flaxseed oil, bromelain or vitamin E to help relieve their symptoms.

It is important for your general health and wellbeing to take regular exercise. However, for some people with incontinence, certain exercises that are high impact can be difficult and lead to leakage. Try to find an exercise that increases your heart rate but that is gentle enough to not put strain on your bladder or bowel. Walking and swimming usually suit most people.

Specific incontinence exercises which focus on strengthening your pelvic floor muscles can help certain types of incontinence, especially stress incontinence. Exercise such as Pilates and yoga can help and you can also do Kegel exercises at home:

For further advice on how to do pelvic floor exercises for incontinence, visit the Bladder and Bowel Foundation website.

Bladder and Bowel Community

Bladder Health UK forums

Age UK – helps to inspire and support older people so they can enjoy later life

Bladder and Bowel UK – have a National Confidential helpline for anyone with bladder or bowel issues 0161 607 8219

Bladder Health UK – gives support to people with all forms of cystitis, overactive bladder and continence issues

Bowel Control UK – provides information about incontinence, healthcare services and available treatments

Continence Foundation – provides comprehensive information about how to approach incontinence

NHS Choices – helps to explain health conditions in more detail

Bladder fistula

a small, tunnel-like hole that can form between the bladder and a nearby area, such as the vagina, in women

Detrusor muscles

found in the walls of the bladder, these muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out. Sometimes the detrusor muscles contract too often which causes an urgent need to urinate

Passive incontinence

having no sensation of needing to open the bowels or urinate

Pelvic floor muscles

these support the bladder and bowel, giving you control when you urinate

Rectum

the final, straight part of the intestine that comes before the anus

Sphincter muscles

these surround the anal canal. Those with bowel incontinence may be advised to exercise these muscles

Urethra

a tube that connects the urinary bladder to the genitals for the removal of fluids from the body