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Dealing with Incontinence

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M T

On January 5, 2020

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Continence

Continence involves maintaining complete control over urination and/or defecation.

Incontinence is the condition in which you fail to maintain complete self-control over urination and defecation. You can experience urinary incontinence, fecal incontinence, or both.

Urinary Incontinence

Urinary incontinence (bladder incontinence) is the unexpected and involuntary leaking of urine. There are several types of urinary incontinence:

Urinary Incontinence
Type	Description
Stress Incontinence	Urine leaks when pressure is exerted on bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
Urge Incontinence	A sudden, intense urge to urinate followed by an involuntary loss of urine.
Overflow Incontinence	Frequent or constant dribbling of urine due to a bladder that does not empty completely.
Functional Incontinence	Inability to make it to the toilet or get clothes undone in time due to a physical or mental impairment.
Mixed Incontinence	Combination two or more types of urinary incontinence.

Urinary incontinence is a symptom, not a disease. It can be the result of everyday habits, underlying medical conditions, or physical problems. If you are experiencing urinary incontinence symptoms, a thorough doctor’s examination may help you to determine the source.

Temporary Urinary Incontinence

Certain food, beverages, and medications act as diuretics, and could be stimulating your bladder and increasing your volume of urine. Examples may include:

Category	Diuretic Examples
Beverages	Alcohol Caffeinated drinks Carbonated drinks Sparkling water
Foods	Artificial sweeteners Chili peppers Chocolate Citrus fruits Foods high in acid Spicy foods Sugary foods Vitamin C in large doses
Medications	Blood pressure and heart medications Sedatives Muscle relaxants

Being overweight and smoking can also contribute to urinary incontinence.

Urinary incontinence may be caused by easily treatable medical conditions such as urinary tract infections and constipation.

Persistent Urinary Incontinence

Underlying physical problems or changes may lead to persistent urinary incontinence. Examples include:

Aging
Enlarged prostrate
Hysterectomy
Menopause
Neurological disorders such as multiple sclerosis, Parkinson’s disease, as stroke, brain tumor, or injuries, such as to the spine
Obstruction from a tumor or urinary stones
Previous pregnancy / childbirth
Prostate cancer

Addressing Urinary Incontinence

Treatment of urinary incontinence is dependent on type and severity.

Changes in health and lifestyle habits can help to reduce the likelihood of and control urinary incontinence. Examples include:

Urinate regularly.
Maintain a healthy weight.
Exercise your pelvic floor muscles.
Monitor fluid intakes. Avoid bladder irritants, such as caffeine, alcohol.
Pay attention to your diet. Eat more fiber, which can prevent constipation, a cause of urinary incontinence. Avoid bladder irritants such as acidic foods.
Do not smoke, or seek help to stop smoking.

Discuss with your doctor means to address persistent urinary incontinence.

Fecal Incontinence

Fecal incontinence (bowel incontinence), is the unexpected and involuntary leaking of feces. There are several types of fecal incontinence:

Fecal Incontinence
Type	Description
Stress incontinence	Feces leaks when you exert pressure on your rectum by bending, exercising, or lifting something heavy.
Urge incontinence	A sudden, intense urge to defecate followed by an involuntary loss of feces.
Flatus incontinence	You have the sensation of a full rectum, but the body’s sensation mechanisms do not work properly and cannot tell whether it is gas or stool.
Passive incontinence	The brain receives no urge instruction to go to the toilet. You are unaware that the rectum is full and ready to empty. The lack of sensations in your back passage prevents conscious control of bowel movements and stool is passed without your knowledge.
Anal and rectal incontinence	Inability to control the anal sphincter muscles due to damage to the nerves, the rectum’s structure, or the muscles in this area.
Overflow incontinence	Results from a blockage in the colon caused by constipation. The initial blockage, caused by a stool that is stuck, blocks yet more stool. Only watery feces can pass around it. That discharge then leaks out because it is so hard to control.
Functional incontinence	A physical or mental impairment keeps you from making it to the toilet or getting your pants or other clothes undone in time.
Mixed incontinence	Combination two or more types of fecal incontinence

Fecal incontinence is most commonly caused by damage to the muscles around the anus (anal sphincters) . Women are affected by accidental bowel leakage about twice as often as men, as vaginal childbirth can damage the anal sphincters or their nerves.

Other potential causes of fecal incontinence as:

Diarrhea, often caused by viruses, bacteria, parasites, certain medications, infection or irritable bowel syndrome.
Impacted stool, often due to severe constipation.
Hemorrhoids, which prevent the muscles around your anus from closing completely.
Inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis.
Neurological diseases, such as multiple sclerosis and Parkinson’s disease, impacting your rectum, anus, or pelvic wall,
Nerve damage impacting your rectum, anus, or pelvic wall, resulting from diabetes, spinal injury, or other factors.
Radiation damage to the rectum, such as after treatment for prostate cancer
Cognitive impairment, due to stroke, advanced Alzheimer’s disease or other factors
Functional impairment due to arthritis or other factors

Treatment of fecal incontinence is dependent on type and severity.

Addressing Fecal Incontinence

Treatment of fecal incontinence is dependent on type and severity.

Changes in health and lifestyle habits can help to reduce the likelihood of and control urinary incontinence. Examples include:

Avoid foods that contribute to bowel irritation.
Eat 20 to 30 gram of fiber each day to make stool more bulky and easy to control
For constipation:
- Drink several glasses of water each day.
For diarrhea:
- Avoid caffeine
- Consider medicines to reduce the number bowel movements and to urge to move the bowels may help.
  1. Imodium
  2. Lomotil
  3. Hyoscyamine
Exercise your pelvic floor muscles (Kegel exercises).
Train your bowels by attempting to have bowel movements around the same time each day to help prevent accidents in between

Your doctor may discuss with you and perhaps recommend non-surgical or surgical procedures if your bowel incontinence is not helped by noninvasive treatments.

Incontinence Products

While you are working to rid yourself of the incontinence, you will need to address the symptoms in order to be able to continue your daily living activities, including your social ones.

Incontinence products include:

Product Category	Product Examples	Primary Urinary Incontinence Addressed	Primary Fecal Incontinence Addressed
Remote toileting receptacles	Bedpans Urinals Commodes Commode/Shower rolling chairs	Urge Overflow Functional	Urge Passive Anal and Rectal Overflow Functional
Bed, wheelchair, and furniture protective pads	Under pads Bed pads and mattress protectors	Stress Urge Overflow Functional	Stress Urge Flatus Passive Anal and rectal Overflow Functional
Incontinence outerwear	Pants with elastic waistbands Trousers with detachable crotch	Functional	Functional
Collection and regulator devices	Urine bag pants Bladder control pads Penile clamps	Stress Urge Overflow Functional	Stress Urge Flatus Passive Anal and rectal Overflow Functional
Personal protective pads, liners, and garments	Feminine hygiene pads Pant liners Disposable undergarments Belted undergarments Adult briefs Pull-Up underwear Protective underwear	Stress Urge Overflow Functional	Stress Urge Flatus Passive Anal and rectal Overflow Functional
Exercise and strengthening devices	Kegel balls Pelvic-floor muscle trainer	Stress Urge Overflow Functional	Stress Urge Anal and Rectal Overflow Functional
Supplements and over-the-counter medicines	Anti-diarrhea products Bladder control supplements Hemorrhoid products Laxatives for constipation Prostrate support supplements	Urge Overflow	Urge Overflow
Clean-up and sanitation	Vinyl Gloves Hand wipes Cleaning products Detergents Liquid sanitizers Refuse containers and bags	All	All

You can find a sampling of incontinence products to help you to prepare for bouts of incontinence, and to clean up after any accidents that occur, by clicking on this link.

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