What is incontinence and why is it important?

As you grow older, problems with losing control of your bladder and bowels can increase. This involuntary loss of control is known as “incontinence”.

Many people feel embarrassed or ashamed to talk about these problems. But if you experience incontinence, it is important to remember that you are not alone. According to the Continence Foundation of America, almost 4.8 million Americans are affected by incontinence.

Whether you are living in your own home or in an aged care home, there are services that can help.

What is incontinence ?

There are two types of incontinence:

• Involuntary loss of bladder control (urinary incontinence)
• Involuntary loss of bowel control (fecal incontinence).

Urinary incontinence

Urinary incontinence is a common condition that has many causes and includes four main types:

• stress incontinence – leaking of small amounts of urine from the bladder
• urge incontinence – loss of urine associated with a sudden and strong need to empty your bladder
• overflow incontinence – leaking of small amounts of urine from the bladder as a result of the bladder not emptying properly
• functional incontinence – when physical or cognitive problems prevent you from getting to the toilet on time to empty your bladder.

Fecal incontinence

Fecal incontinence is more common as you grow older. This type of incontinence is sometimes referred to as rectal incontinence  and includes involuntary loss of gas.

There are many causes for urinary and fecal incontinence and help is available to manage both conditions.

In many cases, incontinence can be managed or cured.

Who can help?

If you have problems with bladder or bowel control, it is a good ideal to speak to your doctor.

Your doctor may be able to suggest different treatments, review and prescribe medication, order clinical tests and refer you to a specialist, continence nurse adviser or continence physiotherapist, if needed.

When you're visiting your doctor it may help to take along information such as:

• how often the incontinence  occurs
• whether it’s urinary or fecal incontinence
• when it started
• times of the day when the incontinence  is worse
• whether there's complete saturation or just a small amount of urine or feces
• whether you have had a fever or found it painful to go to the toilet
• what medications you are taking, if any.

Pharmacists may also be able to provide advice on incontinence  products that are available for purchase, as well as direct you towards local clinics.

National Association for Incontinence

Qualified continence nurse advisers can give you confidential, expert advice through to the National Association for Incontinence. You can also ask about continence products, federal and state government subsidies and printed information resources about incontinence that they can share with you. The National Association for Incontinence can also give you information about continence services in your area.

What about dementia and incontinence?

People with dementia often find it particularly difficult to recognize the need to go to the toilet. Or, they have difficulties finding, recognizing or using the toilet properly.

It can be stressful and challenging for care givers to manage these problems while still respecting the privacy and dignity of the person with dementia. Some tips that may help include:

• observing patterns of when the person empties their bladder and bowel and using this pattern to remind them, at regular intervals, to go to the toilet
• watching for non-verbal clues such as pulling on clothes and agitation and using short, simple words to suggest the person goes to the toilet
• making sure the person’s bed isn’t too high, the toilet paper can be easily seen and the toilet is clearly marked
• using aids such as grab rails to help the person get on and off the toilet
• simplifying clothing with elastic and Velcro waistbands
• using pads and protecting garments
• avoiding constipation by offering enough fluids, offering a high fiber diet and
  encouraging the person to undertake physical activity regularly
• limiting caffeine drinks.

Testing for Underlying Causes of Incontinence

For urinary incontinence, the “gold standard” set of tests is called urodynamics. Urodynamics is a series of tests that replicates the incontinence symptoms and  collects physiological data as the symptoms occur. This data can then be used to  further pinpoint the underlying cause.

For fecal incontinence, anorectal manometry (ARM) is often used. ARM replicates the fecal incontinence symptoms and measures many physiological  variables as the symptoms occur. The information can then be better used to pin point possible underlying causes.

If you are affiliated with a clinic or hospital and are interested in urodynamics or ARM, you may be interested in our testing services.  You can find out more by clicking the button below.