What is incontinence?

Incontinence is a term that 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).

Incontinence is a widespread condition that ranges in severity from 'just a small leak' to complete loss of bladder or bowel control. In fact, over 4.8 million Australians have bladder or bowel control problems for a variety of reasons. Incontinence can be treated and managed.  

In many cases it can also be cured.

Summary

Incontinence is the accidental leakage of urine from the bladder or faeces (bowel motion or poo) from the bowel. It can affect people of all ages. Many Australians experience bladder or bowel control problems including an increase in frequency or urgency without any leakage. Some people experience both bladder and bowel control problems.

Bladder and bowel control problems are common. More than four million Australians regularly experience leakage from the bladder and bowel (incontinence). Many others have bladder and bowel control problems, such as needing to go to the toilet more frequently and an urgency to go without leakage. Together, these problems are often called continence problems.

Although incontinence and continence problems have a considerable impact on a person’s quality of life, many 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 without needing to plan your activities around the toilet.

Incontinence and continence problems are common

Incontinence and continence problems affect people of all ages, gender, cultures and backgrounds. Despite popular opinion, older people are not the only ones affected.

• One in three women who have had a baby experience loss of bladder control.
• One in five children wet the bed at some time.
• One in 100 adults never achieve bladder control at night.
• One in 20 adults experience bladder and bowel control problems.

Bladder and bowel control problems are not an inevitable part of ageing. Believing that continence is a normal part of ageing is not the right response to your bladder or bowel control problems. See your healthcare professional or carer for more information..

Continence problems and bladder or bowel issues

Incontinence and continence problems are symptoms of bladder or bowel dysfunction. They tell you that something is not quite right. Pelvic floor muscle weakness is a common cause of these symptoms. Changes to the nerves controlling the bladder, bowel or pelvic floor can also result in loss of control.

Sometimes, other health problems such as diabetes, stroke, Parkinson’s disease or multiple sclerosis can cause bladder or bowel control problems.   In Women other causes include pregnancy, menopause and taking part in streneous sports. 

Symptoms of bladder continence problems

People with bladder control problems may experience:

• leaking urine with coughs, sneezes or exercise
• leaking urine on the way to the toilet
• passing urine frequently
• rushing to the toilet (urgency)
• getting up twice or more at night to pass urine
• wetting the bed when asleep
• feeling their bladder is not completely empty
• having poor urine flow
• straining to get the bladder to empty
• frequently having urinary tract infections (UTIs).

Types of bladder control problems

Urinary incontinence and continence problems may include:

• 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, but often the cause is unknown
• overflow incontinence – leakage because the bladder does not empty well and overfills. Causes include multiple sclerosis, an enlarged prostate gland and diabetes
• 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.

Treatment for incontinence and continence problems

If you have incontinence or continence problems, you should seek help. There is a range of management options available. The treatments depend on the type of incontinence you have and what you hope to achieve.

An incontinence management plan will usually include several of:

• adequate fluid intake of up to two litres (6 to 8 glasses) each day (your urine should be pale yellow in colour)
• a diet rich in fibre (such as wholemeal bread, cereals, fruit and vegetables) to prevent constipation
• a pelvic floor muscle exercise program
• a bladder retraining program
• a toileting program
• medication
• incontinence aids such as pads, condom drainage or catheters.

Prevention of incontinence and continence problems

There are things you can do to help keep your bladder and bowel healthy, and avoid incontinence and continence problems.

Suggestions for healthy lifestyle choices include:

• Drink plenty of fluid – at least two litres (6 to 8 glasses) each day, unless your doctor advises you otherwise.
• Eat well to prevent constipation and to maintain a healthy body weight (eat wholemeal bread and pasta, brown rice, high-fibre cereal and at least two pieces of fruit and five serves of vegetables every day).
• Exercise regularly (at least 30 minutes every day) to keep fit and to prevent constipation.
• Tone up your pelvic floor with pelvic floor exercises for good bladder and bowel control.
• Practise good toilet habits to prevent bladder and bowel control problems.

Good toilet habits can help to prevent incontinence and continence problems. These include:

• going to the toilet to pass urine only when you have the urge to go – don’t go ‘just in case’
• taking time to completely empty your bladder and bowel
• not delaying going to the toilet when you have the urge to use your bowels
• using the correct posture on the toilet to help you pass a bowel motion (place your elbows on your knees, bulge out your stomach, straighten your spine and put your feet on a footstool (if it is safe to do).

Myths and Facts About Bladder Weakness and Incontinence In Women

Bladder weakness only happens to women who had children and old people - FALSE

Although the risk for incontinence goes up as you age, anyone can experience symptoms at any time. There are many causes for sensitive bladder. The most common ones are:

• Pregnancy and Childbirth can affect your pelvic floor support structures such as muscles and ligaments. Pelvic floor exercises after pregnancy can give you more control over leaks when you need it.
• Menopause related sensitive bladder is due to a significant drop in oestrogen levels. Increased frequency and sudden urges are the most common symptoms. Talk about this with your doctor during one of your checkups when discussing your overall change in your body.
• Being overweight puts pressure on the bladder, urethra, and pelvic floor muscles. Fortunately, weight loss can reduce the pressure.
• Strenuous sports can lead to sensitive bladder due to the excessive demands placed on the bladder that can result in involuntary urine leaks.

There is only one type of incontinence - FALSE

There are different types of incontinence. The main types are:

• Urge incontinence when you have a strong need to urinate but can't reach the toilet in time – it can happen to anyone at any age.
• Stress incontinence when you experience bladder leaks when coughing, sneezing or laughing – it is even more common in younger rather than older women.
• Mixed incontinence is the combination of stress and urge incontinence symptoms.

Having a weak bladder is very rare condition - FALSE

Bladder weakness affects 1 in 3 women over the age of 18.     Over half of women never seek help from their doctor.  More than 4.8 million Australians experience bladder or bowel control problems.

You should drink as little as possible if you have a weak bladder - FALSE

There’s no need to avoid drinking in order to reduce the urge to visit the loo. Keep hydrated! Drinking a lot of water can increase the frequency and urgency of urination. But not consuming enough make your urine more concentrated, both of which boost your chances of bladder irritation. That, in turn, can heighten your risk of incontinence. Also, drinking water can help reduce odours.

Top tip: Get into the habit of sipping water between meals, and not having anything to drink two hours before bed. Avoiding or reducing caffeine, citrus juices, alcohol and carbonated beverages.