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What To Do About Incontinence (Pssst, You’re Not Alone)

Are you an older adult with incontinence problems? You’re not alone. It’s a real issue for many seniors.

Urinary incontinence is when a person has involuntary urine leakage. Another name for it is “overactive bladder.”  

Over 33 million Americans have an overactive bladder (25-33% of all adults in the U.S.). The condition is especially common in women, with half of all females over age 65 experiencing bladder leakage. Bowel incontinence is the leaking of solid or liquid stool, and over 18 million adults in America suffer from this condition.

Having urine or bowel incontinence can make one dread certain situations, avoid some activities, and live a restricted life. There are things you can do to manage and improve your situation, however. We’ll present some suggestions later in this article.

First, let’s look at the different types of incontinence. You may experience one or more of these.

Types of Incontinence

Urinary Incontinence

Some people only leak urine occasionally, especially when laughing or sneezing. Others will dribble urine continuously, while others may exhibit a complete lack of bladder control. Here are the types of urinary incontinence:

1. Stress incontinence is the most common type and happens when pressure is put on the bladder during coughing, sneezing, laughing, or lifting a heavy object. This type can affect people of all ages.
2. Urge incontinence happens when a person needs to urinate but cannot reach the toilet in time. Sometimes, this is caused by waiting too long to find a restroom.
3. Overflow incontinence describes leaking from a bladder that is always full. This can be due to incomplete bladder emptying.
4. Functional incontinence is when people have normal bladder control but, due to physical problems, cannot reach the toilet in time.

Fecal Incontinence

This can occur when a person has diarrhea or has been constipated and cannot reach the restroom quickly enough. In other cases, people cannot control their bowels at all and rarely make it to the toilet before leakage occurs.

Causes of Incontinence

Certain medical conditions can cause incontinence in both men and women. These conditions include obesity, stroke, dementia, Parkinson’s disease, and multiple sclerosis.

Prior pregnancies and childbirth, pelvic floor atrophy, and menopause frequently cause urinary incontinence in women. In men, urinary incontinence is often caused by an enlarged prostate, prostatitis, or nerve and muscle damage.

Fecal incontinence can be caused by diarrhea, constipation, nerve damage in the anus, pelvic floor muscle weakness, rectal changes from cancer or surgery, damage to nerves or muscles during childbirth, gallbladder removal, or medication side effects. Dementia can also cause incontinence as the brain may no longer be able to perceive the need to “go.” 

When To See a Doctor

You should always be aware of situations where it is important to consult your physician. These include:

• The presence of cloudy or bloody urine
• The need to urinate frequently (eight or more times a day)
• Pain when urinating
• Trouble releasing urine despite the urge to go
• The presence of blood in stools or tarry, black stools
• Constipation that lasts for more than a few days

At the doctor’s office, an assistant will usually record your medical history, and your doctor will perform a physical exam. Be ready to answer questions about symptoms you’ve been experiencing and medications you’re taking. A urine and blood sample may be required. A cystoscope, ultrasound, CT scan, or colonoscopy may be ordered.

Possible Treatments Your Doctor May Prescribe

Medications or surgical procedures may relieve your incontinence symptoms, and your doctor may prescribe one or more of these after a thorough exam and necessary tests.

Outside of medications or surgery, your doctor may recommend the following:

Pelvic Floor Exercises  

Also called Kegels, these exercises strengthen the muscles that support the bladder and other organs. To learn more, visit these articles on the Mayo Clinic website: Kegels exercises for women and Kegels exercises for men. Or ask your doctor for information.

Avoid Caffeinated Drinks

Drinks with caffeine, such as coffee, tea, and sodas, are diuretics that increase the need to urinate. Do not limit water intake, however, as water is necessary for all organ functions.

Urgency Suppression

Practice controlling the urge to urinate. Try distracting yourself, practicing deep breathing, staying still, or squeezing the pelvic floor muscles. 

Timed Voiding

Work on controlling the bladder by scheduling times to go to the bathroom. Try to go once an hour. As you gain more control, you can go longer between bathroom trips.

Keep Floors and Hallways Clear

Unobstructed pathways to the bathroom can help you get there faster and more safely.

Double Voiding

This is when a person urinates, then waits a few minutes and urinates again to empty the bladder fully.

Things to Try at Home

To create an environment that is easier at home, try the following:

• Use pads or panty liners in underwear. These have improved greatly in design over the decades and are streamlined and not visible through clothing.
• Wear underwear that is easy to get on and off. Consider wearing slightly larger-sized underwear, washable incontinence underwear, or disposable incontinence underwear.
• Use bed-wetting alarms that detect the presence of liquid. These alarms wake you up before full voiding has occurred so you can make it to the bathroom.
• Put a washable, waterproof mattress pad on your bed in case of a leakage or accident.
• Try absorbent bed pads that go over the sheets to catch any liquid. These can also be used on chairs and in cars.
• A bedside commode may help those having difficulty getting to the bathroom in time.
• Men may use a penile clamp to prevent leakage. Discuss this option with your doctor. The clamp should be released every few hours to avoid infection.

On a Final Note

As mentioned above, the subject of incontinence is one that most people do not enjoy talking about or ever wish to experience. However, there are tactics and solutions for managing and alleviating the problems of incontinence.

Don’t let incontinence problems limit your life. Set up an appointment today to discuss your symptoms with your doctor.

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