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Incontinence

Many people of all ages have a long-term problem with controlling their bladder or bowel, and this can have a real impact on their daily lives.

More than 3.2 million people over 65 in the UK suffer from urinary incontinence, and 6.5 million people of all ages are affected by some form of bowel problem. Many don’t talk about these problems or seek any help, either out of embarrassment or because they think nothing can be done. However, there are actions you can take to help you deal with some of the common problems.


What is Incontinence?

For older people there can be a number of factors that lead to incontinence, some of which are listed below.

  • Problems getting to the toilet – for example, being unsteady on your feet, taking a long time to get to a toilet, or forgetting where the toilet is.
  • Difficulty using the toilet – for example, having no handrails to grip when getting on and off the toilet, or having problems adjusting your clothes due to arthritis in your hands and fingers.
  • Memory problems – for example, forgetting what a toilet is and how it should be used.
  • Bladder problems – if muscles around your bladder are weak, it can lead to stress incontinence.
  • Overactive bladder – this is when urine needs to be passed many times and very quickly. Leakage can occur if the toilet is not reached in time. When the bladder doesn’t empty properly there is an overflow and this usually results in a continuous dribble.
  • Bowel problems – this usually affects older people and can occur as a result of constipation. If the constipation is severe, the bowel can overflow and this causes faecal incontinence.
  • Illness – for example, Alzheimer’s disease or a stroke.

For further information, you may find Age UK’s factsheet Help with continence useful.


Types of Urinary Incontinence

There are many different types of bladder problem. Urinary tract infections (UTIs), such as cystitis, can cause temporary bladder problems, such as the urgent need to pass urine, or a burning sensation when you go to the toilet. There are several different types of longer term bladder incontinence:

  • Stress incontinence – this is usually experienced by women. It is caused by a weak bladder outlet and weak pelvic floor muscles, which can happen as a result of childbirth. Leakage occurs when walking, after gentle exercise, or even when sneezing. Men are likely to suffer from this type of incontinence after a prostate operation.
  • Urge incontinence – this is the result of an overactive or unstable bladder. This means that people have a desperate need to get to the toilet and are unable to get there in time. Urine may need to be passed more often than usual through the day and night. An overactive bladder can occur after a stroke or if a person has suffered from problems with their nervous system, whereby the brain is no longer able to tell the bladder to wait until a toilet is reached.
  • Overflow incontinence – this is when the bladder doesn’t empty properly and urine builds up and overflows, which results in a constant dribbling leakage. There are several explanations as to why the bladder may not empty properly, such as an age-related problem, or severe constipation resulting in a blockage of the bladder outlet. People that have suffered a stroke, multiple sclerosis, or Parkinson’s disease may have this kind of problem with their bladder.

Types of Faecal Incontinence

People with faecal incontinence tend to pass faeces or stools at a moment’s notice with little warning. Faecal incontinence is more common than you may think; in fact one in twenty people suffer from poor bowel control and it gets far more common as you get older.

Constipation

This is the most usual type of bowel problem and happens when hard bowel motions become difficult to pass. Constipation may be caused by:

  • not eating enough fibre
  • not drinking enough (you should drink at least six to eight cups of liquid a day)
  • not being able to move around much
  • some medicines (such as some painkillers)
  • not being able to get to a toilet or putting off going
  • some neurological diseases, such as Parkinson’s
  • bowel diseases such as irritable bowel syndrome (IBS) or colitis.

Diarrhoea

Frequent, urgent watery bowel motions can cause you to have an accident if you can’t find the toilet in time. Diarrhoea has many possible causes, including the overuse of laxatives, a bacterial or viral infection, an irritable bowel or other bowel disease.


Ways to help prevent incontinence

  • Seeking medical help – a professional assessment can be carried out by a district nurse or by a GP. This assessment will tell you why you are experiencing incontinence. A plan will then be devised to help you to manage the problem.
  • Treatment – depending on the cause, medicines, bladder or bowel training programmes and, if necessary, an operation can be performed.
  • Diet – a high fibre diet and sufficient intake of water and soft drinks may be beneficial. Bear in mind that too much caffeine can upset the bladder.

See NHS.UK 10 ways to stop leaks for more information.


Controlling Incontinence

Incontinence may persist regardless of treatment. As a last resort, a catheter can be used. Incontinence products are also available in the form of pads, underpants and bedding protection. These are available to buy in supermarkets and pharmacies, or you can speak to your GP or local Continence Service to see if you are eligible to receive these products free from the NHS.

NHS.UK provide information on Incontinence Products that may be helpful.


Local Information and Advice

Newcastle Continence Service can carry out assessments and provide advice and help for anyone with a bladder or bowel need.


Other Useful Information

Please note – The content on this website is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. If you are feeling unwell, make an appointment to see your GP or contact NHS 111. In an emergency, dial 999.

Last updated: November 22, 2018

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