Incontinence
Incontinence can be an embarrassing topic and can cause anxiety when out and about, especially when you need to rush to find a toilet.
In most cases, incontinence can be cured or effectively treated to help you manage everyday life.
The first step is learn more about your options and seek professional help – and remember, it’s a very common problem that many others live with as well.
What is incontinence?
Many of us have heard of incontinence, but you might be surprised to know that it affects more than 5 million Australians, including young children.
Incontinence can range from a small leak occasionally when laughing or sneezing, to a complete loss of control of your bladder or bowel.
As it affects both bladder and bowel control, incontinence is often broken into two categories: urinary incontinence and bowel incontinence.
Urinary Incontinence
Urinary incontinence is the loss of bladder control which results in the leakage of urine. Stress or urge incontinence are the most common types, but there are several different types that can occur.
Stress incontinence
One of the most common types of urinary incontinence (which normally impacts more women than men), which is caused by a weakened urethral sphincter, or pelvic floor muscles - sometimes even both can be weak / damaged.
Although urine leakage can be a stressful experience, the word ‘stress’ actually relates to the increases in abdominal pressure that puts tension or ‘stress’ on the bladder.
This can range from a small leak during exercise or laughing, to more severe cases where a full bladder means the body cannot hold in any urine at all.
Urge incontinence
Also known as an ‘overactive bladder’, is another very common type of urinary incontinence.²It might come on as a very strong urge to urinate, followed by the release of the bladder instantly, which can be distressing when you’re not in close proximity to a bathroom.
While the exact cause is unclear, there are a few risk factors linked to an overactive bladder, including old age, physical problems (e.g. spinal damage), neurological diseases (e.g. multiple sclerosis) and infections of the bladder, urinal tract or prostate.²
Mixed incontinence
This type is a combination of stress and urge incontinence.
Many women with incontinence generally experience both forms (stress and urge) therefore have mixed incontinence. When mixed incontinence occurs in men, it is usually a result of prostate issues post-surgery.
Overflow incontinence
This is when your bladder doesn’t completely empty, thus creating urine leakage, with or without feeling the need to go. This mainly impacts men with prostate-related conditions.
Functional incontinence
Sometimes even though your urinary system works fine, other factors such as a disability or illness can cause functional incontinence.
This means having accidents due to things like medication or being bed-bound.
Reflex incontinence
When everything is functioning normally, our nerves warn the brain that the bladder is filling up.
With reflex incontinence, the bladder muscle contracts and urine leaks without any indication. Neurological impairments such as spinal injuries or multiple sclerosis can impact those nerves.
Faecal Incontinence
Sometimes poor bowel control can lead to leakage from the bowel or the passing of faeces (poo) without intending it, or in some cases being aware that it has happened. Faecal incontinence mainly happens as people get older, however some younger people do suffer.
There are many causes related to faecal incontinence. It can happen due to frequent straining when doing a poo and general poor toilet habits.
Some medicines and health conditions can also be triggers for faecal incontinence, such as diabetes, Parkinson’s disease, bowel disease and dementia. A weak pelvic floor can also cause unpredictable bowel movements.
As there are a number of contributing factors to faecal incontinence, it’s best to speak with your GP or refer to The Continence Foundation of Australia website6for helpful resources and tips.4
How to prevent incontinence
There are a number of effective preventative methods to help reduce the onset of leakage, or better manage it. Most involve some lifestyle changes.
Daily pelvic floor exercises, if performed properly (can take up to 3 months before you start to see a difference). A number of pelvic floor exercise videos are available on the Continence Foundation of Australia website6. There are also a number of apps to assist with Kegel exercises.
Quit smoking, as coughing can put a strain on pelvic floor muscles.
Consider changing your exercise routine to include low-impact, gentle exercises like yoga and pilates. High-impact exercise and sit-ups can put pressure on your pelvic floor.
Avoid heavy lifting; similar to high-impact exercise, lifting heavy items can increase the chance of leakage. Make sure you engage your core and tighten your pelvic floor before performing such activities.
Lose weight – we all know excess weight comes with many health risks and lifestyle drawbacks, but this could be a key step towards clearing up incontinence. Additional fatty tissues around the midsection can put pressure on the bladder, causing leakage.8
Deal with constipation – never strain when going to the toilet, and never delay in emptying your bowels when you need to go. Eating more fibre and increasing your exercise can also help with constipation.
Dietary changes - cut down on caffeine, alcohol, spicy and acidic foods, and try to drink plenty of water, as this can improve symptoms.
Incontinence pads – if you do experience incontinence, there is a range of different options suited to both men and women that can provide discrete protection to someone experiencing incontinence and can help in avoiding an accident in public.
What should I look for with incontinence pads?
Having the right incontinence pad can really help in living a normal lifestyle, and there’s a world of choice out there when it comes to picking the right one for you.
When looking for incontinence pads, the three key factors to consider are correct absorbency, correct size and correct style.
Here is a helpful guide for choosing an incontinence pad:
Guards & Shields: Similar in shape to a women’s menstrual pad, guards are intended for females and secure to underwear with a range of different absorbency levels. Shields are designed to be worn by males and are more similar in shape and style to that of a cricket protective cup. Guards and shields may be suitable for those with light to moderate incontinence issues, who have the capacity to regularly change the pad.
Nappy style protection: These are disposable nappy-style pads. Similar to a standard nappy, they have elastic waistbands and leg bands to provide more complete support. Suitable for moderate to heavy incontinence and for those who are not super active.
Pull-Up Pants: Pull-ups are tight fitting and work in the same way as regular underwear, with absorbent padding. This may be an ideal option for those who are active, desire discretion or for who might forget to change their pad.
Belted All-In-One: Another disposable option; these pads are held in place by a belt which is great for adjustments and comfort. They may be suitable for people with moderate to heavy incontinence.
Pad and Pant System: A great option for those who are active or for people with poor dexterity. An absorbent pad, that is secured close to the body using stretch pants (see below) or your own underwear. The pad doesn’t have wings or tabs, however this is good for people with moderate to heavy incontinence.
Stretch Pants: Stretch pants are used to keep a disposable pad in place. These are also great for the environment, as they can be washed and re-used multiple times (up to 30 washes). These may be ideal for people with moderate to heavy incontinence.
When to speak with your Doctor
If you’ve taken action to address your incontinence and are still experiencing leakage, or are distressed about your situation, we encourage a confidential chat with your Doctor.
Don’t feel like you need to suffer in silence, as there are plenty of resources and support groups out there that may be helpful to you.
Incontinence issues may seem embarrassing, but remember over 5 million other Australians are experiencing it too!
Incontinence can be uncomfortable and distressing, but our friendly Pharmacists are here to support you with a range of options and products to help, so you can get back to enjoying life with dignity.
Have a confidential chat to your local MediADVICE pharmacist for assistance, and to find out more information.