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Incontinence

Everything you need to know about living well with incontinence

  • Introduction
  • Types
  • Symptoms
  • Daily Living
  • Support
  • Glossary

Introduction

If you’re living with incontinence, its likely you’ll want to understand the condition more, what it is and why it may be happening.

You might be feeling anxious about going about your daily life or embarrassed to discuss your experiences with others. But it’s important for you to realise you are not alone! Incontinence is a really common issue, affecting millions of people in the UK.

NRS Healthcare is here to help you understand what causes incontinence and what types of incontinence you can be diagnosed with. As we specialise in daily living aids, you can trust us to provide a range of reliable incontinence products that can help you manage your condition and feel more confident day to day.

We feel it’s important to help break down the stigma associated with incontinence, and believe that ensuring you have the right information at your fingertips is the first step to achieving this.

If you think you may be incontinent, you should see your GP for professional healthcare advice.

Introduction

What is incontinence?

Incontinence 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). Some people experience incontinence every day, whereas others experience it from time to time.

Urinary incontinence ranges in severity from occasionally leaking urine when you cough or sneeze to having an urgent need to urinate that's so sudden you might not make it to a toilet in time.

Bowel or faecal incontinence means you are unable to control bowel movements which may include feeling little or no sensation when you need to open your bowels (known as passive incontinence, or you may feel that you need to go but the urge is so sudden you are unable to reach the toilet in time.

What causes incontinence?

Urinary incontinence occurs when the normal process of storing and passing urine is disrupted which can happen for a number of reasons. There are several types of incontinence which have different symptoms and causes:

    Stress incontinence: sudden extra pressure on the bladder such as laughing or sneezing, causes urine to leak out of the urethra
    Urge incontinence: otherwise known as having an ‘overactive bladder’. Urge incontinence is caused by detrusor muscles in the walls of the bladder contracting too often, creating an urgent need to go to the toilet
    Overflow incontinence: is often caused by a blockage or obstruction of the bladder, which fills up as usual, but cannot be completely emptied
    Total incontinence: this occurs when the bladder can't store any urine at all and may be caused by bladder problems from birth, injury to the spinal cord or a bladder fistula

Bowel incontinence is usually caused by a physical problem with the parts of the body that control the bowel, for example:

    • The rectum is unable to retain faeces until it's time to go to the toilet
    • Nerve damage, which means nerve signals sent from the rectum don't reach the brain

Incontinence can occur as a result of having long term health conditions, such as multiple sclerosis, diabetes or dementia. It is common in pregnant women and after childbirth due to the increased pressure put on the bladder and pelvic floor muscles. Incontinence is also more likely to occur as a person ages, due to things such as hormonal and menopausal changes in women and prostate problems in men.

Read more about what causes incontinence on the Continence Foundation website

Did you know... "It’s estimated that between 3 and 6 million people in the UK have some degree of urinary incontinence – it is a really common problem."

Main Types of Incontinence

Read on to find out about the types of incontinence you can experience.

People’s experiences of incontinence can vary greatly. There are different types of incontinence, determined by the root cause and how or when the incontinence occurs. It is important for a person’s GP or incontinence advisor to understand what type of incontinence they have. It may be difficult for a person to explain such private experiences with their healthcare team, but it is essential so they can determine the underlying causes, and create an effective treatment plan.
Introduction

Incontinence is usually defined as either urinary or bowel/faecal, but it is possible to have both types. Urinary incontinence is often further categorised into several types, including:

    Stress incontinence: urine leaks out when the bladder is under pressure, for example when coughing or laughing. It is not related to feeling stressed
    Urge incontinence: sudden urge to pass urine, causing leakage
    Overflow incontinence: also known as chronic urinary retention. The person is unable to fully empty their bladder, which causes leaking
    Total incontinence: bladder can't store any urine at all causing the person to pass urine constantly or experience leaking
Did you know... "Major faecal incontinence" affects 1.4% of the general population over 40 years old and constipation affects between 3% and 15% of the population."

Incontinence Symptoms

Concerned you may have incontinence? Read on to find out more about the symptoms.

Some symptoms start off so mildly that you may not realise you have incontinence. You may feel there is a problem but think it will go away on its own, or you may avoid going to your GP about it because you feel it is embarrassing or difficult to discuss. It is important to remember that incontinence is very common, and the earlier you seek treatment for it, the quicker you may be able to resolve it. If you are concerned that you may have any of the symptoms discussed below, please see your GP.
Introduction

The main symptom of urinary incontinence is passing urine unintentionally, but the type of incontinence you have often relates to how much urine you pass during the course of a day:

    Stress incontinence: a small amount of urine leaks when your bladder is put under extra pressure suddenly
    Urge incontinence: there are only a few seconds between feeling the need to go and then releasing the amount of urine stored in the bladder
    Overflow incontinence: a feeling that your bladder is never fully empty, even though small trickles of urine can flow throughout the day
    Total incontinence: when you pass large amounts of urine day and night, or pass large amounts occasionally and leak small amounts in between

Bowel or faecal incontinence symptoms include:

    • Involuntary passing of wind or faeces
    • Slight soiling when passing wind
    • No sensation when needing to pass faeces

Incontinence diagnosis

If you are experiencing problems with going to the toilet or think you might be incontinent, speak to your GP. It can feel embarrassing to talk about these issues, but remember your GP is a professional and the symptoms you are experiencing are really common. Your GP will ask you lots of questions about your bladder and bowel habits and your lifestyle, for example, your diet. They may recommend you undergo some tests to find out what may be causing your incontinence. They may also carry out a physical examination.

Find out more about how incontinence is diagnosed on the NHS website.


Did you know... "There are many types of incontinence, usually caused by damage or weakness to the bladder or bowel."

Living with Incontinence

Read on to discover more about living with incontinence and how it may affect your daily life.

If you are living with incontinence, you may be interested in practical information such as what incontinence products can help you manage your incontinence, and what treatments for incontinence are available to you, as well as changes you can make to your diet and lifestyle to help reduce your incontinence.
Introduction

Impact on daily living

Everyone experiences incontinence differently depending on what type they have, the severity of their symptoms, and if they are also living with another healthcare condition that causes their incontinence. For some people, incontinence will affect their day to day life quite significantly, but there are a number of ways to make daily routines easier when living with incontinence, including incontinence products and incontinence treatments.

Age UK offer an information leaflet with more details on how to live well with incontinence, including practical advice and tips.

Incontinence products

There are lots of incontinence products available to help you manage your condition, make going to the toilet easier and make you feel more comfortable and confident. If you are caring for someone who is living with incontinence, there are a number of products that can help you too.

At NRS Healthcare, we have a team of product advisors and Occupational Therapists available who are able to talk to you about your incontinence (or any other related healthcare conditions) and to help you find the right incontinence aids to meet your specific needs. Our range of products include incontinence management aids, toileting aids and products for carers.

Continence management: these incontinence products will help to protect your underwear, clothing and furniture from any leaks, keeping you dry and comfortable. Some people find that their skin sometimes becomes irritated from wearing pads regularly and having urine or faeces close to the skin, so you may also benefit from using specially formulated skincare. Discover how to fit your incontinence pads correctly and prevent leaks by visiting our blog.


Initially, for urinary incontinence, it is likely you will be advised to undertake:

    • Lifestyle changes
    • Bladder training
    • Pelvic floor muscle training (Kegel exercises)

If these treatments are unsuccessful, there are a number of surgical procedures that may be considered and your healthcare professionals will advise which is likely to be the most effective for you. The various surgical treatments for urinary incontinence can be found on the NHS website.

Procedures for bowel incontinence will likely include the non-intrusive treatments first, such as dietary changes and exercise programmes, moving on to surgical options if these do not have the desired effects. The various treatments for bowel incontinence can be found in more detail on the NHS website.

Incontinence and employment

Most people with incontinence will be able to continue to work but this may cause some anxiety. Depending on the type of incontinence you have, you should be able to find the right incontinence products such as pads and pants to help you manage your condition during the day or night.

NRS Healthcare’s product advice team can help you understand which products are best for your particular needs – call them on 0345 121 8111 or email [email protected]

PLEASE NOTE: our Product Advice Team can only give advice about equipment and products which may help you to live more independently. They cannot give any advice on medications or treatments for symptoms of this condition.

You may wish to discuss your continence condition with your employer, particularly if it is likely to affect your work or require time off.

Bladder and Bowel UK offer some great advice on incontinence and employment. Contact them on their confidential helpline on 0161 607 8219 (Mon-Fri 9am-4.30pm) or email [email protected]

Incontinence diet

There is not really a set incontinence diet that people follow, but eating a healthy diet and drinking enough of the right kind of fluids can improve some types of incontinence. Certain food and drinks can increase urinary incontinence because they make bladder muscles spasm, creating the urge to urinate, including:

    • Alcohol
    • Fizzy drinks
    • Spicy foods
    • Citrus fruits and juices

Drinking six to eight glasses of fluid a day is recommended even if you have incontinence as reducing the amount of fluid you drink may actually decrease the capacity of your bladder.

For people with bowel incontinence, a healthy diet may have a positive effect. Generally, fibre intake can help with diarrhoea and constipation, whilst drinking enough liquid may also help prevent constipation. If you experience diarrhoea, it may be beneficial to avoid fizzy drinks or those containing caffeine, alcohol or milk.

Some people take incontinence supplements in the form of herbal medicines or minerals such as flaxseed oil, bromelain or vitamin E to help relieve their symptoms.


Exercises for incontinence

It is important for your general health and wellbeing to take regular exercise. However, for some people with incontinence, certain exercises that are high impact can be difficult and lead to leakage. Try to find an exercise that increases your heart rate but that is gentle enough to not put strain on your bladder or bowel. Walking and swimming usually suit most people.

Specific incontinence exercises which focus on strengthening your pelvic floor muscles can help certain types of incontinence, especially stress incontinence. Exercise such as Pilates and yoga can help and you can also do Kegel exercises at home:

    1. Identify the correct muscles (tighten as though you are trying to stop urinating or passing wind)
    2. Sit comfortably and squeeze these muscles for up to ten seconds without tightening any other muscles such as your stomach
    3. Release, wait a few seconds and squeeze again
    4. Build up to doing this 15 times in a row, several times a day

For further advice on how to do pelvic floor exercises for incontinence, visit the Bladder and Bowel Foundation website

Did you know... "Incontinence is a medical condition like any other – it is not something to be ashamed of."

Support for Incontinence

Remember - you are not alone!

Some people with incontinence find it can be a lonely experience as they feel embarrassed to talk to other people about it. However, it’s important you know you are not alone and there are lots of supportive online communities and advice helplines which can help you better understand and come to terms with your condition.
Introduction

Communities

Online forums are a great way to share your experiences of living with incontinence and meet people in similar situations.

Bladder and Bowel Community

Bladder Health UK

Resources

Age UK – helps to inspire and support older people so they can enjoy later life

Bladder and Bowel UK – have a National Confidential helpline for anyone with bladder or bowel issues 0161 607 8219

Bladder Health UK – gives support to people with all forms of cystitis, overactive bladder and continence issues

Bowel Control UK – provides information about incontinence, healthcare services and available treatments

Continence Foundation – provides comprehensive information about how to approach incontinence

NHS Choices – helps to explain health conditions in more detail


Did you know... "Incontinence doesn’t go away on its own, but there are many successful treatment options."

Glossary

Unsure what something means? Checkout our Glossary section below.

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology. Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of incontinence as straightforward as possible.
Introduction

Bladder fistula

    – a small, tunnel-like hole that can form between the bladder and a nearby area, such as the vagina, in women

Detrusor muscles

    – found in the walls of the bladder, these muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out. Sometimes the detrusor muscles contract too often which causes an urgent need to urinate

Passive incontinence

    – having no sensation of needing to open the bowels or urinate

Pelvic floor muscles

    – these support the bladder and bowel, giving you control when you urinate

Rectum

    – the final, straight part of the intestine that comes before the anus

Sphincter muscles

    – these surround the anal canal. Those with bowel incontinence may be advised to exercise these muscles

Urethra

    – a tube that connects the urinary bladder to the genitals for the removal of fluids from the body


Last updated on 20/11/2019

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