If you are fortunate to live a long life, you will probably experience incontinence at some point. It's not likely to be a happy experience, but there are things you can do to minimise what many see as the ultimate indignity.
What is incontinence?
Incontinence is the accidental or involuntary loss of urine (wee) from the bladder or involuntary bowel movements. It can be occasional, perhaps due to energetic laughing, coughing or sneezing, or it can be a regular occurrence that you will wish to seek treatment and support for.
Urinary incontinence can occur when you can’t control the urge to wee, when your bladder retains some urine and leaks small amounts over time or you are unable to access a toilet in time due to physical or cognitive inability. The most well-known incontinence is bed-wetting by children but it is important to know that not every child grows out of this and it can be an ongoing issue for teens. As we enter our senior years, it is not uncommon to wake frequently in the night with a need to pass urine. Depending on your physical ability and access to a toilet, this can be a difficult urge to manage.
Soiling your undies and excessive farting can result from childbirth, radiation therapy, surgery, ageing, bowel disease, poor diet, excessive straining… and the list goes on. Like urinary incontinence it can be occasional, but if it happens often it is important that you seek expert advice to find the underlying cause and to help you manage. The Bristol Stool Chart is an exciting way to monitor your poos because how they look can tell you a lot about how your body deals with your diet and lifestyle.
Healthy bladder and bowels
Signs of a healthy bladder are that you know you need to go to the toilet and have time to get there and your bladder empties completely. Urinating between 4 to 6 times a day is common, as is once or twice at night. Normal bowel movements can be daily or every second or third day.
You can help both your bladder and your bowels by eating a good diet with plenty of fibre, drinking plenty of fluids, mostly water (1 ½ to 2 litres each day) and exercising (e.g. walking briskly for 30 minutes every day). (Yes, seems like these three things are good for nearly everything, but really, they are.) Oh, and limit alcohol, caffeine, fizzy drinks and sports drinks. Yes, of course.
There are special exercises you can do to help both your bladder and bowels: pelvic floor muscle exercises. These are the muscles that the brain activates to keep urine and faeces (poo) in until you are ready. Once you are confident you know how to activate your pelvic floor, the exercises can be done anywhere. They’re great to do while you’re on that 30-minute walk! One method of exercises creates a slow “Mexican” wave ascending your vagina and anus. Now that’s worth trying even if you are not incontinent!
You are not alone if you suffer from incontinence. About 1 in 4 Australians experience some form of incontinence. Because risk factors include pregnancy and menopause, women are more likely than men to be incontinent. Not surprisingly, incontinence can affect intimate relationships. Dealing with leaks or a catheter during sex can feel embarrassing or annoying.
Incontinence specialist nurses and physios can help you get the exercises right and they can advise on changes to your diet and lifestyle that can help. You see can a private specialist without a referral, but you will need a GP’s referral for a public specialist. Usually, incontinence takes only 3-5 visits over the course of 3-6 months to fix. Very common. Very treatable
There is a National Continence Helpline and pharmacists can advise if your medications are increasing your symptoms. There are also continence products such as pads and washable continence pants that can help you get out and about and give you confidence while you are recovering.
Routine and planning can also be a big help. When you head out, make sure you know where the public toilets are. And remember, whether it affects yourself or someone you care for, we’re all likely to experience it so let’s support each other.
References and resources
The Continence Foundation of Australia provides lots of resources and advice: https://www.continence.org.au/
The National Public Toilet Map allows you to locate, save your favourites and add toilets to a map. You can find it here: https://toiletmap.gov.au/
Take a look at your next poo and compare it to the Bristol Stool Chart: https://www.continence.org.au/bristol-stool-chart
And for younger readers, take a look at Go Against the Flow: https://www.goagainsttheflow.org.au/