Incontinence Advice

Having a bladder or bowel problem may make you feel embarrassed. But the best thing to do is to talk about it. A health professional can assess your symptoms, identify the cause, and discuss what treatment or exercises may help tackle your problems.

You should never assume that bladder and bowel problems are inevitable. If you are dissatisfied with how your needs are being met by your carers or staff at your care home or in hospital, you can complain. Ask for a copy of their complaints procedure, this must be given on request. If initial complaints are not satisfactorily dealt with, you can seek advice from your local Healthwatch.

Visit Your GP

If you’re suffering from incontinence symptoms, make an appointment to see your GP and prepare to be asked questions about your problems. It will help to have the information clear in your own mind first.

Make a note of details such as:

• When did your bladder or bowel problems start?
• How often does leakage happen?
• How much is lost?
• How are you dealing with it?
• How much, what and when are you drinking?
• Can you feel when your bladder and bowel are full?
• How often do you use the toilet?

You may also be asked for a urine sample, or your bladder may be tested.

Bowel Problems

Many people get stomachs aches or constipation now and again but you need to visit your GP if these problems happen regularly or affect your daily life.

There are various definitions of ‘normal’ bowel movements, they may come more than once a day or once every couple of days but they should always be soft and easy to pass and not cause you to strain.

Constipation

When hard bowel motions are difficult to pass, is the most common bowel problem. The first measure you should take to help relieve constipation is to drink plenty of water and eat plenty of fibre-rich foods. You should also be sure to act on the first urge to pass a bowel movement, the longer you wait before going, the more difficult it will become to pass. Your doctor may prescribe medicines to help your condition and in cases of severe constipation, sometimes suppositories or an enema are needed

Diarrhoea

When you have frequent, urgent watery bowel motions which require finding a toilet immediately to avoid having an accident. You should report any bleeding to your GP as soon as possible. If you are regularly constipated for more than four to six weeks, or if you have diarrhoea that continues for more than a few days, you should always go to your GP for advice.

Checking for Bowel Cancer

From the ages of 60 to 69, you’re eligible for free bowel screening every two years. You should automatically receive a test kit in the post from the NHS. You should always complete this test, as it can pick up signs of cancer before you experience any symptoms.

If you notice anything unusual or are worried for any reason, don’t ignore it – go to your GP. Bowel cancer symptoms can include rectal bleeding and unexplained weight loss.

Bladder Problems

When your bladder is functioning normally, you will go to the toilet 4-7 times a day. You will know when you need to go but have time to get to the toilet. You might wake once or twice in the night to go to the toilet. Your bladder will empty completely each time you pass water. You won’t have any leakage.

If you have any blood in your urine or pain while passing urine, see your GP urgently. If you experience any of the problems explained below, you should make an appointment to see your GP.

Common bladder problems.

Urinary tract infections

Urgent need to pass urine, or a burning sensation when you go to the toilet could indicate a urinary tract infection (UTI), such as cystitis. Symptoms may be uncomfortable but shouldn’t last more than five days. If they don’t go away, see your GP.

Stress incontinence

Stress incontinence is more common in women and is related to weak bladder outlet and pelvic floor muscle strength which can be weakened by childbirth. Coughing, sneezing, laughing or exercise, even just walking can sometimes cause leakage. Pelvic floor exercises can help strengthen the muscles and sometimes mild electrical stimulation is also used. If the problem is severe, an operation may be suggested. You won’t be pushed into choosing this option, but for many it does provide a cure.

Urge incontinence

This manifests as a sudden, urgent need to go to the toilet and not being able to get there in time. You might also need to go more regularly. The cause is often an overactive bladder which can be treated with ‘bladder retraining’. Pelvic floor exercise may also help. Your doctor may prescribe medication to help calm an overactive bladder if other treatments are ineffective.

Nocturia

This is the term used for if you’re regularly getting up more than twice a night to urinate. If it’s also disturbing your sleep, making you tired in the day and affecting your daily activities, speak to your GP or district nurse.

Overflow incontinence

This is more common in men than in women and occurs when the bladder does not fully empty when you urinate, then becomes over full causing unexpected leakage or overflow. If you have trouble starting to pass urine and then feel your bladder hasn’t fully emptied overflow incontinence may be the problem. This condition can also lead to repeated UTI’s (Urinary Tract Infections).

There are various possible reasons for having overflow incontinence and treatment will depend on the underlying cause.

Personal Care

General Health

You should drink 6-8 cups of water every day. Though if you are finding yourself needing to urinate several times in the night, you may need to restrict how much you drink in the few hours before bed. Notice what drinks make your symptoms worse. Drinking tea, coffee or cola can aggravate your symptoms, fizzy drinks, alcohol and drinks with artificial sweeteners can also cause problems. Avoid constipation by eating fibre-rich foods, drinking plenty of liquid and passing bowel movements as soon as possible.

Keeping as mobile and active as you can will help keep your bowels healthy. It is possible that medicines you’re taking could be contributing to bowel problems. Talk to your pharmacist about this.

Skin care

It is important to care for the skin when dealing with incontinence. Washing and drying thoroughly, changing pads regularly and using wet wipes to clean up will all help keep skin healthy. Broken skin needs attention and should be reported to the doctor or nurse immediately otherwise infection can result

Avoiding smell

If you use good quality pads, which absorb some of the smell, and change wet clothes soon after a leakage you shouldn’t need to worry about bad smells. If there is a bad smell, there may be an infection, fresh urine should not smell offensive. Urine will smell bad if exposed to the air for a while so be sure to clean up spills and put wet clothes and sheets into a sealed bag or bucket until ready to wash.

Soiling from bowel incontinence will cause a smell so change pads and clothes as soon as possible and put soiled clothes in a sealed bag or container.

Overcoming Practical Barriers to Continence

If your continence problems are related to practical issues, rather than medical ones there are measures you can take to make things better.

Improving access to the toilet

Consider adjustments around your home to help you get to and use the toilet more easily, such as grab rails and raised toilet seats. If you have more limited mobility, a walking aid or stair-lift may help you get to the toilet in time.

Alternatives to the toilet

Perhaps a commode would make your life easier? They are available in many different designs, often with a lid, and can look like an ordinary chair when not in use. Hand held urinals for men and women are also available should you find yourself bed-ridden or unable to get up to go to the toilet fast enough.

Clothing

If fiddly zips and fastenings are a hindrance, try wearing clothing with elasticated waists, or adapt your clothes by replacing buttons and hooks with Velcro.

Toilet queues

We are so polite in the UK that queue jumping is simply not in our nature! But if you have a condition meaning you may require urgent use of a toilet, there is a card available which states this and can be used to politely skip to the front of the queue, avoiding embarrassment. It is called a Just Can’t Wait toilet card and can be purchased for £5 from www.bladderandbowel.org

Out and About

Plan ahead when going out for the day. Think about the location of the toilets on the way to your destination. Wear protection in case of accidents and take spare pads, pants and wet-wipes with you. Sealed bags for soiled clothing might be useful. Knowing that you can clean up should you have an accident will increase your confidence and encourage you to keep getting out & about. Long journeys require more planning and if you’re going with friends and family, let them know beforehand that you’ll need to use the toilet frequently so you can plan extra stops along the way.

Incontinence products

There are various products available to help you go on with a normal life. Most are available in pharmacies and supermarkets for temporary problems. If you are assessed as eligible for incontinence products it should be possible to arrange the supply free of charge on the NHS through your district or continence service. What is available varies from region to region, so discuss this with your health care provider. Products available range from washable pads and padded pants, disposable pads and pants, bed and chair protectors and, for men, a range of appliances which collect urine into a bag strapped to the leg.

 

This content is based on information from Age Uk and the NHS website.