Health And Wellbeing For The Over 50s

How to Come to Terms with Adult Incontinence


People are being encouraged to speak out about incontinence to raise awareness and thereby, try to dispel any feelings of embarrassment and negative self esteem.

It’s not known exactly how many people in the UK have urinary incontinence. However, according to the NHS, the problem may be more widespread than you might believe. In fact, it’s thought that as many as 6 million people in the UK will suffer from incontinence at some stage in their lives. One in three women in the UK are thought to be affected by the condition.

In spite of its prevalence, it still remains something of a taboo.

UK film director Flora Berkeley has produced a documentary after being inspired by the real life stories of women. The documentary is called Our Story, Life with Adult Incontinence. She highlights the fact that many people don’t realise how common the condition is and how, by talking to fellow sufferers, people start to come to terms with the feelings of embarrassment and negative self esteem.

GP Dr Sarah Jarvis wants to help remove the stigma around bladder sensitivity. She said:

“Urinary incontinence may be the last taboo, but it is incredibly common, especially among women who’ve gone through childbirth or menopause.”

Dr Jarvis went on to say:

“I’m hugely passionate about encouraging women to have a conversation with their family or close friends and most importantly their GP.

“As well as talking about the condition, there are simple lifestyle changes women can try too, including frequent pelvic floor exercises, drinking less caffeinated drinks and finding the right specialist products for you.”

Here’s some useful information about urinary incontinence, and the different types of treatment available if you suffer from this condition.

Urinary Incontinence: What is it?

Urinary incontinence is actually an umbrella term for certain conditions that involve the premature or urgent release of urine. There are two main types of urinary incontinence. These are:

  • Stress incontinence. This has nothing to do with feeling stressed. Instead, the term refers to urine leaking out when the body is under stress; for example, when sneezing or laughing.
  • Urge incontinence. Urge incontinence is when you experience a sudden, urgent need to pass urine. You’re likely to produce urine either during the sensation, or shortly afterwards.

What Causes the Condition?

Although incontinence doesn’t necessarily occur as you age, it is more prevalent in the elderly, and as many as 1 in 3 women over the age of 60 have the condition. A US study from 2008 also found links between elderly women on hormone therapy and increased risk of incontinence.

Pregnancy or an enlarged prostate gland can also contribute to the problem, and obesity can exacerbate symptoms, by placing extra pressure on the area. Likewise, if you’ve got a family history of urinary incontinence, you’re more likely to develop it yourself.

Often, urinary incontinence is caused by damage to or weakening of the muscles that support the bladder. Certain medical conditions, such as Parkinson’s disease or Multiple Sclerosis, can also affect bladder function.

Addressing the Problem

If your problem is mild, you may be able to improve the symptoms yourself. One of the most beneficial things you can do is to focus on strengthening your pelvic floor muscles. These are the muscles you can feel working when you try to pause your flow of urine.

Your pelvic floor muscles run from your pubic bone at the front of the body to the base of your spine round the back. They form a sling shape and are designed to support the important organs in the area, such as your uterus, vagina, bowel and bladder.

In addition to holding everything in place, these muscles perform another very important function. Whenever you have the urge to urinate, it’s these muscles that provide you with the control you need to ensure you get to the toilet on time. When these muscles relax, your bladder contracts, releasing urine.

When Damage Occurs

Regrettably, over time, these important muscles can weaken. As we age, the pelvic floor muscles become naturally more stretched, which can affect how well they function, especially when it comes to holding in the flow of urine. Additionally, when women are pregnant, this often impacts badly on the muscles, which again, leads to problems in later life.

This weakness can cause urinary incontinence, which is when urine leaks out without you being able to control it. In other instances, it may lead to pelvic organ prolapse, where one of the pelvic organs bulges into the vagina. It’s important to note that, although the problem is more common in women, men can experience weak pelvic floor muscles too!

Fortunately, in most cases, the problem can be addressed by strengthening the muscles. If you’re struggling to control your bladder due to weakened pelvic floor muscles, you may find the following exercise helpful.

Exercise to Help Strengthen Pelvic Floor Muscles

The most common pelvic floor exercise is to tighten and release the muscles that you use when you’re stopping the flow of urine. Aim to pull them in tightly, hold for a few seconds, then release. You should try to repeat this at least 10 to 15 times, and over time, aim to increase the amount of time you hold the muscles for.

If you initially struggle to hold the muscle for very long, don’t worry. Exercising your pelvic floor is the same as exercising any other weakened muscle; it will take time to build up muscle tone and get results. However, it is important to keep going with it. Keep practicing, and if possible, keep track of your progression by jotting down how long you’re able to tighten the muscles for each time you do it.

Alternative Treatments

In most cases, it’s possible to strengthen the pelvic floor muscles by exercise alone. However, if the muscles are left badly damaged, for example, as a result of childbirth, then additional help might be needed.

There are a range of alternate treatments for weak pelvic floor muscles, including the use of electrical stimulation on the muscle to help strengthen it, and use of vaginal cones. If you feel that your condition is too severe to treat at home, it’s a good idea to book an appointment with your doctor, in order to discuss the full range of options available to you.

According to a study carried out by Professor Alison Huang from the University of California, yoga can also help improve symptoms. The research, which involved 20 women, all of whom suffered from urinary incontinence, found that those who took part in regular yoga classes experienced a 70% reduction in the frequency of their urine leakage.

‘Yoga has been directed at a variety of other conditions,’ Huang comments, ‘but there’s also a reason to think it could help for incontinence as well.’

Non-Surgical Solutions for Urinary Incontinence

If your problem is moderate to severe, you may want to talk to your GP and discuss alternative solutions. There are a variety of non-surgical treatments available, such as electrical stimulation, which uses an electrical current to strengthen your pelvic floor muscles, or biofeedback, which uses either a small probe or electrodes inserted into the vagina or anus to measure how well you are using your pelvic floor muscles.

Surgery and Medication

If non-invasive techniques are unsuccessful, you may be considered a suitable candidate for surgery or medication. However, it is important to note that there have been significant developments in treatment for urinary incontinence, such as the Urolift technique, which uses a small anchor device to cure an enlarged prostate, or even nerve stimulation, by inserting a needle into the ankle.

To find out which treatment is best suited to you, it’s important to speak to your GP and get a full medical assessment.

Whilst more people are becoming more comfortable about discussing urinary incontinence, bowel incontinence still remains something of a taboo. However, the condition is more common than you think. Indeed, around 10% of people in the UK will experience faecal incontinence at some stage of their lives.

Bowel Incontinence: What is it?

Bowel incontinence is similar to urinary incontinence, in that it involves a sudden, urgent need to go to the toilet. However, unlike urinary incontinence, which involves the passing of urine, bowel incontinence involves the sudden urge to pass a stool.

The condition affects people in different ways. For some, it may only occur occasionally. For others, loss of bowel control can happen every day, and have a serious impact on their lives. It’s more common in those over the age of 60.

Why Do You Have Faecal Incontinence?

There are a variety of reasons why you might be experiencing bowel incontinence. These include:

  • Damage to the muscles surrounding the anus (caused by pregnancy, surgery or injury)
  • Damage caused by IBS, or chronic constipation or diarrhoea
  • Parkinson’s disease

You may experience no sensation when soiling yourself, which is known as passive incontinence. Alternatively, you might be prone to accidentally soiling yourself when passing wind, or you may simply not be able to get to the toilet on time.

Treatment Available

It’s important to note that the condition is not a ‘natural part of aging’ and that there are treatments available to you. If you have this form of incontinence, it’s important to speak to your doctor who will assess the severity of your condition and recommend the right course of action.

Mild Bowel Incontinence

If your condition is mild and only affects you occasionally, you may be able to manage your incontinence yourself by making some changes to your diet and lifestyle. This is particularly beneficial if you think your incontinence is caused by either constipation or diarrhoea.

Eat foods that are high in fibre if you suffer from constipation, and limit them if you have regular diarrhoea. Avoid foods that can irritate the digestive system, such as fatty foods, sugary products and alcohol. Exercise also helps to maintain healthy digestion, and pelvic floor muscle training can help you to ensure you get to the toilet on time.

Additionally, you may find it helpful to wear elasticated trousers, or items of clothing that are easy to lower when you need to go to the toilet.

Moderate to Severe Incontinence

If bowel incontinence is having significant impact in your life, there are other treatments available. Medication such as laxatives or Loperamide may be effective in controlling constipation and diarrhoea, though they shouldn’t be seen as a long-term solution.

In more serious cases, surgery may be the appropriate course of action, such as sphincteroplasty, which repairs the damaged sphincter muscles, or sacral nerve stimulation, which uses electrodes to stimulate the sacral nerves. Tibial nerve stimulation is another, relatively new treatment, which involves a fine needle being inserted into the ankle, and a mild electric current passed through to stimulate the tibial nerve. Although this is a recent treatment, it has enjoyed good rates of success thus far.

It is important to remember that, by speaking out about the subject, you will find that you aren’t alone and therefore you shouldn’t shy away from it. The consequences of not seeking support can be devastating and leave you feeling lonely and isolated, and can affect your career and your social life.

If you would like to watch the video “Our Story, Life with Adult Incontinence” please click on the Youtube link below:

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