Urinary and Bowel Incontinence

Almost everyone occasionally experiences accidents in which urine leaks when it ought to stay put. For some people, the problem is significant enough to disrupt daily activities and make it difficult to maintain good hygiene. Urinary incontinence isn't a normal part of aging. Whenever it occurs, the root problem should be investigated, because proper treatment can help.

Smells or stains are clues to watch for, since people may be too embarrassed to discuss this condition. If you suspect a problem, reassure the individual that incontinence is not a psychological problem, character flaw, or personal failure — it's a medical symptom that deserves the same attention you'd give to any other medical problem.

A doctor can help determine what kind of incontinence is present and what's causing it. Consulting a gynecologist, urologist, or geriatrician may be necessary. A wide range of treatments are available, including pelvic floor exercises, bladder training, medication, the use of catheters, and surgery. Or sometimes all that's needed is changing the choice of clothing and making the toilet more accessible.

Proper treatment depends on the underlying problems causing incontinence. While a doctor should determine the best approach, the following simple strategies may also prove helpful.

• Scout bathrooms when out in public, and choose seating with quick access in mind. At home, a bedside commode helps if the bathroom is too far or mobility problems make it hard to reach quickly.

• Make sure clothes are easy to remove and the toilet is accessible.

• Try scheduling regular bathroom trips or bedpans every hour or two.

• Limit caffeine and alcohol. Otherwise, don't impinge on drinking fluids because dehydration is a serious medical problem. Avoiding fluids between dinner and bedtime is fine, though.

• Be alert to signs of infection, such as more frequent need to urinate, unusual odor or color, pain or blood when urinating, and fever. Discuss any of these symptoms with the person's doctor.

• Try using absorbent pads or diapers. Waterproof liners on beds or furniture help when other efforts fail.

Also, consider cleanliness. Urine is quite acidic. It's especially important to keep skin clean if diapers or pads are used. Make cleanliness easier by providing moist wipes and a container for soiled clothes. Encourage the person to use the bathroom often or make frequent changes to avoid rashes and sores. An ointment may help prevent rashes; sores should be taken care of immediately. If necessary, contact a doctor for advice.

Bowel Incontinence

Bowel incontinence is perceived as rare because people are reluctant to seek help for it. Yet it affects over 5.5 million Americans. Bowel incontinence places undeniable stress on an individual and his or her caregivers and is often a primary reason for nursing home placement. In some cases, though, the problem can be solved far less drastically.

If the person you're caring for is experiencing fecal incontinence, contact a doctor. He or she can sort out the possible causes and recommend treatment. Often, the underlying problem is constipation or diarrhea. When stool obstructs the bowel, some can leak around the blockage. Diarrhea has the opposite effect and may make it hard to get to the bathroom in time.

Sometimes the problem is the result of diet. A lack of fiber may slow the workings of the bowel, while a diet high in greasy, fatty foots may contribute to diarrhea. Medications can also contribute to diarrhea and constipation. In other cases, health conditions and injuries are to blame.

When accidents occur, try to be calm and understanding. In addition, if diapers are worn, be sure to cleanse body folds carefully and use an ointment to prevent rashes at each change.

Source: from Caregiver’s Handbook, Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.  Use of Content | Medical Disclaimer