Urinary incontinence (UI) isn’t a disease, it’s a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what’s behind your incontinence.
The main symptoms are the sudden urge ‘to go’ and the release (leakage) of urine
(or feces) when you don’t want to release it. When and how this occurs will depend on the type of urinary incontinence experienced.
Most caregivers become familiar with incontinence issues at some point. Both family and professional caregivers find they must get up to speed quickly on issues related to incontinence and how to keep their patient comfortable while living with this inconvenient condition.
Caregiving issues related to incontinence are priorities to master. Leaving an elderly or confined person sitting or laying in their bodily waste for more than a few minutes is a form of abuse called elder neglect. Elder neglect is serious and illegal . Being soaked in human waste is unhealthy, uncomfortable and humiliating for any normal, healthy person. Human waste is a leading cause of skin irritation and infection in the elderly and can lead to bed sore complications which can prove fatal if left unchecked.
In Part 2 of this series, let’s talk some more about incontinence we cover information about both temporary incontinence and persistent incontinence, their triggers and symptoms.
Causes of Temporary Urinary Incontinence:
Urinary tract infection: Infections can irritate your bladder, causing you to have strong urges to urinate. These urges may result in episodes of incontinence, which may be your only warning sign of a urinary tract infection.
Medication : Heart medications, blood pressure drugs, sedatives, muscle relaxants and other medications may contribute to bladder control problems.
Alcohol – Alcohol acts as a bladder stimulant and a diuretic, which can cause an urgent need to urinate.
Bladder Irritants – Chocolate, tomatoes, onions, caffeine containing products, citrus fruits, carbonated beverages, spicy foods, alcohol, natural and artificial sweeteners, processed foods (high in sodium) can stimulate bladder contractions and the release of fluids.
Constipation: The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency. In addition, compacted stool can sometimes interfere with the emptying of the bladder, which may cause overflow incontinence.
Causes of Persistent Urinary Incontinence
Persistent Urinary Incontinence (PUI) can be a condition caused by a host of conditions or underlying physical problems such as: Dementia (many people do not realize that any chronic brain disease can cause fecal or urinary incontinence), Inflammatory Bowel Disease, renal insufficiency, Diabetes, head trauma, muscle damage, nerve damage, rectovaginal fistula, spinal chord lesion all can and most do contribute to loss of bladder and/or bowel control.
Other Causes of Incontinence
Hysterectomy In women, the bladder and uterus lie close to one another and are supported by many of the same muscles and ligaments. Any surgery that involves a woman’s reproductive system — for example, removal of the uterus (hysterectomy) — may damage the supporting pelvic floor muscles, and can lead to incontinence.
Painful bladder syndrome (interstitial cystitis) This chronic condition causes painful and frequent urination, and rarely, urinary incontinence.
Bladder Cancer or Bladder Stones Incontinence, urinary urgency and burning with urination can be signs and symptoms of bladder cancer or bladder stones. Urinary stones — hard, stone-like masses that can form in the bladder — may be to blame for urine leakage.
Neurological Disorders Multiple sclerosis, Parkinson’s disease, stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.
Obstruction A tumor anywhere along your urinary tract can block the normal flow of urine and cause incontinence, usually overflow incontinence. Urinary stones can be present in your kidneys, bladder or ureters.
Pregnancy and childbirth Pregnant women may experience stress incontinence because of hormonal changes and the increased weight of an enlarging uterus. In addition, the stress of a vaginal delivery can weaken muscles needed for bladder control. The changes that occur during childbirth can also damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, your bladder, uterus, rectum or small bowel can get pushed down from the usual position and protrude into your vagina. Such protrusions can be associated with incontinence.
Aging Normal aging can lead to changes of the bladder muscle leading to a decrease in the bladder’s capacity to store urine and an increase in overactive bladder symptoms. Risk of overactive bladder increases if you have blood vessel disease, so maintaining good overall health — including stopping smoking, treating high blood pressure and keeping your weight within a healthy range — can help curb symptoms of overactive bladder.
After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. With less estrogen, these tissues may deteriorate, which can aggravate incontinence.
Urinary incontinence can affect your quality of life and your mood. You may become depressed and be afraid to go out and enjoy your usual activities because you worry about not finding a bathroom in time and having an “accident”. Having to get up several times every night can leave you feeling even more tired than before.
If you have urinary incontinence, let your doctor or healthcare professional know. Speaking to an incontinence specialist or nurse is the first step. You may find that special leak-proof pads or other incontinence products sold in pharmacies will help you manage the problem. Changing the time of day for taking medicines or lowering the dose may also help. Special non-spill bottles may be a good idea for night-time use, eliminating the need to get out of bed each time you have to urinate.
Let’s Talk About Incontinence is a caregiver education blog series sponsored by CertifiedCare.org …where all types of caregivers benefit from complete elder care education. Make sure your caregiver is tested and registered by CertifiedCare prior to hire or as a condition of continued employment. It is dangerous to use caregivers who do not have sufficient frail elder care education.
South Med J. 2001;94(10)
Attorney Cathleen V Carr
Ivan Merkelj, MD, Department of Geriatric Medicine and Gerontology, College of Medicine, East Tennessee State University, and the Extended Care and Geriatric Department, James H. Quillen VA Medical Center, Mountain Home, Tenn