Learn about the causes of Incontinence & find a practitioner in Auckland, Hamilton, Bay of Plenty, Wellington, Christchurch, Dunedin to help you overcome Incontinence within New Zealand.
Incontinence is the inability to control excretions. The term is most commonly used in reference to urination but the problem also affects bowel movements. Urinary incontinence is more common in the elderly and the condition affects more women than men. Bowel incontinence is not a condition in itself but a sign of underlying problems such as diarrhoea, muscle and nerve damage or dementia.
Urine incontinence is the interruption of the normal process of passing urine and occurs for a variety of reasons.
Stress incontinence – When the pelvic floor muscles become weak they are unable to fully close the urethra and sudden pressure on the bladder (through laughing, coughing or sneezing) can cause urine to leak out.
Causes of a weakened pelvic floor include pregnancy, menopause, age, obesity and having a hysterectomy.
Urge incontinence – Sometimes referred to as 'overactive bladder syndrome', urge incontinence is the bladder contracting too early even before it is full and without enough time to reach a toilet. No one specific cause has been identified but urinary infections (such as cystitis), Parkinson's disease, MS and strokes can all cause urge incontinence.
Overflow incontinence – A blockage or obstruction to the bladder causes urine to build up resulting in frequent leakage. Overflow incontinence obstructions can be caused by an enlarged prostate (in men), urinary stones, constipation or urinary incontinence surgery.
Total incontinence – When the bladder is incapable of storing urine through a birth defect, spinal cord injury or bladder fistula, large amounts of urine or periodical passing of urine occurs often with frequent leakage.
Other contributory facts to urinary incontinence include medications, caffeinated drinks (which act as diuretics), infections (UTIs) and smoking (a persistent smoker's cough weakens muscles at the base of the bladder).
The bowel has an internal and external sphincter for the passing of stools. When the bowel is full, the internal sphincter opens to allow stools to pass into the rectum. This is an involuntary action. Messages are then sent from nerves in the rectum to the brain to tell you to pass a stool through the external rectum. The external rectum remains closed until you allow it to open.
Three factors affect normal bowel function:
- problems with the sphincter muscles
- the inability of the rectum to store stools properly (until it's time to go to the toilet)
- problems with the central nervous system (whereby signals from the rectum to the brain are not sent)
The sphincter muscles are typically damaged during childbirth resulting in bowel incontinence. Injury or damage to the bowel or rectum from surgery can also cause problems with the sphincter muscles.
Common reasons for the rectum being unable to store stools properly include diarrhoea (particularly with conditions such as Crohn's disease. IBS and ulcerative colitis), constipation and rectal cancer.
Conditions such as diabetes, MS, stroke and spina bifida can damage the nerves in the rectum (which send messages to the brain) resulting in bowel incontinence.
Alzheimer's disease, dementia and severe learning difficulties can all cause people to lose control of their bowels even though no physical damage has been caused to the body.
Urinary incontinence is a loss of bladder control and the main symptom is passing urine when not meaning to. In cases of stress incontinence, this can occur during physical activity or normal bodily reactions such as sneezing or coughing. Laughing and lifting heavy objects can also result in urine leakage.
Urge incontinence symptoms are typically the sudden and intense need to pass urine commonly triggered by position changes or the sound of running water. People with urge incontinence usually wake several times in the night to go to toilet.
Overflow incontinence is common in men with an enlarge prostate gland and symptoms include a feeling that the bladder is never fully emptied and frequently passing small amounts of urine.
Bowel incontinence symptoms vary from case to case with some people experiencing a sudden need to use the toilet but unable to get there in time (known as urge bowel incontinence). People with passive soiling incontinence experience no sensation before passing a stool.
Bowel incontinence can cause stools to vary in type and consistency ranging from:
Additional symptoms of bowel incontinence may include:
In the first instance you should visit your GP if you are experiencing urinary incontinence. If you're female, the GP will perform a physical examination of your vagina to test the strength of your pelvic floor muscles. If you're male, they will check your prostate gland to see if it is enlarged.
If an infection is suspected by your GP they will take a urine sample to test for bacteria. If your problem is the inability to fully empty your bladder, an ultrasound or residual urine test will be used to see how much urine is left in the bladder after urination.
The ultrasound creates an image of the bladder to determine how much urine remains. If this fails, then a catheter is passed through the urethra and into the bladder and the remaining urine is drained. This may be done using a sedative and painkiller.