Incontinence: Treatment, symptoms, advice and help
Incontinence means loss of bowel or bladder control resulting in faecal or urinary incontinence respectively. This may result from excessively weakened or overactive muscles of sphincters.
Incontinence: Incidence, age and sex
Urinary incontinence is more common than faecal incontinence. Faecal incontinence is generally seen in older adults as a result of aging. On the other hand, urinary incontinence may affect an individual at any age. Both children and adult population are susceptible to urinary incontinence.
Signs and symptoms of incontinence: Diagnosis
Both faecal and urinary incontinence are symptoms of some underlying disorder. Urinary incontinence can be of various types namely ‘stress’, ‘urge’ and ‘overflow’ incontinence. Stress incontinence results from sudden increase in pressure with cough or physical activity. It is usually a result of weakened pelvic musculature. Urge incontinence is usually encountered in elderly individuals and manifested as a sudden need to urinate. Overflow incontinence refers to unavoidable leakage of urine even after voiding.
Urinary and faecal incontinence should be comprehensively evaluated. The history and physical examination must be corroborated with rectal and vaginal examination. Urinary bladder may also be examined using an instrument called as cystoscope. Like wise rectum may also be examined by another instrument called proctosigmoidoscope.
Causes and prevention of incontinence
There are various causes which may lead to incontinence. Faecal incontinence may result from nerve damage (seen in diabetes and multiple sclerosis), muscular damage (inflammatory bowel disease, child birth and rectal prolapse. On the other hand, urinary incontinence may result from psychological causes (emotional trauma, stress, anxiety), physiological causes (young children, weakening of muscles due to aging and menopause) and pathological causes (urinary infections, prostate problems, prolapse of uterus, obesity, diabetes mellitus and multiple sclerosis).
The complications of faecal and urinary incontinence may result from the abovementioned causes. However, incontinence in itself may be socially embarrassing and distressing to the affected individual.
The treatment of incontinence depends upon other underlying causes which need to be evaluated and eliminated. Treatment modalities include supportive measures like strengthening of the pelvic musculature by special pelvic exercises and bladder training. Dietary regulations include avoidance of spicy food, fruit juices, carbonated drinks, alcohol and caffeine. Post menopausal women may find relief from vaginal oestrogen creams or vaginal sling surgery.