It’s often the butt of jokes but incontinence is not just a normal part of ageing or motherhood — and it doesn’t go away on its own.
It’s incredibly common, affecting more than 5 million Australians — women, men and children. Fewer than 1 in 3 people actually seek help for incontinence.
These are just some of the key messages of World Continence Week, this June 18 to 24.
Incontinence is any accidental or involuntary loss of urine from the bladder, or bowel motion or wind from the bowel. It can mean anything from a ‘small leak’ to complete loss of control (i.e. wetting or soiling yourself). But it can be managed, treated and, in many cases, cured.
What causes incontinence?
Faecal incontinence (loss of bowel control) is often linked to pregnancy, getting older, some types of surgery and radiation therapy, constipation or severe diarrhoea. It may also be associated with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), an umbrella term that includes Crohn's disease and ulcerative colitis.
Paraplegia and profound disabilities such as cerebral palsy — as well as several other rarer medical conditions — can affect a person’s bladder and bowel control.
It’s little wonder that continence is a challenge for so many Australians, of all ages and genders.
Are you incontinent?
If you think you may be experiencing bladder problems but are not sure if you need help, try this quiz put together by the Continence Foundation of Australia.
- Do you sometimes feel you have not completely emptied your bladder?
- Do you have to rush to use the toilet?
- Are you often nervous because you think you might lose control of your bladder (or bowel)?
- Do you wake up twice or more during the night to use the toilet?
- Do you sometimes leak before you get to the toilet?
- Do you sometimes leak when you lift something heavy, sneeze, cough or laugh?
- Do you sometimes leak when you exercise or play sport?
- Do you sometimes leak when you change from a seated or lying position to a standing position?
- Do you plan your daily routine around where the nearest toilet is?
If you answered 'yes' to any of these questions you may have a bladder (or bowel) control problem. Speak to your doctor or call the free National Continence Helpline on 1800 33 00 66 (Mon–Fri, 8am–8pm AEST).
Treatment is available, from lifestyle changes and pelvic floor strengthening exercises (see below) to medications, surgery and aids such as pads and catheters.
How to stop leaks
For many people with incontinence, these self-help tips and lifestyle changes may be enough to relieve symptoms.
Train your pelvic floor This can be really effective, but it's important to do pelvic floor exercises properly.
You can feel your pelvic floor muscles if you try to stop the flow of urine when you go to the toilet. To strengthen your pelvic floor muscles, sit comfortably and squeeze the muscles 10–15 times in a row (that’s one set). Avoid holding your breath, or tightening your stomach, buttocks or thigh muscles at the same time.
When you get used to doing pelvic floor exercises, you can try holding each squeeze for a few seconds. Every week, you can add more squeezes, but be careful not to overdo it, and always have a rest in between sets.
Watch this video to see comedian, actor and continence ambassador Bev Killick talk to the public about pelvic floor exercises:
Exercise right High-impact exercise puts pressure on your pelvic floor muscles and can increase leakage. Sit-ups can also make you leak by straining your pelvic floor muscles.
If you want to strengthen your pelvic floor to relieve symptoms, and you normally run or do aerobics-style classes, consider replacing them with Pilates. This method of stretching and strengthening core muscles is becoming more popular as a treatment for stress incontinence.
Lose weight Being overweight can weaken your pelvic floor muscles and can cause incontinence because of the pressure of fatty tissue on the bladder. Your symptoms may improve and, in some cases, clear up completely if you shed the excess weight.
Curb constipation Straining to empty your bowels weakens your pelvic floor muscles and makes leakage worse — never delay the urge to empty your bowels if you can help it.
If you live with constipation, try eating more fibre and exercising more. It may also help if you change the way you sit and use your muscles to empty your bowels. A specialist physiotherapist can advise you on this; use the healthdirect Service finder tool to find one here.
Cut back on caffeine It irritates the bladder and can make incontinence worse. Coffee has the greatest effect, so stop drinking it or switch to decaffeinated coffee. Soft drinks, tea and cocoa also contain caffeine, so reduce these too and replace them with water and herbal or fruit teas.
Click here for more advice on managing bladder leakage.
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