Incontinence

IncontinenceIncontinence is uncontrolled, inadvertently releasing the urine or the stool. Incontinence in older people, as well as in young children, is usually a consequence of some basic disorder, such as urinary tract disease, constipation, immobility or regular medication intake (due to some other illness).

Incontinence is not and should not be considered as an inevitable part of ”aging”. However, it is more common in the elderly, mostly due to the gradual reduction in the effectiveness of muscular sphincters and ligaments in the urinary and digestive tracts.
The problem of incontinence generally disappears with successful treatment of the underlying disorder – e.g. urinary tract infection or prostate problem.
Some digestive tract diseases, as well as too little fiber in food, can also make it difficult to control the stool. In all such cases, curing the underlying disease usually solves incontinence, too.

A specific type of fecal incontinence, which occurs mainly in the elderly, is the result of accumulation and stoppage of hard feces in the intestine (usually in the rectum). Partial clogging disrupts the mechanism of regular defecation. If their amount increases, feces will press the urinary bladder and urinary incontinence will occur. Incontinence may sometimes occur even after severe disorders such as stroke, spinal cord injury, or senile dementia.

In some of these cases the basic disorder is unlikely to respond to therapy, and incontinence will need to be treated separately.

Frequency

Approximately 5% of people over the age of 65 suffer from incontinence at least to a small extent. In most cases it is about the inability to retain urine. Some older people can not withstand several hours without urination; if their bladder is full, they will sometimes drop some urine when they cough or sneeze. Others may feel a strong urge to urinate even though there is virtually no urine in the bladder.

Fecal incontinence (inability to hold the stool) affects only a small percentage of the elderly, and may sometimes be a sign of depression. Inability to retain urine and stools is extremely rare and occurs only in very old people who are ”trapped” in the bed.

What to do?

Regardless of age, you should consult your doctor if you are unintentionally releasing your urine or stool. Your doctor will examine you and make any necessary diagnostic tests to find out if incontinence is the result of some basic illness, such as urinary tract infection. If it is, and if the condition can be cured, your doctor will prescribe appropriate therapy. However, if the basic disorder can not be treated, there are a number of measures that can reduce the unpleasant consequences of incontinence.

Treatment

Self-help: you may be able to partially control urination and defecation if you regularly and frequently go to the toilet. Rooms in which you are staying and sleeping should be near the toilet, and keep a chamber pot next to the bed. Wear clothes that are easy to handle, i.e. without small buttons or clasps.

If you are having problems with a memory loss, use reminders, maybe even an alarm clock that will remind you to go regularly, say every two hours, to the toilet. If you suffer from urinary incontinence, do not drink plenty of fluids, especially before going to bed. To prevent fecal incontinence, eat foods with high fiber content and do not forget that bowels usually begin to ”work” for about an hour after the meal.

Professional help: your doctor may be able to prescribe a medicine that will stabilize the urinary bladder activity, so that the urge to urinate occurs at smaller intervals. Unfortunately, there are still no drugs to effectively stabilize the bowel movement, although the condition can be improved with laxative or some other medications.

There are a number of aids for people suffering from incontinence, and your doctor will inform you about them. Your doctor can help you and get them. An example is a two layered laundry: the outer porous layer absorbs the urine and neutralizes the odor while the inner layer (near the skin) remains relatively dry. With such underwear you can avoid unpleasant situations and dirtying outer clothing, as well as skin changes around the genitals that can be caused by urine.

In some cases of urinary incontinence catheterization can be applied, i.e. the insertion of a plastic tube (in the urinary bladder) by which the urine is emptied into the bag. The bag is then emptied at certain time intervals. In case of persistent fecal incontinence, it is sometimes recommended to surgically tighten or strengthen an anal sphincter. There is also another possibility of preventing incontinence – a tiny electrical device that is surgically implanted close to the urinary bladder or rectuml. With constant, tiny electric impulses, the sphincter muscle is stimulated and this results in its longer closure, although the muscles will open whenever you want.