Causes and Diagnosis of Urinary and Bowel Incontinence

By Lynn Wilson, Co-Founder of The CareGiver Partnership

Lynn Wilson

Incontinence is most common among older adults because bladder and sphincter muscles weaken with age, decreasing the body’s capacity to store urine and stool. Causes may be temporary and the condition may be treated with a change in habits, or they may indicate a more serious medical condition. Urinary and bowel incontinence often are correctable and always are manageable.

Temporary Causes

Certain foods, drinks and medications can cause temporary incontinence. Alcohol and caffeine act as a bladder stimulant and diuretic and can cause an urgent need to urinate, while carbonated beverages, artificial sweeteners, and spicy or acidic foods also can aggravate the bladder. Heart and blood pressure medications, sedatives and muscle relaxants, and other medications may contribute to bladder control problems. Easily treatable medical causes include urinary tract infections and constipation, which can cause urinary or fecal incontinence, because impacted stool can put pressure on the bladder and weaken rectal and intestinal muscles. Diarrhea also can cause or worsen fecal incontinence.

Longer-Term Causes

Serious medical conditions that can cause urinary or bowel incontinence include obstruction, such as a tumor or stones; bladder or rectal cancer; and nerve damage, which can be caused by straining during bowel movements, spinal cord injury, stroke, diabetes or multiple sclerosis. In women, a decrease in estrogen production can lead to deterioration of the bladder lining and urethra, which can aggravate incontinence. In men, prostate problems such as inflammation, an enlarged gland or cancer, can contribute to incontinence. Dementia or other mental health problems also can make it difficult to recognize and respond to urges to urinate or defecate.

Diagnosis

Incontinence may be diagnosed and treated by a gynecologist or urologist, who will ask for a medical history and provide a physical exam of the abdomen, genitals, pelvis, rectum and nervous system. Methods for diagnosing urinary incontinence may include cystoscopy to view the inside of the bladder, urinalysis or urine culture, post void residual to measure urine left after urination, urodynamic studies to measure pressure and flow, and uroflow to measure flow pattern. Patients may be asked to keep a bladder diary before an exam or have a blood sample drawn. A fecal incontinence exam and diagnosis may include a digital exam, ultrasonography, and a range of other methods to test sensitivity and function.

Maintaining Overall Health

Blood vessel disease can increase the risk of overactive bladder, so it’s important to maintain good overall health by quitting smoking, treating high blood pressure and keeping weight within a healthy range. Because incontinence can cause serious skin problems that often lead to infection, it’s important to keep skin clean, moisturized and protected with products formulated to treat incontinence.

For a supply of resident informational brochures and access to more than 500 incontinence products with free doorstep delivery ($50+), call The CareGiver Partnership at 1-800-985-1353 or visit www.caregiverpartnership.com.

This is the third of three articles Lynn wrote for “Senior Industry Insider,” a monthly newsletter for professionals in the senior living industry. To read all three in the newsletter, visit Lynn’s archives page.

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