Incontinence can be classified as urinary incontinence and fecal incontinence. It means that one cannot control the urination and excretion voluntarily. Incontinence would not just lead to fidgeting, stinky smell, damage on our skin, but also increase the chance in getting pressure sores and urinary-tract infection. Psychologically, incontinence may cause embarrassment and discomfort. It may affect our self-confidence and, as a result, cause us to avoid social interactions. In more serious cases, it may even bring depression.
For those who need to use adult diapers or underpads, they feel too embarrassed to enquire more about the subject, leading to unnecessary distress.
Urinary incontinence would usually happen to elderly women. Aged people tend to have incontinence because the volume of bladder is smaller and the pressure that can bear urethra has decreased. Therefore, some urine would remain in the bladder after urination. Yet, this would not directly cause incontinence. The direct causes can be separated into two main categories, namely, the temporary one and the established one.
The causes of temporary incontinence are manifold, which include:
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Infection, for example inflammation of the urethra, vaginal atrophy etc.
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Drug, such as diuretics and psychiatric drugs
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Alcoholic or caffeinated drinks
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Bodily actions are being restricted, due to stroke and joint pains
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Constipation
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Psychological factors, like depression
The established incontinence can be further subdivided into 4 categories and their roots are different.
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Functional incontinence
The patient can sense the urge to urinate. But because of the restriction on bodily activities, he or she cannot go to the toilet immediately, and thus result in incontinence. This would happen to those who are disabled, elderly and those who have chronic disease (like stroke, Parkinson's disease, Alzheimer's disease).
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Urge incontinence
This kind of incontinence would take place if the muscles of bladder are overly sensitive, or the brain cannot effectively control the bladder. In that case, the patient must urinate immediately once he or she has the urge to do so. Otherwise, it would give rise to incontinence. This situation is found mostly on those who had stroke several times, patients having Alzheimer's disease, and the elderly.
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Overflow incontinence
Its causes include enlargement of the prostate, diabetic neurogenic bladder, and urethral stricture. This kind of incontinence would also happen to those who have urinary neuropathy (e.g. nerve atrophy and spine neuropathy). Since the tension of the patients’ bladder is too low or the bladder does not have much contraction force, the urine would remain in the bladder. In effect, the patients would urinate involuntarily.
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Stress incontinence
Lack of hormone and vaginal surgery would lead to pelvic muscle relaxation. When the pressure of the patients’ tummy increases, perhaps due to coughing, laughing or doing sports, he or she would urinate involuntarily. This situation would happen to postpartum women, chubby people, people who have long-term cough, and elderly.
How to prevent urinary incontinence
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Avoid alcoholic or caffeinated drinks
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Eat more food that contains fiber
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Strengthen the muscle of pelvic floor
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Try not to be overweight
Fecal incontinence
Once the nutrition of the food is being absorbed by the digestive system, the residue will be transferred to rectum. The rectum would then further absorb any useful material from this residue, and the remaining indigestible waste would become feces.
When the feces are stored to a certain amount, one will want to have bowel movement. But when one grows older, he or she would have greater chance to encounter fecal incontinence. The reasons behind include degeneration of bodily functions, muscle atrophy, sphincter damage, constipation, and unresponsive nervous system.
In such cases, the patients’ rectum would be less sensitive and the rectum’s storage size would also decrease.
Preventive measures
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Perform exercise for levator ani, so as to strengthen the contractual force of sphincter
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Perform exercise to prevent constipation
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Avoid laxative abuse
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Avoid eating irritating and greasy food
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Cultivate the habit of having bowel movement routinely
How to deal with incontinence
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Evaluate and find out the cause of incontinence, and take the correct actions to solve it
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Evaluate the causes of incontinence, including the physical, mental, social, and environmental factors
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Check one’s own health record, medical history, and drug record
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Pay attention to the symptoms of incontinence
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Take notice of the habit of urination and bowel movement, mark down the volume of each excretion
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Consult doctor or go to continence clinic for body check
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Urine sample test
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X-ray
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Cystoscope
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Medical ultrasound
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Urodynamic testing
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Pay attention to personal hygiene, in order to avoid urinary tract infection
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Personal aspects:
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Wear clothing that is easy to strip
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Eat more food that contains fiber, so as to prevent constipation
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Avoid irritating drinks
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Regulate our drinking habits
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Potty training
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Dermal aspects:
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Observe the skin’s condition
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Change the diapers and clothing that got wet as soon as possible
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Protect the skin, such that the urine and feces would not damage it
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If one uses adult diapers, he or she should apply some cream on the hips and private parts
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Environmental aspects:
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The bed should be close to the washroom
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The bed cannot be too high
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Ensure sufficient lighting in the washroom and the floor is dry
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Choose a stool that is higher than the normal one and one can add handrail near it
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Keep the washroom ventilated, in order to reduce foul smell
Points to note when choosing adult diapers:
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Breathable, soft, comfortable, and suitable size
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With elastic stickers and widening design
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Easier to wear and free movement is possible after wearing it
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Allow emission of hot air, such that the humidity of the skin is balanced
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Strong moisture-absorbing power
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