Treating incontinence
Urinary and faecal incontinence are medical conditions closely associated with incontinence anxiety. Urinary incontinence constitutes involuntary loss of urine while faecal and flatus incontinence involves the involuntary loss of liquid or stool. Both conditions are highly destressing, and impacts may aspects of a sufferer’s life (e.g., social and occupational capacity and psychological wellbeing).
A number of treatments and management strategies are available for incontinence anxiety. They include the following:
Biofeedback: Biofeedback helps individuals to increase their awareness of a normal body function e.g., muscle tightening and relaxing. A variety of methods or instruments are used to provide visual (e.g., watching a screen or mirror) or auditory (hearing a sound when the correct action occurs) information about the body function under the guidance of a therapist. The goal of biofeedback is to improve the function of the body using the immediate feedback gained and through repeated practise until able to perform that function unassisted.
In the case of incontinence, pelvic floor muscle training can be assisted with biofeedback. This could involve small sensors being placed inside the vagina or beside the anal opening to capture electrical activity of the pelvic floor muscles. Ultrasound can also be used for biofeedback, placing the probe on the lower belly or on the skin near the back passage. A biofeedback therapist (usually a specially trained physiotherapist) will help coach the correct use of pelvic floor muscles through relaxation and contraction of the muscles.
Bladder retraining: Bladder training involves learning techniques which calm down bladder urgency prior to passing urine. It includes pelvic floor muscle training and other specific strategies. It also includes learning how to empty the bladder well.
Bowel retraining: Bowel retraining is the process of retraining your bowels to have more regular complete bowel motions which are passed without straining. Like bladder retraining it also includes strategies for reducing bowel urgency and bowel leakage.
Kegel exercise: Kegel Exercises (also known as pelvic floor muscle exercises or Keges) is a muscle exercise aimed at improving and maintaining bladder and bowel function. Through relaxation and contraction of the pelvic floor muscles, Kegel exercises can increase the strength and endurance of the pelvic floor muscles and may improve or eliminate incontinence symptoms. Place this above biofeedback
Pelvic floor electrical stimulation: Pelvic floor electrical stimulation involves the use of a device to deliver electrical stimulation to the pelvic floor muscles helping them to work better.
Community-based support: Community-Based Support involves connecting with other individuals with incontinence anxiety and sharing one’s own experiences. This can occur online through message boards, chatrooms and blogs, or in real life through events and support groups.
Diet and exercise: Incontinence symptoms can be managed through changes to diet and exercise routine. Certain fluids can irritate the bladder and increase incidence of urinary incontinence (e.g., caffeinated drinks) while certain foods (e.g., spicy foods) can irritate the bowel and increase the risk of faecal incontinence. Exercise can assist in muscle strengthening and weight loss which may reduce risk of incontinence.
Home care: Family caregivers can provide support and assistance to individuals with incontinence. This can range from providing emotion support to assistance with continence products.
Facility care: Urinary and faecal incontinence are a leading cause of institutionalisation, particularly for the elderly. Nursing home carers can assist residents with regular toileting practices along with issues regarding incontinence.
Pharmaceuticals: Medications can be prescribed to treat and manage incontinence symptoms. Potential use and choice of medications are best discussed with your treating medical professional.
Continence products: Continence products such as urinary catheters, liners, pads, protective underwear, and absorbents can be used to manage incontinence symptoms.
Surgical procedures: Use of injectable bulking agents, surgical insertion of mid-urethral slings, and stoma therapy may be considered for severe cases of incontinence.
It is strongly recommended that individuals discuss the use and choice of treatment approach with their treating medical professional. For more information regarding the management and treatment of urinary and faecal incontinence see the following websites:
https://www.continence.org.au/