Incontinence --- Causes and Top 10
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Last updated October 26, 2016 (originally published December 23, 2011)

By Louise Carr, Associate Editor and Featured Columnist

Incontinence is one of the great health taboos, a condition no
one talks about even though many of us suffer from it at some
point in our lives.

Incontinence is the unintentional passing of urine or fecal
matter. We take it for granted that we know when we’ve got to
go, and that we will make it safely to the restroom in time for
nature to take its course. When you suffer from incontinence
this security disappears. Daily life becomes embarrassing,
shameful and distressing. Sufferers may turn down social
invitations, limit their life to avoid being caught out, and feel
like they should suffer in silence.

Many people believe that incontinence only affects the elderly.
It’s true that incontinence is much rarer in young women and
men but it still affects this group of people.

According to the Department of Urology, New York University
School of Medicine (2001) 3% to 17% of women suffer from
incontinence. Between 3% and 11% of men suffer

The chance of suffering incontinence rises steadily from middle
age. According to the Journal of the American Medical
Association, almost one in 10 people over the age of 65 suffer
from urinary incontinence.

Causes of Incontinence

Exactly what causes incontinence? Your bladder is a useful yet
highly sensitive part of your body. The bladder is a stretchy
bag of muscle that holds urine from the kidneys until it’s full,
supported by the pelvic floor muscles. When the bladder is
ready to release its contents, a message is transmitted to the
brain to tell the pelvic floor muscles to open the urethra and
urine is pushed out of the bladder.

If any part of this system malfunctions, you experience
incontinence. There are many different types of urinary
incontinence. The first two are responsible for over 90 percent
of all cases.

The first type of incontinence is "stress incontinence", where
your pelvic floor muscles are too weak to hold the urethra
closed and prevent urination when under pressure. You may
suffer stress incontinence when you laugh, sneeze, exercise or
cough. Stress incontinence is caused by nerve damage during
childbirth, or by pregnancy, obesity, or a condition which
affects the supporting tissues.

"Urge incontinence" is a different kind of problem. With urge
incontinence you pass urine at the same time, or right after,
you feel an intense need to pee. You simply have no time to
reach the bathroom. When you suffer from this condition you
pee a lot, and you need to get up many times during the night.
Urge incontinence is often caused by urinary tract infections,
neurological conditions, diabetes, or constipation.

Other people have what’s called "mixed incontinence", with
symptoms of both stress and urge incontinence.

Overactive bladder syndrome produces similar symptoms to
urge incontinence.

Overflow incompetence is when your bladder cannot
completely empty when you pee, and it swells to well above its
usual size – this condition is common in men with an enlarged
prostate gland.

Total incontinence is severe and continuous urinary
incontinence that usually affects people as a result of surgery,
bladder disorder or injury.

Bowel incontinence, or fecal incontinence, is an inability to
control your bowel movements. This condition can vary in
severity from the embarrassment of breaking wind to complete
loss of bowel control. Bowel incontinence is not normally a
condition in its own right, but is most often a sign of another
condition or disease. According to the American College of
Gastroenterology, over 5.5 million Americans suffer from bowel
incontinence. Bowel incontinence is caused by muscle damage
during childbirth, diarrhea, laxative use and, conversely,

Incontinence can be distressing and disruptive, but it is not
normally life threatening. Thankfully there are a number of
ways in which you can treat incontinence and start enjoying a
less stressful life. We’ve rounded up the latest research to give
you the top 10 remedies for urinary and fecal incontinence.

Watch Your Fluid Intake to Curb Incontinence

It may seem like the obvious solution to avoiding incontinence
– drink less water – but this theory is problematic. While you
need to be careful you don’t drink too much water because this
can lead to an increase in bathroom trips if you have urge
incontinence, you need to keep hydrated.

If you don’t drink enough water, you risk irritating the bladder
and developing constipation, which can make incontinence

You should drink a regular six to eight glasses of water a day.
Research from the University of Akron, Ohio in 1996 found that
increasing fluid intake and maintaining adequate fluid levels in
the body resulted in decreased incidences of urinary
incontinence. Don’t go crazy but don’t worry about drinking
too much – according to a 2011 study from Brigham and
Women's Hospital and Harvard Medical School, Boston there is
no significant risk of urinary incontinence associated with
higher fluid intake and women shouldn’t restrict their water
drinking to try and prevent incontinence.  (Read more about
the amount of water you should drink every day and why.)

Cut Out Caffeine to Combat Incontinence

However, not all fluids are created equal. Caffeine can be a
problem for incontinence sufferers.

Caffeine is a diuretic, which means it makes you produce more
urine. Try cutting down your caffeine intake and choosing
decaf drinks, milk and water instead. According to a 1999 study
from the School of Nursing, Hawaii Pacific University, Honolulu
the relationship between a decrease in the amount of caffeine
women consumed and fewer daytime episodes of urinary
incontinence was reasonably significant.

However, a 2011 study from Curtin University of Technology,
Perth, Australia found green tea drinking was inversely
associated with urinary incontinence in middle-aged and older
women in Japan.

Those who drank more than 700 milliliters ( 24 ounces) of  
green tea daily had a 37% lower incidence of urinary

The researchers pointed out that coffee, black tea and other
sources of caffeine didn’t have the same effect.

Limit Fizzy Drinks to Prevent Incontinence

And fizzy drinks don’t count as water, either. A 2003 study by
the University of Leicester, UK found carbonated drinks, as well
as obesity, were significant risk factors for developing stress
incontinence. Carbonated drinks can irritate your bladder and
trigger the urge to pee. Cut down your consumption of soft
drinks, sparkling mineral water and club soda and give your
bladder a rest. (Read more about sodas and their effect on
your health. Are
diet sodas bad for your health?)

Limit Intake of Acidic Food and Drink to Treat Incontinence

Acidic food like citrus fruit – orange, lemon, lime – and
pineapple, which is also acidic, can irritate the bladder and
increase symptoms of incontinence. Tomatoes are also acidic
and they trigger incidents of urge incontinence in some people.
Cranberry juice may be good for urinary tract infections but it
can cause problems for people with an overactive bladder. If
you want to see if you can fix your incontinence, try cutting out
acidic foods and drinks to see if it makes a difference.

Pelvic Floor Training Helps Remedy Incontinence

Because your pelvic floor muscles are essential for holding back
the flow of urine, it makes sense that strengthening exercises
for these powerhouses could help stop incontinence.

Pelvic floor muscle training is a set program of specific
exercises that you need to complete throughout the day. Many
studies, including a 2010 study from the University of Montreal,
Canada point to pelvic floor exercises as one of the first steps
in a treatment program for stress or urge incontinence. The
study showed women who completed pelvic floor training were
more likely to report they were cured of incontinence or
improved than women who did not, and they reported better
quality of life. The study also showed that the greatest
improvements were seen in women who maintained the
program for three months or more.

Bladder Training Also Helps Prevent Incontinence

Bladder training – a series of learned techniques to increase the
amount of time that elapses between feeling the need to pee –
is often combined with pelvic floor exercises to treat stress
incontinence. A course of bladder training lasts over six weeks
to be effective. One 1997 study from Florida Hospital, Orlando
demonstrated that bladder training was an effective therapy to
reduce episodes of urinary incontinence in older women living
at home.

Botox For Incontinence?

While Botox may be best known as a cosmetic wrinkle
treatment, you may be surprised to learn that the Food and
Drug Administration has approved Botox for treating urinary
incontinence as a result of spinal cord injury, multiple sclerosis
or other neurological conditions. It seems
Botox is effective for
treating incontinence. Studies, including 2008 research from
Hôpital Sainte Marguerite, Marseille, France show that when
Botox is injected into the bladder it relaxes the muscles that
cause involuntary urination and consequently increases the
bladder’s ability to hold onto its store.

Can Biofeedback Treat Incontinence?

Biofeedback is a method of “feeding back” information about
bodily functions that are out of our voluntary control, like heart
rate or bladder function, in order to make the involuntary
process something you can control.

The effectiveness of biofeedback for any condition, and
specifically urinary or fecal incontinence, is debated. However,
one 2009 study from the Department of Medicine and Center
for Functional Gastrointestinal and Motility Disorders, University
of North Carolina found biofeedback was more effective than
pelvic floor exercises in reducing the severity of fecal
incontinence and the number of incidents of fecal incontinence.

Consumption of Fat Linked to Urinary Incontinence

While also being a danger to other aspects of your health, it
seems saturated fat may be a risk factor for urinary
incontinence. A 2004 study from the University of Leicester, UK
stated that total fat intake, and intake of fatty acids, was
associated with an increased risk of stress incontinence. The
researchers looked at 5,816 women aged 40 and above in a
long-term study. The scientists were unsure of the possible
associations connecting these two factors, and further studies
are necessary to explain the link.

Cut Down on Alcohol to Treat Incontinence

Your favorite alcoholic drink is stress-relieving and sociable but
it can aggravate bladder problems. Alcohol is dehydrating
because it increases the amount of urine your bladder stores,
which leads to further bathroom trips. Beer, wine and spirits
also interfere with the brain’s signals to the bladder, worsening
incontinence. Research in 2011 from Curtin University, Perth,
Australia looked at 300 women in Japan aged 40 to 75. There
was some evidence that the risk of urinary incontinence was
increased by alcohol consumption. (Can diabetics and people
who need to control blood sugar drink alcohol?
Which alcohol
can diabetics drink?)


Walking Prevents Urinary Incontinence

A 2012 study, also from Curtin University of Technology in
Perth Australia led by Drs. Lee and Hirayama discovered that
walking for at least 1000 a week can greatly reduce urinary
incontinence in both women and men. Walking the equivalent
of 300 minutes a week reduces the risk of incontinence by 36%
in men and 43% in women. That works out to about 43
minutes a day.  Get going!

A new study has linked incontinence to the metabolic
syndrome. Basically, having extra weight, especially round your
waist line, increases your risk of incontinence. (Read more
metabolic syndrome and how it affects incontinence.)


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Walking just over 40 minutes a day greatly reduces your  risk of incontinence.