With the number of surgeries I’ve had, and my openness about my experiences, many people approach me with their most embarrassing questions. So I have had more conversations about bowel and bladder control than I can count. I wish it weren’t so awkward for people to discuss because it can bring a lot of undue stress at an already difficult time. Urinary and fecal incontinence are both manageable if you can get over your awkwardness about it.
Whether you are dealing with incontinence or you care for someone who is, this is an embarrassing subject. Additionally, most of the time articles focus on loss of bladder control, they hardly mention bowel control. And it is hard to talk about, especially with those you love.
Hopefully, you are dealing with a mild, short term issue from an injury or illness, and you just need to figure out how to get by until it improves. How can you make it improve? Can you get that control back? And how can you live with it in the meantime?
Let’s get uncomfortable. (I would love to do a bad pun here, but I’m afraid it would be in poor taste.)
Causes of Incontinence
There are a number of things that can cause incontinence both urinary and fecal, some are temporary, some are treatable, some you are just stuck with. Both fecal and urinary incontinence can be brought on by illness, surgery or injury. Most pregnant women experience some degree of it during or after the pregnancy. And it can be a side effect of many diseases and treatments. It is more common than you might think. But it is not pleasant and should not be ignored. The Mayo Clinic provides fairly exhaustive lists for urinary incontinence causes and fecal incontinence causes.
Treating Incontinence
If this situation is serious or long-term, you should talk to your doctor. Incontinence can be a sign of a serious ailment and may need medical treatment. I know folks who were so embarrassed to discuss their bowel movements that cancer went undetected for months when it should have been treated.
If the cause of your incontinence is known and doesn’t require medical intervention, there are a number of actions you can take. Some cases of incontinence respond well to treatment.
1 – Exercise
Courtesy of Gray’s Anatomy
Sometimes incontinence can be a result of an injury or illness where the muscles that control your body functions have been damaged. In those cases exercise can actually help quite a lot.
Your ‘core’ as it has been coined are a muscle group that envelop the trunk of your body and are made up of a number of muscle groups. Although popular among exercise programs to promote strong posture and flat tummy, these muscles work together to do far more than that.
These muscles contribute strongly to your basic body functions and organ health. They envelop and protect your organs and in some cases they control some of the organ function. When they are all strong and in balance your body works efficiently and effectively. Knock one of them out of whack and you will notice problems. Fail to get your muscles back on track and those problems will become chronic.
You do not need to go out and implement a full core workout yet. You are recuperating, so you need to keep it simple to start.
Start by exercising your pelvic floor muscles a couple of times a day. These muscles go from tailbone to pubic bone and from hip to hip. The urethra (urine) and anus (feces) run through it. It is a crucial muscle in continence. These exercises are challenging at first, but once you get used to them, you can practically do them in your sleep. There are some great detailed instructions available, some are generic, but some target men or women specifically. These exercises are a great lifelong practice and could contribute to your quality of life as you age. The one thing I would add to these instructions is that I finally figured out I was doing it right, not by squeezing, but by feeling like I was pulling the pelvic muscle up toward by abdomen. It took me several days of practice after surgery to finally get it right.
Next is posture, you can practice this if you are in bed, in a wheelchair, on crutches, etc… I’ve done them all. The key is to pay attention to your body. Assistive medical devices can contribute to some really bad habits if we are not careful. The key is to keep your core upright and tight as often as possible. Engage your core muscles, not just your abdominal ones, but all of the muscles, including the ones that wrap around your body and include your back. Tighten them, hold your body straight and tall and keep your shoulders back. Practice this often throughout the day.
Both of these habits will contribute to your bladder and bowel control. However, like all things, moderation is key; overdoing even good habits can have adverse effects. Read: Should we engage the abdomen all the time? Once you are ready, you can explore an appropriate core workout plan as part of your recovery and lifestyle. This will give you a jumpstart and good habits for life.
2 – Change Diet & Medication
Incontinence can also be a result of diet. Certain foods, drugs and vitamins can contribute to quantity and quality of urine and feces, which contribute to control of your bladder and bowel. These things may have to be adjusted in order to gain control.
Drugs & Vitamins
Read the side effect of any medication or vitamins you are taking whether they are prescription, over-the-counter or herbal. Diarrhea, excessive urination and anal leakage are all fairly common side effects I have seen on my medications. Some examples of vitamins and drugs that can cause diarrhea are very common such as excessive Vitamin C, D or E as well as antibiotics, antidepressants and antacids.
Do not assume that if your doctor recommended it that you must continue with that specific drug; it may be possible for your doctor to switch it. Drugs effect different people differently and what causes one chronic diarrhea may not bother another. Your doctor may tell you to put up with it or they may switch drugs. You won’t know if you don’t ask.
When you do talk to your doctor, make sure that you tell them about everything you are taking. Many people leave out the “natural” remedies and find out later that it was the cause of the problem all along.
Food & Diet
There are a lot of foods that have a laxative effect on our bodies. Knowing what they are and eating wisely will go a long way to helping you regain control. The food groups below can all contribute towards diarrhea. You may want to eliminate many of them and see if your continence improves, if so you can start adding them back until you find a good, balanced diet that works for you.
- High fiber foods – Most of us are aware that high fiber foods contribute to bowel movements, but do we know what all of those foods are? Whole grains, beans, some fruits, legumes and vegetables are high in fiber. But so are many plant based food additives and thickeners. Start reading labels and make sure you know what you are eating. If you love your veggies, consider cooking them first. Cooking vegetables breaks down the fiber somewhat.
- Dairy – While some people find dairy foods cause constipation, others notice the opposite. This just proves that our bodies are all different. You may have to experiment a little to determine if cheese and yogurt help or hinder your continence.
- Sweeteners – As the daughter of a wheelchair bound diabetic, I can tell you this one is a real challenge. Many of us try to watch our sugar intake when we are on bed rest, but excessive sugar-free candies, drinks and gum can land you in big trouble. If you eat sweeteners at all, try eliminating them first and see if that helps.
- Fats – I am not necessarily talking about fired chicken here, although that counts too. While fats are absolutely necessary to our bodies, they have a laxative effect, so we need to examine our intake of fats both good and bad. Pasta heavy on the olive oil, for example, can cause all sorts of unintended consequences.
- Acidic foods and drinks – Citrus, tomatoes and cranberry juice can all raise the acidity of your urine and irritate your bladder, making incontinence worse. Skip juices and citrus fruits and stick to plain water.
- Alcohol, coffee, sugar and spices – Sounds dismal doesn’t it? All of these things are common causes of incontinence, both urinary and fecal. Nobody is suggesting you give up everything forever, just try to give up a few things for a little while why you determine the problem. Try taking one thing away for a week and see if it helps, if not, try something else.
Use our Food and Output Diary to keep track of your changes and their effects: Food and Output Diary
3 – Drink Water
Drink an appropriate amount of water. Many people, when faced with urinary or fecal incontinence think the answer is to drink less. Unless you are drinking excessively, that is not the answer. 6 – 8 oz. or 250 ml glasses of water a day will keep you hydrated and healthy. Reducing your fluid intake can result in kidney problems, blood clots or dozens of other side effects that could make the whole problem worse. So drink a reasonable amount of water every day.
4 – Medications for Incontinence
If exercise and diet haven’t helped, it is likely time to see your doctor. There are plenty of over-the-counter and prescription options open to you. I would not suggest relying on the over-the-counter options for too long without consulting your doctor; you could be masking a larger problem. Or making it worse. So keep a journal and give your doctor all of the facts, so they can help you make an informed choice.
There are a number of medical treatments for incontinence and overactive bladder, from Botox to Estrogen. These medicines can treat the symptom, or in some cases can treat the cause of the incontinence.
There are a number of antidiarrheal medicines available over-the-counter. If you expect to take them longer, talk to your doctor and see which ones are safest for you over the long term.
Moving Forward
No matter your circumstances, these are necessary body functions. We don’t like to talk about them, but we all have to live with them. Be sure to pay attention to this and deal with it as best you can. These body functions can be early indicators of a bigger problem. They can also be a huge impediment to your quality of life, if left unchecked. So communicate with your doctor and your loved ones to make sure you stay happy and healthy.
