Incontinence is a term that describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal or bowel incontinence).
Incontinence is a widespread condition that ranges in severity from 'just a small leak' to complete loss of bladder or bowel control.
Incontinence and other complaints that suggest weakness in the muscles supporting the bladder, uterus or bowel (the pelvic floor muscles) are common for many people who have chronic obstructive pulmonary disease (COPD) and other chronic lung conditions.
Going to the toilet between four and six times a day and no more than twice at night is normal. However, if you suffer from any of the following complaints, you may have a weak pelvic floor muscles:
- Urgency: a sudden and urgent need to go to the toilet and an inability to ‘hold on’.
- Incontinence: a leakage of urine or faeces from the bladder or bowel.
- Stress incontinence: a small leakage of the urine from the bladder when the pelvic floor is stressed by activity, such as coughing, laughing, sneezing, straining or lifting, jumping, running or doing exercise.
- Constipation or straining: the inability to empty without great effort.
- Frequency: a need to go to the toilet frequently, which indicates an inability to ‘hold on’.
- Other symptoms: such as vaginal flatus (wind) or inability to keep tampons in.
About the pelvic floor
The pelvic floor is made up of layers of muscle and other tissues.
Contraction of the pelvic floor muscles is important in preventing urgency (the urgent need to go to the toilet), constipation and incontinence (the leakage of urine or faeces). The pelvic floor muscles also contribute to good posture. The pelvic floor muscles can be weak from:
- Chronic coughing.
- Pregnancy and childbirth.
- Continual straining to empty bowels (constipation).
- Heavy lifting.
- Growing older.
- Being overweight.
- Being unfit.
- Changes in hormone levels at menopause.
What can you do to strengthen your pelvic floor?
The pelvic floor holds up and supports the organs in the pelvis including the bladder, the bowel, the uterus (or womb) in women and the prostate in men.
The pelvic floor helps to control bladder and bowel function. When the pelvic floor muscles contract, they contribute to the functional control of the bladder, the bowel and the uterus during daily activities. Coughing and sneezing causes increased pressure on the pelvic floor muscles.
A weak pelvic floor cannot do its job properly. Research has shown that the pelvic floor responds to regular exercise of these muscles. In fact, the sooner you start pelvic floor muscle exercises, the better your chance of preventing or overcoming many of the problems associated with a weak pelvic floor.
If you experience stress incontinence, contracting the pelvic floor before any activity (for example, coughing, sneezing, lifting or jumping) will increase pressure to the pelvic floor and can help to protect you against leakage. Practise this technique regularly to ensure that it becomes a lifelong habit.
Some simple steps to keep your bladder and bowel healthy
- Try to drink at least six to eight cups (one and a half litres) of fluid a day (unless advised otherwise by your doctor).
- Limit the amount of caffeine (for example, coffee, cola and tea) and alcohol you drink as these drinks irritate the bladder.
- Try to go to the toilet only when your bladder is full and you need to go (emptying your bladder before going to bed is fine).
- Take your time when urinating so that your bladder can empty completely.
- Keep your bowels regular and avoid constipation.
- Do not strain when using your bowels
- Keep your pelvic floor muscles in good condition.