What Causes Incontinence in the Elderly

Incontinence refers to the loss of voluntary control over the urinary or bowel functions due to several underlying reasons. Losing control over your essential bodily functions can cause other complications that may be detrimental to your health. Although age is a contributing factor in the decelerating metabolic processes of the body, there are far more serious aggravating circumstances that lead to continence loss.

Incontinence affects more than 6 million people in the UK alone and a large fraction of this number affects the elderly population. When a person reaches middle age, the organs of the body slowly fail to function properly and the urinary and the digestive systems bear most of the brunt of aging. Symptoms of incontinence begin to appear past 50 years of age, which may include the following:

  • Uncontrollable passage of urine often accompanying stress or pressure on the bladder like coughing, laughing or physical exertion
  • Difficulty in starting urination, weak stream when started and the bladder does not empty completely, thus, the person has to use the toilet more frequently
  • Sudden, urgent need to void, often the urgency gets so strong the person voids before even reaching the toilet
  • Irregular bowel movement which alternate between diarrhoea and constipation associated with Crohn’s disease, ulcer, coeliac disease, and other gastrointestinal inflammations
  • Flatulence and bloated feeling, pain and discomfort accompanying every cycle of digestion

At the onset of the symptoms, it is best to seek medical help. A professional health care provider can help in determining what causes incontinence and the best possible treatment option. Medical checkups and laboratory tests can confirm the possibilities of having incontinence. If detected early and treated immediately, almost all types of incontinence can be cured.

Some of the common treatments effective in treating incontinence may include the following:

Therapeutic Exercise

Most cases of incontinence are caused by weak pelvic floor muscles and loose anal and urethral sphincters. Kegel exercises are proven to be effective in strengthening these muscles and improving muscle tone and closure capabilities. Repeated contractions of the muscles responsible for the control of urination and bowel movement many times each day can bring back elasticity and muscle strength.

Alteration of Behavioural Patterns

Old habits may die hard but old bad habits must be altered. Habitual delaying of urination and incomplete voiding contribute to the irregular toilet patterns that confuse the bladder nerves. Keeping a regular schedule for voiding and defecating help set the body’s normal biorhythm.

Medication

Anti-cholinergics and anti-depressants help in calming overactive bladder muscles. Diuretic medications treat urinary retention and improve the micturation (urination) process. Some antibiotics may actually harm the friendly bacteria in the stomach, intake of Probiotic agents help in regaining the normal balance of good and bad microorganisms in the gut

Bulking Implants

Bulking agents like collagen is used to improve closure capabilities of the sphincters. This treatment is found to be effective in sealing the urethral sphincter to prevent urine leaks. Efficacy of this treatment is temporary and will need repeated injections every several months. This is not an invasive procedure and may be done as an out-patient in a doctor’s clinic.

Surgery Options

Invasive and laparoscopic procedures may be done to improve bladder support. Sling procedure, bladder augmentation and bladder neck suspension are the most common types of procedure.

Nerve Stimulation

This treatment is aimed at stimulating the bladder nerves through the sacral nerve in the buttocks and the tibial nerve in the ankle. The electrical stimulation may help invigorate enervated nerves in the bladder.

Medical Inserts

Vaginal pessaries are made of rounded-shaped silicone devices inserted inside the vaginal cavity to support the neck of a collapsed uterus and ease the pressure on the bladder. Artificial sphincters are used to replace or augment loose anal and urethral sphincters.

Incontinence Products

Elderly patients in nursing homes who are suffering from complete incontinence are managed with incontinence products to keep them dry and comfortable. Many patients in these facilities have lost complete control over their cognitive functions and cannot take care of themselves and incontinence pads and pants and other products help keep the patients dry and comfortable.

Understanding what causes incontinence and seeking medical intervention can help the suffering person live a normal, productive life.

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