Why are Spina Bifida and Incontinence Interrelated?

Spina Bifida occurs when the spinal cord and vertebrae fail to develop properly in the womb. This results in a gap or split in the spine, damaging the central nervous system.      

 

Most people that have spina bifida will have various continence issues. Those with Spina Bifida are actually usually born with a healthy, undamaged urinary system. However, the interrupted nerve supply between the urinary system causes leakage. This is also known as having a neurogenic bladder. For the majority of people with Spina Bifida, messages between the brain, bladder and bowel are broken. This means they experience a loss of sensation and sphincter control.

Urinary Incontinence

Due to the lack of communication between the brain and bladder, many people with Spina Bifida have overflow incontinence. Mobility issues are common in Spina Bifida, and can also contribute towards urinary incontinence. This type of incontinence is known as functional incontinence.

Individuals with spina bifida can often also often experience kidney stones, kidney scarring and hydronephrosis.

Lack of Mobility can Impact the Bladder and Bowel. Read more about Functional Incontinence

Approximately 70% of all spina bifida patients will have to have some form of drug therapy later in life to try to control their bladder over-activity

Bowel Incontinence

Most people with spina bifida will have some loss of bowel control. Nerves controlling the bowel, including the anus are located low in the spine. This explains the difficulties with bowel control faced by people with Spina Bifida.

 

Spina bifida often causes the following:

  • An inability to keep the anus closed
  • A lack of sensation in the anus and rectum
  • No urge to empty the bowel

 

Constipation is also common in people with Spina Bifida, caused by overflow incontinence. The symptoms of this include the following:

  • Sensation is intact but the muscles that push the stools out do not work
  • Hard and dry stools 
  • Stools that are painful and difficult to pass

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Improving Bladder and Bowel Problems

 

The following are common methods to improve bladder and bowel control:

 

Bladder and Bowel Retraining

Bladder management programs are recommended for people with Spina Bifida. This can help bladder control become better overtime. Bowel retraining and bladder retraining means establishing your bladder or bowel into a regular routine, retraining your brain to hold on rather than going whenever you feel urge to go. Retraining is a gradual process, which involves increasing the length of time until the you feel more confident with your control. Bladder and bowel retraining also involves regulating the times that you visit the toilet, until progression is made.

 

Focus on your Diet and Lifestyle

It is important to eat a healthy, balanced diet with plenty of fibre and consume enough fluid to regulate the bowel. You should also ensure you keep stools at the right consistency to avoid constipation. Keeping a healthy diet includes reducing the consumption of caffeine and fizzy drinks as these are common bladder irritants. Many people often like to keep a bladder/bowel diary to test which foods or drinks affect function.

Our Tip: Try drink at least one cup of fluid each hour during the day. Avoid ‘brown’ drinks, which includes anything with caffeine or fizzy drinks

Medication

Medication is often provided to people with Spina Bifida to improve bladder and bowel control. Some of these medications help prevent spasms of the bladder muscle, reducing urgency and frequency.

 

Laxatives

Many people with Spina Bifida experience constipation due to a lack of mobility. Laxatives can help prevent impaction of the bowel, causing overflow incontinence.

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