02 Jan 2010
Would you share with friends and family that you leak urine when coughing or laughing or that you constantly drip? Definitely not information you would volunteer readily, especially since incontinence only strikes after you hit 50. Or so you thought.
Urinary and bowel incontinence is not necessarily part of the natural ageing process, pointed out Dr Lim Jit Fong, Consultant, Department of Colorectal Surgery, and Director, Pelvic Floor Disorder Service (PFDS), Singapore General Hospital (SGH). “While the majority of patients with incontinence are elderly, many that we see at the Pelvic Floor Disorder Clinic are in their 40s,” he said.
Shamed into silence
“Many feel ashamed and humiliated by incontinence. Bladder and bowel control are the most basic human physical functions. Losing that is equivalent to losing dignity and self-worth. That’s why sufferers end up withdrawing from social interaction,” said Ms Juriyah bte Yatim, Advanced Practice Nurse (Intern) at PFDS.
“This sets off a vicious cycle, and can cause emotional problems such as depression. Very often, they also refuse to admit that they need help for the condition,” she added.
Although incontinence isn’t inevitable, some are more likely to develop it. The condition affects more women than men. Those who are overweight are also susceptible as weight increases pressure on the bladder and surrounding muscles. Smokers with a chronic cough add stress to the urinary muscle, which can result in incontinence. Diabetic or kidney patients are also prone to the condition.
Types of incontinence
In Urge Urinary Incontinence, patients cannot hold their bladder when they feel the desire to urinate. This condition is caused by abnormal contractions in the bladder, which can be a result of inflammation, infection or cancer.
As for Stress Urinary Incontinence, it is often related to weakened pelvic floor muscles and post-menopausal hormonal changes. The patient leaks urine when there are sudden changes in pressure caused by actions like jumping or sneezing.
Similarly, there are two types of bowel incontinence. In Passive Faecal Incontinence, patients may find their underwear stained with a bit of faeces when they least expect it, such as upon waking up in the morning, or after a day out.
As with Urge Urinary Incontinence, those suffering from Urge Faecal Incontinence cannot delay going to the toilet when they feel the urge to empty their bowels.
Left untreated, both types of incontinence can lead to skin problems such as rashes, sores, irritation and infection.
Simple solutions
Urinary and bowel incontinence can be treated and even cured. If the condition is mild, pelvic floor exercises can help to strengthen the pelvic muscles. Sometimes, medication, oestrogen supplements or antibacterial drugs are prescribed to improve organ function and fight off infection. Patients are also advised on lifestyle changes, such as reducing fluid consumption. For more serious cases, surgery is recommended.
Dr Lim said: “It’s important to seek treatment early. The condition will be less severe, so treatment costs less and results tend to be better. Incontinence doesn’t kill, but it takes away your life.”
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