Living with double incontinence

What is Double Incontinence?

The term ‘double incontinence’ refers to faecal and urinary incontinence occurring together. However, most people do not realise that there are multiple types of incontinence, each with different symptoms and causes. Understanding the kind of incontinence someone is suffering from is the first step in helping address the problem.

What is Double Incontinence?

• Urge incontinence

Urge incontinence is often caused by nerve or muscle damage but can also be caused by medical conditions. A group of symptoms called ‘overactive bladder’ can often result in urge incontinence, when the bladder muscle is more active than normal. It manifests as a sudden, intense urge to urinate, and can lead to accidents as the individual rushes to the toilet. Often, when someone experiences urge incontinence, they do not recognise the urge to go to the toilet until it is too late.

• Stress incontinence

Stress incontinence occurs when the bladder experiences sudden pressure. Laughing, sneezing, and lifting heavy objects can all cause urine leakage. Stress incontinence is usually caused by a weak pelvic floor muscle or damaged sphincter muscle in the urethra, allowing urine to leak out. Some people also experience mixed incontinence, a combination of both stress and urge incontinence.

• Overflow incontinence

Overflow incontinence occurs when the bladder is filled with too much urine, and it overflows. It can also be referred to as Chronic Urinary Retention. For a variety of reasons, the bladder nerves do not signal to the brain that it needs to be emptied or cannot be emptied fully. It can take a long time to completely empty the bladder, and it therefore becomes overfilled and leaks to relieve pressure.

• Functional incontinence

Functional incontinence can occur when a person has difficulty with one or more of the steps required to use the toilet. For example, if someone has limited mobility and cannot get to the toilet in time or if someone is confused and doesn’t know where to find the toilet. Functional incontinence can also occur if a person struggles to remove their clothing due to limited dexterity.

• Bowel Incontinence

Bowel incontinence occurs when a person cannot control their bowel movements. This form of incontinence can occur after an injury to the nerves, or after an illness such as inflammatory bowel disease or inflammatory bowel syndrome. However a common cause of bowel incontinence is severe or prolonged constipation or diarrhoea. For many sufferers, the nerve signals from the rectum do not reach the brain in time, causing a person to defecate before they can reach the toilet.

• Double Incontinence

When a person suffers from bowel incontinence concurrently with urinary incontinence, the condition is referred to as double incontinence, or combined incontinence. This is one of the most exhaustive incontinence and can severely impact a person’s physical and mental wellbeing.

What Causes Double Incontinence?

Double incontinence can have many different causes. It is important to note that it is not a disease, but it’s a symptom of a bigger problem that can be related to physical problems, lifestyle factors, or other underlying medical conditions. These underlying issues will need to be addressed before the double incontinence can be treated.
Remember, the factors leading to a loss of bladder control and faecal incontinence might not indicate a serious problem. There are many simple lifestyle changes that can help ease the problem.

Double incontinence is usually caused by damage to the network of muscles and nerves that control urination and bowel movements. This damage can be caused by straining during bowel movements, medical conditions (such as multiple sclerosis) and physical problems and is often reversible. Connective tissue diseases could be the underlying cause of double incontinence. Crossed reflexes between the pelvic floor, urethra, and bladder could explain the problem, as can damage to the muscles and sphincters.

The following factors have all been linked to the occurrence of double incontinence:

• Age – Double incontinence can occur at any age, but it is more common in people over the age of 65.
• Nerve damage – Conditions and illnesses that cause nerve damage have been shown to cause double incontinence. Diabetes and multiple sclerosis are both common causes.
• Gender – Women suffer from double incontinence more often than men, mainly due to the fact that faecal incontinence can sometimes be a complication of childbirth.
• Weight – People who have a BMI (body mass index) above 30 are classified as obese, and they are at a much higher risk of suffering from all kinds of incontinence
• Dementia – People suffering with dementia late-stage Alzheimer’s disease are at a higher risk for double incontinence.
• Physical disability – Different physical disabilities can make it difficult for a person to get to the toilet on time, especially if they are confined to a wheelchair or a bed.
• A Stroke - Many people who have suffered a stroke also develop incontinence. This is due to the weakening of the muscles and nerves that control the bladder and the bowel. The most common type of incontinence for stroke patients is overflow incontinence, causing a slow leak out of the urethra.

How Can You Avoid Double Incontinence?

Ultimately, the best way to treat double incontinence is to prevent it in the first place. Here are some simple ways that can help you to avoid incontinence before it ever starts:

• Strengthen your pelvic floor – Practice pelvic floor exercises throughout your life, so that your pelvic floor muscles are strong and in good condition as you age, or in the event of illness
• Reduce episodes of constipation – Ensure that your diet is rich in high-fibre food so that you can go to the toilet without straining
• Don’t strain when going to the toilet or urinating – Straining can put real pressure on the muscles , so make sure you don’t strain too much when using the toilet
• Reduce your weight – Having a high BMI can lead to instances of incontinence, and put you at risk for many other illnesses
• Control diarrhoea – Treating or preventing the causes of diarrhoea, including food intolerances and intestinal infections, can help you prevent double incontinence
• Quit smoking – Smoking can cause coughing, which can weaken the muscles in your bladder and bowel
• Drink 6-8 glasses of fluid per day – Ensure that you are well hydrated by drinking 6 to 8 glasses of water, juice, or herbal tea each day.