Functional Incontinence - What You Need To Know / HARTMANN Information Centre

The HARTMANN Team

Introduction

Anyone suffering with persistent incontinence knows just how embarrassing, uncomfortable and frustrating it can be. Functional incontinence, the inability to make it to the toilet in time despite knowing you need to urinate, can be especially stressful. Read ahead to learn all you need to know about functional incontinence.

What Is Functional Incontinence?

Functional incontinence is a type of urinary incontinence that can affect people with mental or physical disabilities. They are often aware of their need to urinate, but for certain reasons they cannot get to the toilet in time. This can result in a small leakage of urine, or fully emptying the bladder. This condition can be embarrassing for the sufferer, and can cause physical problems such as infections, rashes and discomfort.

How To Avoid Functional Incontinence?

Here are some of the ways that a person can avoid functional incontinence:

  • Daily pelvic floor exercises

Pelvic floor exercises, including Kegels, can help to strengthen the pelvic floor muscles and prevent incontinence in the first place. As a result, a person may be able to hold their urine in for longer periods of time. Most people need to practice these exercises for at least 3 months before they notice a difference.

  • Quitting smoking

People who smoke are likely to cough more than others, and this increases your chances of incontinence. Coughing strains your pelvic floor muscles, weakening them over time. Quitting smoking will improve your overall health, and so you should seek advice from a pharmacist or your GP as soon as possible.

  • Assess your exercise routine

Some people with functional incontinence are still able to engage in physical exercise. While hitting the gym is often a healthy hobby, avoid high-impact exercises. These place additional pressure on your pelvic floor muscles, resulting in increased leakage. Sit-ups should also be a no-go, as they also strain these muscles. Some of the best types of exercises to strengthen your pelvic floor include pilates and yoga.

  • Avoid lifting heavy objects

Make sure that you cross weight lifting off of your gym routine, and avoid lifting heavy objects around the house.

  • Get down to a healthy weight

Some people end up with functional incontinence because of their weight. Obesity weakens your pelvic floor muscles, and the pressure of fatty tissue on the bladder can cause leakage. In the most extreme cases, a person’s weight can prevent them from getting to the toilet on time. Speak to your GP about getting down to a healthy weight.

  • Prevent and treat constipation

When you strain to empty your bowels, it weakens your pelvic floor muscles and will make urine leakage worse in the long run. If you find that you are suffering from constipation on a regular basis, add more fibre to your diet. You should also ensure you are getting enough exercise.

  • Say ‘no’ to caffeine

Caffeine irritates and stimulates the bladder, making any kind of incontinence worse. Switch to decaffeinated coffees or teas, and drink more water.

  • Cut down on alcohol

Similar to caffeine above, alcohol is a diuretic. This means that it will cause you to urinate more often. If you suffer from functional incontinence, this means more trips to the toilet, and more chances for an accident.

  • Drink plenty of water

People suffering with functional incontinence are often worried about drinking too much water, as they worry about using the toilet too often. That said, drinking water keeps your body hydrated and prevents your urine from becoming too concentrated.

What Causes Functional Incontinence?

Functional incontinence can have many different causes. The most common cause is an issue that prevents a person from moving quickly enough to get to the toilet. This can include the inability to remove clothing in time, transfer from a wheelchair to a toilet, or mobility issues that prevent walking. Illnesses and conditions associated with functional incontinence commonly include musculoskeletal problems, such as arthritis or severe back pain, as well as neurological problems, including multiple sclerosis (MS) and Parkinson's disease.

Mental issues can also contribute to functional incontinence. An inability to think or communicate clearly can make getting to the toilet on time impossible. For instance, for those with Alzheimer's disease or other types of dementia, they may not be able to think clearly enough to plan or anticipate when they will need the toilet. Even if they recognise that they need to urinate, they might not be able to find the facilities. In severe cases of depression, some people lose all will and desire to care for themselves. This can include neglecting to get up and go to the toilet.

While a person’s home can be modified or designed to help them access the toilet quickly and easily, functional incontinence can be hard to deal with out of the home. Toilet facilities are not always accessible, or may not be designed for easy use by people with disabilities.

When Should You Seek Medical Advice?

You should always seek medical advice when you first start noticing any signs of incontinence. If you are unable to make it to the toilet in time to urinate, your GP can help.

Diagnosis Of Functional Incontinence

When you visit your GP about your functional incontinence symptoms, they will thoroughly assess your medical history. They will likely ask you many questions about any medications you take and illnesses that you are suffering from. They will also want to know about your general mental and physical health. These topics might include:

  • Diet
  • Past or present illnesses
  • Family medical history
  • Hydration
  • Exercise routine
  • Your general mobility

While you are in the GP’s office, they might do some routine and simple tests, including a urinalysis, in which they screen your urine for abnormalities. This might be done in the surgery, or you might be sent to an off-site lab. Additional tests could include pelvic floor strength tests, bladder strength tests, and checking for any abnormalities in your urinary tract.

Some patients are asked to keep a food and drinks diary in which they track the following:

  • Food intake
  • Water intake
  • Exercise
  • Drinks intake
  • All urinary and bowel movements
  • Incontinence instances

How To Treat / Manage Functional Incontinence

No matter what kind of treatment protocol you follow for your functional incontinence, ensure that you have reliable incontinence products on hand. This will keep you dry and clean while you seek treatments to get the problem under control.

For functional incontinence, the most important factor is the underlying cause. If you can get the underlying cause of your immobility under control, you can often help reduce instances of incontinence.

Behavioural treatments designed to help other forms of incontinence might also be helpful for reducing accidents. Your doctor might suggest the following treatments and strategies:

Scheduled urination: You or your carer can set a schedule for your trips to the toilet. This is ideal for preventing the need to get to the toilet in a hurry. You can relax and take your time, assured in the knowledge that you will make it in time. For people with mental disabilities or dementia, a person might not recognise that they need the toilet, and so a schedule can help prompt them to go before an accident happens.

Bladder training: This is a time-honoured technique that can lengthen the time between your trips to the toilet. Start by going to the toilet and attempting to urinate every two hours. If you feel like you need to go again before the next 2 hours is up, stand still and contract your pelvic floor muscles. Concentrate on reducing your urge to urinate. Once it is minimal and fully under control, make your way to the toilet. Work on staying dry and avoiding accidents for 3 full days. Once you reach this goal, slowly increase the intervals between using the toilet, until you can make it for three to four hours without feeling the urge to urinate.

Pelvic floor exercises: As mentioned above in the section on preventing incontinence, pelvic floor exercises are designed to strengthen the series of muscles that support and control the bladder and urethra.

Summary

By putting some of the above strategies and techniques into practice, you can reduce your instances of functional incontinence, and potentially eradicate the problem. No one deserves to suffer in silence, so make sure that you seek help from a medical professional as soon as you notice recurrent episodes of incontinence.

 

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