Incontinence & Younger People – What You Need to Know

older woman and teenager

Incontinence is a common problem that affects many people of all ages. It can be caused by an illness, surgery, injury, or disability. But did you know that incontinence also affects younger people? It’s true – 900,000 children and young people suffer from bladder and bowel dysfunction in the UK.[1]

Find out what to do if you or your child has incontinence and learn about the best ways to manage it here.

In this article, we will discuss:

  1. How does incontinence affect younger people?
  2. Causes of incontinence in younger people
  3. Common bladder and bowel issues affecting younger people
  4. Tips on managing incontinence
  5. Who to talk to about incontinence?

How does incontinence affect younger people?

It can be extremely distressing for anyone at any age to suffers with incontinence. For young people, it can negatively impact on their self-esteem and confidence, their learning and overall academic performance. According to a British Journal of Health Psychology study by the University of Bristol,[2] incontinence can cause several problems for teenagers, including:

  • Poor academic performance caused by frequent trips to the toilet during class and exams
  • Stress and anxiety from hiding the problem from teachers and friends
  • Reluctance to engage in sport, music and other extra-curricular activities
  • Depression, low mood, and feelings of hopelessness
  • A lack of self-esteem and lowered self-confidence
  • Physical discomfort, rashes from wet clothing, and a lack of resources to manage the problem

Causes of Incontinence in Younger People

Before discussing the most common causes of incontinence in younger people, it’s important to distinguish between the three main types of urinary incontinence that can affect them:[3]

  • Stress Incontinence – Stress incontinence can develop if the pelvic floor muscles and/or the urethral sphincter muscles are damaged. Urine is released if you physically exert yourself. Triggers include lifting heavy objects, coughing, sneezing or laughing or lifting a heavy object.
  • Urge incontinence – The urge to pass urine suddenly. It can often lead to leaking urine if you are unable to get to a toilet quickly.
  • Nocturnal enuresis – Also known as bedwetting, this occurs when you accidentally leak urine whilst sleeping at night.

Here are some of the most common causes of urinary incontinence in younger people:

  • Urinary tract infections (UTIs) – Urinary tract infections can cause incontinence in younger people, more so for females. A UTI is an infection that causes the bladder to become inflamed and irritated, which causes frequent urination, discomfort when passing urine, or a burning sensation while passing urine. UTIs affect females more because their urethra is shorter than a males, resulting in bacteria being able to travel more easily into the bladder. It is important after passing urine when you wipe yourself to wipe front to back as this will reduce the risk of transferring any bacteria from your bowel to the urethra that could cause a UTI
  • Ectopic ureter – Approximately 1 in 2000 children are born with ureters that do not connect properly to the bladder.[4] Normally, the ureters connect the bladder to the urethra and allow for normal urination. However, an ectopic ureter drains outside of the bladder, causing an inability to hold urine. The condition gives rise to persistent problems because our bladders produce urine at an average rate of two millilitres per minute. In girls, urine can leak out of the vagina, and in boys, it drains into the penis or prostate.
  • Neurological problems – Underactive bladder syndrome or urinary retention due to neurologic deficit can be caused by a spinal cord injury, stroke, multiple sclerosis, and other neurological disorders. Urinating is difficult because the nerves that tell your brain how much urine is in your bladder are damaged.
  • Injuries – Injuries are another common cause of urinary incontinence, especially for young women and girls. A study from the Health Department of Stellenbosch University shows that high-impact sport injuries, such as those that occur during gymnastics and running, can damage the pelvic muscles over time.[5]

Common Bladder and Bowel Issues Affecting Younger People

According to the Children’s Bowel and Bladder Charity, these are some of the most common bladder and bowel issues that affect teenagers and children.[6]

Bowel Problems

  • Constipation – When you defecate (do a poo) fewer than four times per week, it’s called constipation. Over time, the poo stays in your bowel for too long and dries out. It then becomes painful or difficult to push out, making you avoid going to the toilet.
  • Stool Withholding – This term is used to describe when people repeatedly avoid pooing. It can cause a blockage of hard stools (poo) to form in the bowel, and then fresh stool overflows and leaks around it. When this leakage occurs, it is called soiling.
  • Overflow – Sometimes, you might feel like you have diarrhoea because you are pooing more than three times per day. However, this could be overflow poo leaking out around a blockage.
  • Rectum stretching – If you withhold your stool for too long, your rectum (lower bowel) can stretch out, and it stops telling your brain when it’s time to go to the toilet. This can result in faecal incontinence because you simply don’t know you need to poo.

Bladder Problems

  • Constipation can cause urine leakage – When you’re constipated, the extra stool in your bowel can put pressure on your bladder and cause you to leak urine
  • Urinary Tract Infections – A urinary tract infection (UTI) can cause severe pain and irritation in your bladder. It can also make it painful to pass urine and cause your urine to be dark and your urine can also smell.
  • Urge incontinence – You might feel like you have an ‘overactive bladder,’ which is a type of urge incontinence. This is when you have a strong urge to pass urine and may experience leakage of urine before you get to the toilet.
  • Dehydration during the day – If you don’t drink regularly enough during the day, you might experience bedwetting at night. That’s because your bladder can no longer stretch enough to hold all your urine and therefore you may pass urine whilst you are asleep.
  • Low Vasopressin Levels – Vasopressin is a hormone that slows down urine production while you sleep.[7] However, not everyone produces enough vasopressin. If that is the case, you can take a medicine called Desmopressin to help; speak to your GP.
  • Being a Heavy Sleeper – Normally, your bladder should send a signal to your brain to wake you up when you need to pass urine. However, if you are a really heavy sleeper, this signal might not be effective. A bedwetting alarm may help as an alarm sound goes off as soon as you start to pee. Over time, this can help to train your brain so that you wake up when your bladder is full in the night.

Tips on Managing Incontinence

While it can seem like incontinence is ruling your life, once you get it under control and implement proper management, you can get back to living a normal and full life. Sport, school trips, and hanging out with friends are all possible, and you can thrive.

  • Seek medical advice – If you suspect you have a problem with your bladder or bowel, it’s important to get medical attention right away. Start by speaking to your GP or a nurse about the issues you are facing. While it might feel embarrassing to you, remember this is more common than you think and they deal with this problem regularly so they will understand, and are there to help you. If you sought help as a child for bedwetting but still experience problems now, there is help available for you.[8] Speak to your doctor; they can effectively help to treat and manage your symptoms so you can lead a normal life.
  • Lifestyle changes – These simple lifestyle changes can help you get your bladder and bowel issues under control.
  • Wear the right clothes – Tight trousers, bodysuits, one-piece rompers, and too many layers can all make it tough to get to the toilet in time. Make things easier on yourself – wear loose clothing that you can remove quickly when you need to go to the toilet urgently. Wear darker clothing like black or navy as leaks are harder to see.
  • Staying hydrated – While it may seem counterintuitive to drink more water when you are having trouble with incontinence, dehydration exacerbates your problems. Not only does it make your urine more concentrated and can lead to UTIs, but it also causes your bladder to lose its elasticity. Over time, your bladder can no longer hold as much urine, leading to even more problematic incontinence. Stay hydrated by drinking plenty of water, low-sugar drinks, and herbal teas. Avoid drinks that irritate the bladder such as energy drinks, caffeine and fizzy drinks.
  • Eating healthily – While we all like to snack on junk food at times, keeping a healthy diet can help with your bladder and bowel incontinence. Eating plenty of fibre-rich foods, such as whole grains and leafy green vegetables, can help keep you regular and ease bowel incontinence.
  • Exercise – Keeping physically fit is good for your mind and body, helping you to get the rest you need and stay in good shape. You can also do specific exercises, called pelvic floor exercises, to help strengthen your pelvic muscles and prevent incontinence. While these exercises are often associated with women, men can also benefit from doing them as well.
  • Choosing the right products to manage incontinence – Bladder and bowel incontinence pads are discreet and easy to use, removing the embarrassment and discomfort of accidental soiling. From small adhesive pads that catch a few drips of urine to pull-up pants that take the worry out of faecal incontinence, you can find incontinence products in all shapes and sizes. It is important that you choose the correct products for your height, weight, gender, and specific needs. If you use ill-fitting or unsuitable products it could lead to leakage or dampness, which could cause, soreness, rashes and chafing.

Use our fitting guide to help you choose a secure fit. You can find it here.

If you need help picking the right products, try our product selector.


Who to talk to about incontinence

If you are experiencing bedwetting, bladder incontinence, or bowel incontinence, it is easy to feel alone. However, there is always someone you can speak to for help and support. Start by speaking with your parents or a trusted family member, if possible. It can seem embarrassing at first, but they are there to listen to you and help you. You will feel a lot better once you open up and start talking about it.

That said, we know that not everyone can turn to their family members for help with sensitive issues. In that case, you can always speak to a trusted teacher or a school counsellor. They will help you to access resources and medical attention that will help you manage the problem.

You can always make an appointment with your GP, or in some cases you may be able to self-refer to your local Bladder & Bowel Service (sometimes called Continence Service). Even if you are under the age of 16, you have the right to confidentiality when speaking to your doctor or a nurse. However, if your doctor has a reason to believe you are in danger, they may need to break this confidentiality.

There are some great online resources that can help you, including The Children’s Bowel and Bladder Charity, ERIC and Bladder and Bowel UK’s Children’s and Young Person page.[9] They also run a free helpline that you can phone at 0161 214 4591 – it’s completely confidential, and they can give you tips and advice on dealing with your problem.


Struggling with Incontinence? You’re not alone

While it is typically thought of as an older person’s problem, incontinence can affect many young people in the UK. Remember – if you are experiencing bladder or bowel incontinence, you are not alone. There are people you can speak to for help and products you can use to manage your symptoms.

 


References

Bladder and Bowel UK. (2021, March 17). World Sleep Day: What is Nocturia? – Bladder & Bowel UK Blog. Bladder & Bowel UK. https://www.bbuk.org.uk/blog/world-sleep-day-what-is-nocturia/

Marques, A., Stothers, L., & Macnab, A. (2010). The status of pelvic floor muscle training for women. Canadian Urological Association Journal = Journal de l’Association Des Urologues Du Canada, 4(6), 419–424. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997838/

News Medical Life Sciences. (2017, December 12). Urinary incontinence may affect learning and academic performance of teenagers. News-Medical.net. https://www.news-medical.net/news/20171212/Urinary-incontinence-may-affect-learning-and-academic-performancec2a0of-teenagers.aspx

NHS Choices. (2019). Overview – Urinary incontinence. NHS. https://www.nhs.uk/conditions/urinary-incontinence/

NHS England. (2018). Excellence in Continence Care. In NHS England. https://www.england.nhs.uk/wp-content/uploads/2018/07/excellence-in-continence-care.pdf

Nursing Times. (2004, May 18). Addressing the needs of teenagers with continence problems. Nursing Times. https://www.nursingtimes.net/clinical-archive/continence/addressing-the-needs-of-teenagers-with-continence-problems-18-05-2004/

The Children’s Bowel and Bladder Charity. (2020a). Information on bowel and bladder problems. ERIC. https://www.eric.org.uk/info-on-bowel-and-bladder-problems

The Children’s Bowel and Bladder Charity. (2020b). Teens. ERIC. https://www.eric.org.uk/pages/category/teens

Urology Care Foundation. (2020). What is Ectopic Ureter? – Urology Care Foundation. Www.urologyhealth.org. https://www.urologyhealth.org/urology-a-z/e/ectopic-ureter

 

Sources

[1] https://www.england.nhs.uk/wp-content/uploads/2018/07/excellence-in-continence-care.pdf

[2] https://www.news-medical.net/news/20171212/Urinary-incontinence-may-affect-learning-and-academic-performancec2a0of-teenagers.aspx

[3] https://www.nhs.uk/conditions/urinary-incontinence/

[4] https://www.urologyhealth.org/urology-a-z/e/ectopic-ureter

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997838/

[6] https://www.eric.org.uk/info-on-bowel-and-bladder-problems

[7] https://www.bbuk.org.uk/blog/world-sleep-day-what-is-nocturia/

[8] https://www.nursingtimes.net/clinical-archive/continence/addressing-the-needs-of-teenagers-with-continence-problems-18-05-2004/

[9] https://www.eric.org.uk/pages/category/teens

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