Incontinence after stroke

Incontinence is extremely common after a stroke. This happens when muscles that control urine and stool are weakened. Unconscious leaking is the most common symptom, but there can be other types of bladder and bowel control problems as well.

Urinary incontinence is more common among stroke survivors .

There are many different types of continence problems that can occur (sometimes in combination) as a result of stroke. These include:

• Frequency – the need to pass urine more often
• Urgency – feeling a sudden, urgent and uncontrollable need to pass urine. This is due to bladder spasm or contractions. Often there is no time to get to the toilet, so sometimes accidents happen.
• Nocturnal incontinence – wetting the bed while asleep may also happen.
• Functional incontinence – caused when the physical effects of a stroke impede mobility or make it difficult to unfasten clothes in time to use the toilet
• Faecal incontinence – or uncontrolled bowel movement. This can be caused by damage to the part of the brain controlling the bowel, not being able to get to the toilet in time, diarrhoea or constipation.
• Constipation with overflow – large stools can get stuck and block the bowel. Liquid stools above the blockage can flow around it causing watery stools to leak.

Incontinence after stroke can be treated, managed and cured. The first step is a full assessment by health professionals. They ask how well the stroke survivor can control their bladder and bowels before the stroke. They also consider things like what the patient eats and drinks, his/her medications and how much they exercise.

These tests include :

• Bladder scan : An ultrasound to find how well the bladder is emptying and if it is painless.
• Urine tests : The stroke survivor is asked to pass urine in a small jar.The sample is checked to see if there is an infection.
• Rectal examination : Checking for any abnormalities in the rectum, performed by a specialist doctor.
• Bladder and bowel diary : Keeping a diary of how much the stroke survivor drinks, how much fluid thay pass and how often.

After the assessment, the health professionals will work with the stroke survivor to develop a plan to manage and improve the incontinence.

The different types of treatments and therapies for incontinence after stroke include primarily exercises and medications for bladder and bowel control. These are:

• Time Voiding, which includes scheduling bathroom breaks at specific times to avoid the sudden and uncontrollable need to go.
• Medication. Stool softeners or laxatives can help with bowel incontinence.
• Pelvic floor muscle training which is also known as Kegel exercises, builds strength in the pelvic floor muscles leading to better muscle and bladder control.
• Urgency control : A combination of deep breathing and complex mental tasks help ignore the need to go.

Early diagnosis and treatment of incontinence is important to prevent possible complications such as urinary tract infections or skin breakdown. 

Some other tips to manage incontinence are:

• Change the timing, amounts and types of liquids intake which can help control urinary incontinence.
• Change of diet can be helpful.
• Use clothing that’s easy to take on and off.

Hope above is of help to any affected. Any thoughts to share – please comment in, or join any of our groups as under.

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