Incontinence: what is it and what can you do?

Pelvic floor training is a widely recommended approach for managing incontinence, specifically urinary incontinence. These exercises target the muscles that control urination and defecation, known as the pelvic floor muscles. Strengthening these muscles can help improve bladder and bowel control, reducing episodes of leakage.

To perform pelvic floor exercises, follow these steps:

• Identify the correct muscles: Start by locating your pelvic floor muscles. The muscles you engage to do this are the ones you want to focus on during the exercises. However, it's important to note that regularly interrupting urination to find the muscles can disrupt the normal emptying of the bladder, so this method should only be used for identification purposes.
• Get into a comfortable position: Find a comfortable position to perform the exercises, such as lying on your back or sitting upright. Make sure your body is relaxed, and avoid tightening your abdominal, buttock, or thigh muscles during the exercises.
• Contract and lift: Squeeze and lift your pelvic floor muscles as if you are trying to prevent passing gas or stop the flow of urine. Hold this contraction for a few seconds, making sure to breathe normally throughout.
• Release and relax: After holding the contraction, release the muscles and allow them to relax fully. Take a brief rest before starting the next repetition.
• Repeat and progress: Aim to perform several sets of contractions each day. Start with a few repetitions, gradually increasing the number over time. Be patient, as it may take a few weeks or more to notice significant improvements.

There are several medications available that can help manage different types of incontinence. Here are some common medications used for treating urinary and bowel incontinence:

• Antimuscarinics: These medications, such as darifenacin and oxybutynin, are primarily used to treat urge incontinence. They work by relaxing the bladder muscles, reducing sudden urges to urinate and helping to control leakage.
• Mirabegron: Mirabegron is another medication used for urge incontinence. It works by relaxing the bladder muscles and increasing the bladder's storage capacity, resulting in reduced frequency of urination and decreased leakage.
• Duloxetine: Duloxetine is commonly prescribed for stress incontinence. It is an antidepressant that also affects certain nerves involved in controlling bladder function. Duloxetine helps to strengthen the muscles around the urethra, providing better control over urine leakage.
• For bowel incontinence, specific medications are not as widely used. However, in cases of diarrhea-associated bowel incontinence, loperamide may be recommended. Loperamide is an anti-diarrheal medication that can help reduce bowel movements and improve control over bowel function.

A variety of pads and pants are designed for incontinence:

• Bed and chair sheets are ideal for immobile patients with light incontinence
• All in one pads are best for heavy incontinence and immobile patients as they can be fitted around the patient
• Pull-up pants are designed like underwear and are great for mobile individuals with moderate incontinence
• Slip-in pads are discrete and designed for mild incontinence
• Wipes and cleansing sprays are handy for cleaning