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5 ways to dodge incontinence

Also: Doctor-rating websites offer helpful but limited advice; Taming incontinence without surgery.
August 13, 2015
Harvard Medical School

5 ways to dodge incontinence

Most people take bladder control for granted — until the unintended loss of urine interrupts the ability to carry on an ordinary social and work life.

Often, the causes of incontinence are out of a person's control. For example, in women, incontinence is a common side effect of childbirth. For men, it's most often a side effect of treatment for prostate problems.

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Most people take bladder and bowel control for granted — until something goes wrong. An estimated 32 million Americans have incontinence, the unintended loss of urine or feces that is significant enough to make it difficult for them to maintain good hygiene and carry on ordinary social and work lives. The good news is that treatments are becoming more effective and less invasive. This Special Health Report, Better Bladder and Bowel Control, describes the causes of urinary and bowel incontinence and treatments tailored to the specific cause.

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Although it may not be possible to avoid incontinence, you can take steps to lower the chances that you will develop this distressing problem.

  1. Watch your weight. Excess weight and incontinence can go hand in hand, particularly for women. One theory is that extra abdominal fat can weaken the pelvic floor muscles and lead to stress incontinence (leaking when coughing, laughing, sneezing, etc.). In some cases, simply losing weight can improve incontinence.

  2. Don't smoke. Smoking threatens your health in many ways. It also doubles the likelihood that a woman will develop stress incontinence. Nicotine has also been linked to urge incontinence.

  3. Stay active. In the Nurses' Health Study, middle-aged women who were most physically active were least likely to develop incontinence.

  4. Minimize bladder irritants. Caffeine and alcohol have been linked to urge incontinence (the feeling you need to urinate even when the bladder isn't full). Carbonated drinks, the artificial sweetener aspartame (NutraSweet), spicy foods, and citrus fruits and juices cause urge incontinence in some people.

  5. Don't strain with bowel movements. This can weaken the pelvic floor muscles. If your stools are frequently hard or take considerable effort to pass, talk with your doctor. In a study involving people ages 65 and older, treating constipation improved a variety of urinary symptoms, including frequency, urgency, and burning. Increasing the fiber in your diet and drinking enough fluid can help prevent constipation.

Treatments for urinary incontinence are more effective and less invasive than ever. If you have problems with the unintentional loss of urine, don't suffer in silence. Talk with your doctor. 

For more on treating bladder and bowel incontinence, buy Better Bladder and Bowel Control, a Special Health Report from Harvard Medical School.

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News and Views from the Harvard Health Blog

Doctor-rating websites offer helpful but limited advice

A recent survey found that nearly a third of Americans had read patients' online comments about clinicians, and that 21% had used them when choosing a clinician.

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The bladder workout: Tame incontinence without surgery

An overactive bladder (also known as urge incontinence) causes a sudden urge to urinate, even when your bladder isn't full. For some people it's simply a nuisance. For others, the urge can't be controlled, which leads not only to incontinence but also to a potentially severe negative impact on quality of life.

Bladder training can go a long way toward helping with urinary incontinence. Bladder control training entails learning to urinate on a schedule (timed voiding) and doing pelvic muscle exercises.

Here's a step-by-step bladder-training technique:

  1. Keep track. For a day or two, keep track of the times you urinate or leak urine during the day.

  2. Calculate. On average, how many hours do you wait between visits to the bathroom during the day?

  3. Choose an interval. Based on your typical interval between needing to urinate, set your starting interval for training so that it's 15 minutes longer. So, if you usually make it for one hour before you need to use the bathroom, make your starting interval one hour and 15 minutes.

  4. Hold back. On the day you start your training, empty your bladder first thing in the morning and don't go again until you reach your target time interval. If the time arrives before you feel the urge, go anyway. If the urge hits first, remind yourself that your bladder isn't really full, and use whatever techniques you can to delay going. Try the pelvic floor exercises (also called Kegels), or simply try to wait another five minutes before walking slowly to the bathroom.

  5. Increase your interval. Once you are successful with your initial interval, increase it by 15 minutes. Over several weeks or months, you may find you are able to wait much longer and that you feel the urge less often. After four to eight weeks, if you think you have improved, do another diary. Compare your initial diary to your second diary to note the improvements in voiding intervals and voided volumes—this process reinforces the bladder training process.

No one should have to live with incontinence. For more ways to keep incontinence from getting in the way of doing the things you love, buy Better Bladder and Bowel Control, a Special Health Report from Harvard Medical School.

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Better Bladder and Bowel Control

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Urinary incontinence
SPECIAL BONUS SECTION: Urodynamic testing
Treating urinary incontinence
Managing urinary incontinence
Fecal incontinence
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