What is Urinary Incontinence?

Urinary incontinence, commonly known as an overactive bladder, is marked by a loss of control over your own bladder. Sometimes this can mean that urine leaks from your body from time to time, but it can also mean a complete loss of bladder control which causes you to wet yourself often. Urinary incontinence can affect patients at any age but is particularly common among older patients.

Urinary incontinence occurs when bladder muscles are too weak or sensitive. Weak muscles may result in leakage whenever you exercise, laugh, sneeze or cough. This means your muscles are not strong enough to stay closed when your body exerts itself. Stress incontinence is characterized by leakage whenever you lift something heavy. Other types of urinary incontinence include urge incontinence, marked by overactive bladder muscles that cause you to feel like you need to urinate when there is little or no urine in your system.

The causes of urinary incontinence range from prostate problems to nerve damage in your bladder muscles. Your primary doctor will be able to determine the necessary forms of treatment after a consultation about the specific cause of your case. Accordingly, incontinent patients have been treated with several different methods, which can include options such as physical exercises, external devices or medication. Surgery is available but very rarely used unless the urinary incontinence is causing infection to other health complications for the incontinent patient.  Urinary incontinence is usually managed by a urology specialist.

What is Fecal Incontinence?

Fecal incontinence is similar to urinary incontinence, but involves your ability to control your bowel and pass stool properly. Fecal incontinence, also called bowel incontinence, can cause leakage of feces from your rectum suddenly or unexpectedly, or when you pass gas. In more severe cases, fecal incontinence can mean a total inability to manage of the bowel muscles, which causes patients older than toddlers to expel fecal matter at inappropriate times uncontrollably. Patients who have had surgery for hemorrhoids or rectal cancer sometimes experience fecal incontinence after their procedure.

Fecal incontinence is most frequently caused when you are constipated, when you have diarrhea or if you have been previously diagnosed with muscle or nerve damage. Usually the muscle that is too weak is the anal sphincter muscle, which controls your bowel movements and unfortunately weakens naturally as you age. Damage can also happen as a result of giving birth.

And although it may seem counter-intuitive—constipation can also cause fecal incontinence when hard, dry and impacted stools in your body that are too hard or big to pass to weaken and stretch out your bowel muscles, causing unnecessary leakage when watery stool or diarrhea from higher up the rectum leak around the impacted mass and out the rectum.

Although treatment to cure fecal incontinence is not widely available, you should talk to a GI doctor about ways to improve episodes or symptoms. Depending on the cause of your fecal incontinence, you may need to take drugs to encourage bowel movements, inhibit bowel movements or control muscle movement in the colorectal region. Simple dietary changes and physical therapy may also improve symptoms of incontinence.  It is always important to consider the underlying cause of bowel incontinence, as neurological damage needs to be excluded.


Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014