1.3 Describe types of: • urinary incontinence • faecal incontinence

This guide will help you answer 1.3 Describe types of: • urinary incontinence • faecal incontinence.

Types of Urinary Incontinence

Urinary incontinence refers to the involuntary leakage of urine. It can significantly affect a person’s quality of life, impacting physical, social, and emotional well-being. There are different types of urinary incontinence, classified based on their causes and symptoms.

Stress Incontinence

Stress incontinence occurs when there is pressure on the bladder. It might happen during activities like coughing, sneezing, laughing, or exercising. This is the most common type of incontinence in women, particularly after childbirth or during menopause. It happens because the pelvic floor muscles, which support the bladder and urethra, weaken. If the muscles are not strong enough to keep the urethra closed, urine may leak when abdominal pressure increases.

Urge Incontinence

This is also called overactive bladder (OAB). Urge incontinence involves a sudden, powerful need to urinate, followed by involuntary leakage. The person may feel a strong desire to use the toilet even if the bladder is not full. It often disrupts sleep because people often wake needing to urinate. Causes include bladder irritation, nerve damage, or conditions like multiple sclerosis, Parkinson’s disease, or urinary tract infections (UTIs). For some, certain drinks, foods, or medications can worsen symptoms.

Overflow Incontinence

Overflow incontinence happens when the bladder is unable to empty completely. This causes it to overfill, leading to constant or frequent dribbling of urine. People with this type may feel they cannot fully empty their bladder, which can cause discomfort or an intermittent flow of urine. It’s often seen in men with prostate issues, such as an enlarged prostate obstructing the urethra. It can also occur due to nerve damage from conditions like diabetes or spinal cord injuries.

Mixed Incontinence

Mixed incontinence is when someone experiences more than one type of incontinence. For example, stress and urge incontinence often occur together in women. This combination can make symptoms more complex and require different treatment approaches.

Functional Incontinence

Functional incontinence occurs when a person cannot reach the toilet in time due to physical or mental challenges. This might happen with mobility issues, such as arthritis, or cognitive difficulties, like dementia. Functional incontinence is not caused by problems with the bladder itself, but by difficulties with accessing the toilet.

Reflex Incontinence

Reflex incontinence happens when the bladder empties without the person having control, often without the urgency to urinate. This typically occurs in individuals with neurological conditions that interfere with nerve signals, such as spinal cord injuries or strokes. The brain and bladder do not communicate properly in these cases.

Temporary Incontinence

Temporary incontinence is short-term and usually caused by specific factors. Common triggers include urinary tract infections, medications such as diuretics (which increase urine production), or excessive intake of alcohol and caffeine. Once the cause is treated or removed, the incontinence often resolves.

Types of Faecal Incontinence

Faecal incontinence refers to the inability to control bowel movements, leading to involuntary leakage of stool or gas. This condition can vary in severity, from occasional minor leakage to loss of bowel control. Factors such as age, medical conditions, and injury can play a role in its development. Just like with urinary incontinence, there are distinct types of faecal incontinence.

Urge Faecal Incontinence

Urge faecal incontinence happens when a person has a sudden need to open their bowels and cannot control it in time. The feeling of urgency is difficult to delay, leading to accidents if no toilet is immediately available. Conditions such as diarrhoea, rectal inflammation, or nerve damage can contribute to this type.

Passive Faecal Incontinence

Passive incontinence, also known as passive soiling, occurs when stool leaks without the person being aware of it. This type is often associated with problems in the anal sphincter muscles or reduced sensation in the rectum. It can also happen in individuals with neurological conditions that affect the ability to feel when the rectum is full.

Overflow Faecal Incontinence

This occurs when stool builds up in the rectum, often due to long-term constipation. Over time, the rectum cannot hold any more stool, and softer stool or liquid leaks around the blockage. This is more common in older adults or those with mobility or mental health issues. If untreated, faecal impaction (a hard mass of stool stuck in the rectum) can develop.

Functional Faecal Incontinence

This type arises when a person has a normal functioning bowel but cannot access the toilet in time. This might happen due to mobility issues, such as arthritis or severe pain when moving, or cognitive disorders like dementia. The loss of independence or access to toilet facilities can play a significant role.

Total Faecal Incontinence

Total faecal incontinence is the complete loss of bowel control. This means the individual cannot control any type of bowel movement, whether it’s gas, liquid, or solid stool. It is often caused by severe damage to the anal sphincter muscles or nerves due to surgery, childbirth trauma, or diseases like Crohn’s.

Temporary Faecal Incontinence

Temporary faecal incontinence usually results from temporary factors such as acute diarrhoea or gastrointestinal infections. Once the underlying cause is treated or resolved, bowel control often returns to normal.

Traumatic Faecal Incontinence

This occurs due to an injury to the anal region, sphincter, or nerves controlling the bowel. Common examples include childbirth injuries, surgery complications, or physical trauma affecting the muscles or nerves involved in bowel control.

Treatment and Management of Incontinence

Both urinary and faecal incontinence can have a profound impact on daily life. Treatment depends on the underlying type and cause. Understanding the different types is the key to providing effective care.

For urinary incontinence, management may involve pelvic floor exercises, bladder training, medications, or in severe cases, surgery. In some cases, lifestyle changes like managing fluid intake, avoiding bladder irritants, or losing weight can help.

For faecal incontinence, treatment often starts by addressing the cause. Dietary changes, such as increasing fibre, may help with constipation or diarrhoea. Pelvic floor exercises can strengthen the muscles controlling bowel movements. Skin care is also essential to avoid irritation from leakage.

Use of pads, continence products, or toileting schedules might help minimise discomfort and accidents in both types. For persistent symptoms, consulting with healthcare professionals is critical.