Urinary and Fecal Incontinence

Urinary incontinence (the loss of bladder control) and fecal incontinence (the loss of bowel control) are common health issues that may arise from problems with the pelvic floor muscles. Symptoms can include occasional or frequent leaking, increased urge to urinate/defecate and increased frequency of trips to the toilet. These conditions are not only distressing, but disruptive to daily life. While an estimated one in four women experience some form of incontinence during their lifetime, this can be a problem that affects men as well.

When loss of bladder control happens with a laugh, cough, sneeze or with activity it is usually labeled ‘stress incontinence’. This implies that a force or stress on the pelvic floor caused the leak. When incontinence happens with a strong urge to urinate, or due to a cue such as the sound of running water, walking past a restroom or as you run to the bathroom, then this is typically labeled ‘urge incontinence’. This implies that your urinary system could not properly cope with an urge to urinate. You might also experience symptoms associated with both of these types of incontinence in which case it can be labeled as ‘mixed incontinence’.

Loss of bowel control is divided into three categories. Passive fecal incontinence is the involuntary passage of gas or stool without awareness, urge fecal incontinence is the loss of stool even though someone is actively trying to hold it in, and fecal seepage is the leakage of stool following an otherwise normal bowel movement.

Incontinence can initially be caused by many factors. From a physiotherapy perspective, incontinence issues are often impacted by injured or weak muscles in the pelvic floor. For this reason, strengthening, endurance training and coordination exercises are typically used. However, sometimes incontinence can be impacted by other muscle issues – such as a muscle being too painful or tight to work properly, or interference from a prolapsing organ, or scar tissue or poor bathroom habits. For these reasons, sometimes flexibility and connective tissue must be improved, bladder training must be included or toileting posture must be changed.