Friday, November 30th, 2018
More than 15 million people suffer a stroke worldwide each year. Approximately half of all stroke survivors admitted to a medical facility will be affected by temporary bladder incontinence and one in three will struggle with bowel incontinence. Losing control of one’s bladder or bowel movements can be frustrating and embarrassing for survivors. Fortunately, there are many strategies to help survivors regain bladder and bowel control after suffering a stroke. It’s important to remember that every stroke is different and every recovery and rehabilitation model will be unique for each stroke survivor. In this case, it all starts with a greater understanding of the causes of incontinence.
There are many types of incontinence a survivor may experience following a stroke, with some survivors experiencing more than one. It’s important to remember that constipation, diarrhea, and urinary retention are all common following a stroke and may increase urge and functional incontinence issues. It is equally important to remember that there are many proven strategies to help individuals regain control and minimize accidents.
For some stroke survivors, incontinence may be a consequence of the damaged brain tissue suffered from a stroke event. This tissue damage can cause muscular spasms, loss of sphincter control, and other impairments. Those struggling with cognitive difficulties may not be able to properly or effectively communicate their need to use the restroom in time, causing delays and potential accidents. Motor impairments are common after a stroke, which can increase the amount of time an individual needs to reach the bathroom and adjust their clothing. The extra exertion required to move as a result of stroke motor impairment may lead to leaks and accidents.
Urinary urge incontinence involves an immediate urge to use the restroom and “is by far the most frequent long-term, chronic urologic complaint,” according to a report by The New York Times. This urgent need to use the restroom is typically caused by bladder contractions, which may result in the loss of bladder control and nighttime urges. The average adult will typically urinate about six to eight times a day, however, a stroke survivor may feel the need urinate more than usual.
Bowel incontinence is less common following a stroke than urinary incontinence. Diminished mobility often leads to increased constipation for stroke survivors which may result in control difficulties. A stroke survivor may not be able to eat or drink as much as usual and may be undernourished or dehydrated. This can also lead to constipation or bowel incontinence issues. Some individuals may struggle with fecal impaction in the rectum, causing constipation, and this condition can add pressure to the bladder, exacerbating urinary control issues.
Research has shown that it may be easier to regain control of bowel movements than combat urinary incontinence. Again, motor impairments are common following a stroke and these deficits may interfere with an individual’s ability to make it to the restroom and also undress themselves in time. With these impairments in mind, wardrobe modifications such as switching to pants with an elastic waist band for convenience may be prudent. If an individual is dealing with more severe mobility issues, home modifications may be necessary to ensure the person can easily and quickly reach the restroom unhindered. Bedpans and portable urinals can also be strategically and discreetly placed in rooms to minimize accidents. Adult diapers are a solid backup plan, especially if the survivor has some room to go in the recovery journey before being able to manage using the bathroom independently.
Making small changes to a person’s diet and feeding schedule can be helpful. For example, survivors struggling with bladder control at night may need to minimize fluid intake in the hours leading up to bedtime. Similarly, some food and drink exaggerate incontinence issues. Coffee and alcohol, for example, can compound frequency and urge issues and should probably be avoided. Establishing set times for bathroom breaks staggered throughout the day, or timed voiding, may also be beneficial. Once a comfortable routine has been established, the space between these scheduled breaks can be increased.
There are also exercises designed to strengthen the muscles of the pelvic floor, which can help survivors struggling with urinary stress incontinence and bowel incontinence. These exercises can be performed at home and many individuals notice improvements within a few weeks. The United States National Library of Medicine has compiled a helpful guide to a few of these exercises. If exercises and lifestyle adjustments have failed to address a survivor’s incontinence issues, their doctor may recommend the use of medications for constipation or incontinence.
Thankfully, long-term incontinence is uncommon following a stroke and the latest research suggests that only about 15 percent of stroke patients will continue to experience incontinence issues one year after suffering a stroke. Nonetheless, even short-term incontinence can be upsetting and embarrassing for survivors. Here at Saebo, we are committed to stroke support and recovery for all survivors and their families. Saebo offers a wide range of products that combine cutting-edge technology with evidence-based rehabilitation techniques. Our offerings and network of Saebo-trained therapists can help you or a loved one to obtain all the necessary tools to maximize stroke recovery.
All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.