Bowel and Bladder Dysfunction Conditions Cause Incontinence

Symptoms, Bowel andor Bladder incontinence2-1

Definitions

The words bowel and bladder dysfunction refer to any type of problem affecting the passing of urine or the elimination of stool. More specifically, bowel dysfunction involves the retention of feces within the bowel—commonly known as constipation, or the involuntary leakage of stool while passing gas and, in severe cases, at any time. Similarly, bladder dysfunction implies either the inability to pass urine or the need to urinate all too often. The ability to control these needs has many different levels, and may if left untreated, lead to incontinence, that is to say, a complete loss of control over bladder and bowel functions, involving the involuntary passing of urine or stool.

General information

In recent years, studies have indicated a frequency of bowel or bladder dysfunctions that reaches very high percentages in certain groups of patients: 40%-70% of multiple sclerosis patients, 70%-80% of people having sustained spinal cord injuries, and 32%-70% of Parkinson’s patients experience problems regarding the regulation of stool and urine. Another interesting fact that applies to a greater majority of individuals is that almost 1 out of 3 women who have given birth without a C-section experience some kind of incontinence. The most common type of incontinence is bladder incontinence among these women.image of the bladder and all its parts that could cause bladder dysfunction.

It is safe to say that bowel and bladder dysfunctions are generally problems that do not affect young people. However, this always depends on the cause of the dysfunction: Parkinson’s disease most of the time affects the senior generation. Therefore, the incontinence issues accompanying the disease will also affect a population of those over 65 years old. On the other hand, spinal cord injuries may cause bladder and bowel issues in younger individuals. 

Both the issues of bladder and bowel dysfunctions are considered by many individuals “taboo subjects”—people refuse to talk about these kinds of conditions and as a result, postpone their meeting with a physician.

Due to the embarrassing nature of these issues, patients experiencing symptoms such as the ones described are socially and emotionally debilitated and they refrain from social activities for fear of leaking stool or urine in public. They also experience a decline in their sexual life, as intercourse is an activity that causes them to stress out at the prospect of a leak. Isolation, depression, low self-esteem, and anxiety in the workplace are indicative of the low quality of an individual’s life when experiencing such issues.

Bowel dysfunction

men, pee, toilet

Constipation: Common causes

When assessing the problem of constipation, one must always keep in mind that toilet habits are extremely individualized. While many people may be used to going to the bathroom once a day, others may do so three to four times a week, which is also considered normal. By strict definition, a person is medically considered constipated when they start passing stool less frequently than they used to, or the quantity of feces is diminished each time they do.

There are great varieties of reasons for why a person may be experiencing the symptoms of constipation:

  • Idiopathic constipation: The symptom of constipation cannot be explained due to dietary habits, stress, or an underlying condition, namely there is no known cause for the problem.
  • Way of life: Altering one’s daily habits or having unhealthy habits are two of the most common causes of constipation. Travelling, waking up at a different time, excessive stress or consuming low-fiber foods leads to the inadequate relief of the bowel. What one must keep in mind is that postponing the passing of stool due to social obligations leads to unnatural bowel “training,” and the appearance of constipation.
  • Irritable bowel syndrome: A condition of uncertain causes, irritable bowel syndrome may lead to periods of serious constipation followed by periods of diarrhea, or a state of permanent constipation.
  • Secondary constipation due to underlying pathologies: Constipation can be a result of other diseases, like Parkinson’s disease, multiple sclerosis, diabetic neuropathy or Hirschprung’s disease. Colorectal cancer and hypothyroidism are also among the conditions causing secondary constipation.  

Involuntary passing of stool

The partial or complete loss of control over one’s bowel functions is a problem that is treatable. Even though it is considered by many people a reason for embarrassment, and many times medical attention is not sought, the involuntary passing of stool is a debilitating state that can be reversed.

Causes

  • Hemorrhoid surgery: Contrary to popular beliefs that hemorrhoids are pathological findings, this is quite untrue. Hemorrhoids serve as a natural barrier, stopping the stool from exiting the rectum when one is passing gas. An abnormal enlargement of the hemorrhoids many times has to be treated with surgery, a complication of which is nerve and muscle damage to the area, leading to fecal incontinence.
  • Neurological conditions: The stool function is regulated by nerves and muscles. The anal sphincters relax to pass stool and constrict to retain it, whereas the nerves responsible for controlling it sense the existence of stool in the bowels, therefore giving a signal to start the excretion process. Neurological conditions such as multiple sclerosis, spinal cord injuries, or stroke many times lead to the dysfunction of the nerves in the area.
  • Childbirth: Surprisingly, childbirth leads to extreme pressure exerted on the pelvic muscles and nerves. A natural childbirth, especially with an episiotomy, can lead to the dysfunction of the regional nerves, a process that can deteriorate over time, finally leading to a loss of bowel control.
  • Constipation: Chronic constipation causes pressure in the anal region, leading to a weakening of the muscles and nerves.

Treatment 

Whether the problem is constipation or the involuntary passing of stool, treatment is available. It involves changing one’s dietary habits, special exercises for the strengthening of the pelvic region, surgery, or medication. Treatment is always administered depending on the cause and a physician’s opinion should be sought once the symptoms appear.

Bladder dysfunction
Inability to pass urine-Diminished urination

An average person passes urine which, on a daily basis, amounts to 800 ml to 2 liters. A person is considered to be having the symptom of oliguria (a diminished quantity of urine) when they relieve themselves of 400 ml of urine daily or less.

There are two distinct reasons why this might be happening. One involves an abnormally small volume of urine produced by the kidneys (renal failure), and the other one, the inability to pass urine that has already reached the bladder.

Renal Failure: Causes

  • Hypovolemia: Reduced fluid circulation. This can be a result of blood loss or fluid loss, due to extreme diarrhea, vomiting, diuretics, or extensive burns. Hypovolemia may also be caused by anaphylactic shock.
  • Medication: NSAIDs, cyclosporine, or some medications prescribed for hypertension may lead to renal failure.
  • Conditions affecting the kidneys: Inflammation of the kidneys due to autoimmune diseases like systematic lupus and Goodpasture’s syndrome, infection, increased blood clotting and various other conditions can cause a reduced production of urine.
  • Obstruction of urine: After it is produced, urine follows a route through the ureters in order to reach the cyst. Any obstruction of this path due to conditions such as cancer, narrowing of the ureters, or kidney stones blocking the tubes, can prevent urine from reaching the bladder.

Inability to pass urine that has reached the bladder: Causes

Neurological conditions: Even if a person feels the need to urinate, in order for the process to take place, regional nerves have to pick up the stimulus and send it over to the brain. Conditions like multiple sclerosis, diabetes, inflammation of the spine or brain, or heavy metal poisoning result in the message failing to reach the brain. Therefore, a person may feel the need to urinate but fail to do so.

Benign prostatic hyperplasia: The enlargement of the prostatic gland causes pressure on the urethra, through which urine is passed from the body. This results in the urethra becoming gradually smaller and weakened, finally losing its ability to pass urine.

Urethra pathologies: Kidney stones have the ability to move around in the urinary tract. When they end up located in the urethra, they obstruct the natural movement of urine and do not allow it to leave the body. A similar cause is urethral stenosis (narrowing of the urethra).

Urinary tract infection: One of the most common symptoms of a lower urinary tract infection is the need to urinate while producing only a small amount of urine each time.

Overactive bladder. Causes:

  • Neurological causes: The condition in which one’s nerves send signals to the brain that induce urination all too often. This may be due to Parkinson’s disease, strokes or diabetes.
  • Pregnancy: Even from the first weeks of pregnancy, the increasing uterus volume exerts pressure on the cyst, causing a woman to feel the need to urinate more often than usual.
  • Enlarged prostate: An enlarged prostate pressures the urethra and blocks urine flow. This causes the bladder to constrict due to irritation and signals the need for frequent urination.
  • High fluid consumption: Naturally, the frequency of urination depends on our daily fluid intake. The more fluids one consumes, the greater need there will be for that person to urinate.
  • Infections: Usually, urinary tract infections are accompanied by a frequent need to urinate. 
  • Bladder stones

Bladder Incontinence

Bladder incontinence is the inability to control one’s need to urinate, therefore resulting in the involuntary passing of urine. It is divided into the following types:

  • Stress Urinary Incontinence: Loss of urine happens when coughing, exercising, or sneezing.
  • Urgency Incontinence: Involuntary passing of urine which is accompanied by a strong wish to urinate. The patient feels the urgent need but has lost urine by the time they reach the bathroom.
  • Mixed Incontinence: The combination of the two above.

Causes:

  • Urethral hypermobility: In cases of great abdominal pressure, the urethra has to be supported by the regional sphincters so as not to release any urine. Conditions that exert pressure on the muscles actually weaken them and render them unable to stop the urethra from passing urine when under pressure (cough, exercise, etc.). Such conditions involve normal childbirth or chronic constipation.
  • Hyperactive muscles: The sphincters’ dysfunction causes urine to be passed from the body in the fashion of urgency incontinence. Reasons why this may happen include multiple sclerosis, Parkinson’s, prostatic hyperplasia, cyst inflammation, cyst cancers, and many other.
  • Degeneration due to aging.

Treatment

Mild or severe bladder incontinence can be a debilitating symptom, causing patients to refrain from social activities or feel embarrassed and stressed in public. Sexual life can also be affected because urine leakage many times happens during intercourse. 

Treatments vary from medication to surgery, and there are tests like a urodynamic study, which help determine the type of incontinence with great efficacy.