ARTHRITIS AND INCONTINENCE

There are four main ways that diabetes can cause problems with a person's bladder and bowel control:

Limited mobility

Limited mobility can result in people with arthritis not reaching the toilet in time. Some of the measures people take to avoid accidents can actually make their incontinence worse:

  • Some people may go to the toilet before they get the urge to urinate (wee) in order to avoid accidents later. While this may work for the short-term, it can lead to the bladder losing its volume capacity over time – resulting in it having to empty more frequently in increasingly smaller amounts.
  • Some people will reduce their fluid intake in the hope it reduces the number of trips required to go to the toilet. While this appears logical, the reverse is true. Insufficient fluid intake causes urine to become concentrated, which can cause the bladder to become irritated, leading to it emptying its contents more often. This can result in frequency and urge incontinence.

Joint stiffness

Stiffness (particularly in the hands and wrists) can make removing underwear and outer clothing difficult.

Overactive bladder

The bladder empties as a result of the bladder muscle contracting and pushing urine (wee) out through the urethra (the bladder outlet tube). As people get older, the bladder muscle can become overactive, resulting in more frequent contractions, along with the urge to urinate. The two main symptoms of an overactive bladder – frequency and urge incontinence – can worsen over time, to the point where leakage occurs before reaching the toilet.

Constipation

People affected by arthritis frequently develop constipation – either because they are not as active as they used to be, or because they are limiting their fluid intake to manage their bladder control problems.

Constipation is one of the main causes of incontinence, particularly in older people. An overfull bowel restricts the bladder’s volume and capacity to hold urine, which can lead to frequency and urge incontinence. In addition, straining on the toilet due to constipation can stretch and weaken the pelvic floor, which can lead to stress incontinence.

MANAGEMENT

There are a number of lifestyle changes that you can make to regain control of your bladder or bowel:

Eat well

A healthy diet rich in dietary fibre to avoid constipation. We need at least 30gm of fibre each day. Eat at least 2‐3 serves of fruit, 5 serves of vegetables and 5 serves of cereals and breads. It is important to get the balance right as just adding fibre to your diet without increasing your fluids can cause or make constipation worse. If you continue to have constipation, see your doctor.

Drink well

Drink adequate fluids to quench your thirst. Speak to your doctor about how much fluid intake is right for you. Water is the best fluid as this can help stop bladder irritation and improve bowel function (which can affect bladder control). Be aware that recommended fluid intake varies with hotter weather, more exercise and other health conditions.

Get moving

Aim to exercise for 30 minutes most days. Remember that walking is great exercise.

Keep your pelvic floor muscles strong

Your pelvic floor muscles give you control over your bladder and bowel. Squeeze and draw up your pelvic floor muscles to control the urgency to go to the toilet. When you feel the urge to pass urine (wee) or open your bowels (poo), stop, stand still or sit down on a firm seat.  Squeeze and draw up your pelvic floor muscles. Think about something else rather than the urge. The urge should diminish or go away at this point so you can get to the toilet without rushing.

Go to the toilet when your bladder feels full or when you get the urge to open your bowels. Do not get into the habit of going ‘just in case’. Take time to completely empty your bladder and bowel. To get into the correct sitting position on the toilet: sit on the toilet, elbows on knees, lean forward and support your feet on a footstool. To avoid kidney damage, if you think your bladder is not emptying completely talk to your doctor or diabetes nurse.

SEEK HELP

In many cases incontinence can be prevented, better managed and even cured. Talk to your doctor or contact the National Continence Helpline on 1800 33 00 66.

The National Continence Helpline is staffed by continence nurse specialists who offer free and confidential information, advice and support. They also provide a wide range of continence-related resources and referrals to local services.

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Last Updated: Tue 23, Jun 2020
Last Reviewed: Fri 20, Mar 2020