Question: I have started to have a problem with bladder leakage when I cough, laugh, or exercise. Is this a normal part of aging and is there anything I can do about it?
Answer: What you are describing is a common problem affecting at least 13 million Americans with 85% being woman between 15 and 64. It is called urinary incontinence, or poor bladder control, and it is Not a normal part of aging. Many people never talk to their doctors about it due to embarrassment and urinary incontinence goes untreated. The elderly in particular may be fearful of admitting they have urinary incontinence due to fear of being placed in a nursing home.
The most common causes of poor bladder control include pregnancy, menopause, obesity, urinary tract infections, constipation, surgery for prostate or hysterectomy, reduced mobility preventing you from getting to or using the toilet, neurological and musculoskeletal conditions such as multiple sclerosis and arthritis, health conditions such as diabetes, stroke, heart conditions, respiratory conditions, prostate problems and some medications.
The good news is that many types of bladder incontinence respond well to exercises and 80% of cases see improvement without surgery. Obesity, pregnancy, childbirth, regular heavy lifting, and a chronic cough can weaken the pelvic floor muscles but both men and women can strengthen these muscles with specific exercises at any age. At the Homestead Rehabilitation and Healthcare center, seniors are using these exercises in conjunction with regular toileting schedules to reduce bladder leakage and improve quality of life. Occupational therapists at the Homestead have specialized training and help individuals strengthen their pelvic floor muscles and decrease or possibly eliminate incontinence. Kegel exercises have been proven to be the most effective exercises to strengthen the pelvic floor muscles if done correctly. Occupational therapy can help to re-train the pelvic floor muscles in order to use them properly.
Incontinence can be prevented by adopting a healthy diet and lifestyle. Here are some tips to incorporate into your life to prevent urinary incontinence.
- Drink 6 to 8 cups of fluid daily unless otherwise advised by your doctor. Many elders stop drinking because they worry about bladder leakage but this can cause dehydration and urinary tract infections.
- Cut down on alcohol, soda and drinks with caffeine as they irritate the bladder
- Eat a healthy diet with plenty of fiber
- Eat 2 servings of fruit daily and 5 servings of vegetables, cereals and breads each day
- Maintain an ideal body weight; excess body fat strains the pelvic floor and can lead to bladder and bowel control problems.
- Stop smoking. Chronic coughing associated with smoking can weaken the muscles of your pelvic floor and lead to bladder and bowel control problems. Talk to your doctor or pharmacist for information on quitting smoking.
- Get active. Exercise for 30 minutes most days. Even gentle walking helps.
- Do pelvic floor exercises regularly.
- Visit your doctor if you suspect you have a urinary tract infection
Linda Cammaroto, OTR/L is an Occupational Therapist with over 30 years experience and a clinical background in the management of older adults and incontinence. Linda works with an interdisciplinary team at the Homestead to implement strategies to enhance bladder and bowel continence for older adults in a residential care facility.
