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Incontinence Q&A

by Staff Writer It's happening more often that when I urinate some extra always ends up in my pants. Is this a sign that I'm becoming incontinent?

You may be experiencing post-micturition dribble. Post-micturition dribbling is leakage of a small amount of urine after you've finished urinating. It's not a sign of impending incontinence. On the other hand, it can be a chronic and sometimes embarrassing problem. In men, it may be due to aging or an anatomic abnormality in the urinary tract. In women, it may be a sign that the floor of the pelvis that supports the bladder is weaker than it should be. This can happen as a result of giving birth. Less commonly this symptom can be caused by a blockage somewhere in the urinary tract. See your doctor to find out why you're having this symptom. If there's no other cause, your doctor may recommend specific exercises to help strengthen the muscles that support your bladder.

Every time I sneeze I pee a little. It's starting to be embarrassing. I've tried using a maxi pad because I don't want to wear a diaper. Are there products other than adult diapers that are made for this problem?

What you're experiencing is stress urinary incontinence. In women, this is usually caused by weakening of the muscles in the pelvis that support the bladder. Aging and childbirth can weaken these muscles and cause urine to leak when you cough, sneeze, laugh or exercise. Occasionally, this symptom can come from problems in the urinary tract. That's why it's a good idea to get checked out by a doctor. There are special exercises called Kegel exercises that help strengthen the muscles that give the bladder support. Doing these regularly should improve your symptoms over time. If you're overweight, losing weight may also help the symptoms. There are alternatives to adult diapers. Look for bladder protection pads. They're comfortable to wear and soak up odor and moisture so you don't have to worry about embarrassing leakage.

Sometimes I wake up with gas and when I pass it I actually poop my pants. What can I do?

It sounds like the pressure of passing gas is causing you to pass feces too. This could be due to a weak sphincter muscle. The sphincter muscle is the circular muscle that tightens and relaxes. When you're not having a bowel movement, it tightens to hold feces in. When it's time to have a bowel movement, it relaxes. The sphincter muscle can weaken over time or as a result of giving birth and lead to the symptoms you're describing. Other things can cause the passage of feces when you have gas as well. If you're constipated or recently passed a large or hard stool, it can irritate the sphincter muscle and keep it from closing properly. At the other extreme, diarrhea (loose or watery stools) can cause leakage when you pass gas as well. See your doctor to find out why you're having this problem. Your symptoms may respond to something as simple as dietary changes or exercises to strengthen your sphincter muscle. How you prevent it will depend on what's causing it.

Is it true that when people get older they start losing control of their bowel and bladder? And is it normal for that to happen when one gets older...or is there something wrong?

Bowel and bladder control issues become more common with age, but that doesn't make it normal. Some people maintain control of their bowels and bladder even at an advanced age. It's not an inevitable part of aging. There are a variety of reasons people have bladder or bowel control problems and the symptoms can vary. The symptoms can range from occasional "accidents" or leakage to complete loss of bowel or bladder control. Don't accept the idea that loss of bowel or bladder control is a natural part of aging. Find out what's causing it. Once you know, there are a number of treatments available, depending upon the cause. These range from something as simple as dietary changes (avoiding caffeine, more fiber etc.) or exercises to strengthen the muscles in the pelvis to treatments for specific problems. Some people are afraid to talk to their doctor about this problem. Don't be. You owe it to yourself!

I had trouble with incontinence during my pregnancy and while it's better now, it's still not the way it was before. Is there anything I can do to restore control?

It's not uncommon for women to experience bladder control problems during pregnancy. This is usually stress incontinence. Stress incontinence is where the symptoms occur with coughing, sneezing or laughing. Why does this happen? As the uterus enlarges during pregnancy, it puts added pressure on the bladder. Sometimes that pressure is too much! After pregnancy you may continue to have problems because carrying a child weakens the muscles that support the bladder. In addition, sometimes childbirth can damage nerves that control the bladder and lead to problems with incontinence. If you've given birth and are still having incontinence, see your doctor to make sure there's no other reason for your symptoms. If your bladder control issues are due to weak pelvic muscles, there are specific exercises you can do to strengthen them. These are called Kegel exercises. Losing weight may also help. If you're worried about leakage, there are light absorbency pads and pantiliners you can place in your underwear for added peace of mind.

I feel like I practice good hygiene, but I have noticed "skid-marks" on my underwear. Is this what people refer to as "anal leakage"? Can I do anything about it?

It could be anal leakage. Anal leakage can happen for a number of reasons. Hemorrhoids can cause minor leakage of feces from your anus. It can also happen if you're experiencing loose or watery stools. Constipation and passing a hard stool can irritate the muscle that holds your feces in, causing it to stay open. People who have given birth and those who have a common condition called irritable bowel syndrome may also experience this problem. Your doctor can help determine why you're experiencing "skid marks." If it's due to constipation, taking a stool softener or fiber supplement may improve your symptoms. If you're experiencing diarrhea, over-the-counter anti-diarrheal medications may help. There are also specific exercises you can do to strengthen the muscles that keep feces from leaking. Also available are comfortable pads you place in your underwear for added protection and peace of mind.