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Incontinence

Health NewsThe National Association for Continence (NAFC) calls urinary incontinence a symptom, not a disease and says that's important to remember because symptoms can be treated, if people will talk about them. (Note: This story focuses on urinary incontinence. To read about fecal incontinence see "Fecal Incontinence.") It's estimated that some 12 million people suffer from incontinence or uncontrollable loss of urine in the United States. The American Academy of Family Physicians (AAFP) says that it's most common in women over the age of 50 and women who have just given birth, but it also affects younger people, and it is also common in young children. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 10 percent of 5-year-olds, 5 percent of 10-year-olds, and 1 percent of 18-year-olds experience episodes of incontinence. It is twice as common in boys as in girls.

Types of bladder problems

Incontinence can occur when there are problems with the urinary system and with bladder control. (Read about "The Urinary System") There are different types of bladder control problems. Each of them happens for a different reason and each is treated differently. They can also be signs of other problems that need treatment. NIA, NAFC and AAFP say the different types include:

Treatment options for children

NIDDK says parents or guardians of children who experience bedwetting at night or accidents during the day should treat this problem with understanding and patience. It's important to remember that the child isn't doing this to annoy you, and he or she shouldn't be punished for it.

Most cases of bedwetting probably result from a mix of factors including slower physical development, small bladder capacity, an overproduction of urine at night, a lack of ability to recognize bladder filling when asleep and sometimes, anxiety.

Daytime incontinence in children can be associated with urinary infections. (Read about "Urinary Tract Infections") Other possible causes include an overactive bladder or abnormal elimination habits, such as infrequent voiding and constipation. (Read about "Constipation")

One issue parents should be aware of is that nighttime incontinence may be one sign of another condition called obstructive sleep apnea (Read about sleep apnea in "Sleep"), in which the child's breathing is interrupted during sleep, often because of inflamed or enlarged tonsils or adenoids. (Read about "Tonsils & Adenoids") In addition, a small number of cases of incontinence are caused by physical problems in the urinary system in children. Rarely, a blocked bladder or urethra may cause the bladder to overfill and leak.

The good news for parents is that many children overcome incontinence naturally - without treatment - as they grow older. NIDDK says the number of cases of incontinence goes down by 15 percent for each year after the age of 5.

If the incontinence persists, talk with your doctor about ways to help your child. For example, bladder training can help your child hold urine longer. In bladder training, you figure out how long your child waits between trips to the bathroom, and gradually try to extend that amount of time. A moisture alarm may help at night, by alerting the child to wake up when he starts to urinate. There are also medications available. Medication can help slow down how fast your body makes urine. Another type of medication can help the bladder relax so it can hold more urine.

Treatment options for adults

Many adults with incontinence are embarrassed. They try to hide the fact from everyone, including their doctors, but they are not alone. According to the National Institute on Aging (NIA) one in ten people over the age of 65 is incontinent. That's over ten million people according to NAFC. The group also says that 80 percent of incontinent people can be cured or have major improvement.

That's why it's important to talk with your physician or healthcare provider. He or she needs to check and see if there are other medical reasons for your incontinence before you can start treating it. Many times incontinence will disappear when the underlying medical problem is addressed. Then you can move ahead with treatments specifically for the incontinence.

The treatments fall into four areas - behavioral, drugs, surgical and non-surgical.

In cases where incontinence can't be cured, there are devices to help you manage it. NAFC says catheters, pelvic organ support devices, urethral inserts or patches, external collection systems, and absorbent products can be helpful. Again, talk to your doctor, which is always the first step in solving an incontinence problem. Doctors can't help you if they don't know, and since incontinence often is a sign of a more serious problem, it is important you bring it up.

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