Bladder and Bowel Dysfunction

Bladder dysfunction and bowel dysfunction refer to problems with urinating and passing stools. These may lead to the unwanted passage of urine or stool, called urinary or fecal incontinence.

If you have these types of bladder and bowel problems, you may feel embarrassed at the thought of bringing them up with your doctor or other health care provider. The conditions can be physically and emotionally difficult to deal with, but you shouldn't feel uncomfortable about talking to your health care provider. Health care providers are used to dealing with these issues and can help you manage the problem.

Causes of bladder and bowel dysfunction

For the bladder and bowel to function correctly, certain nerves in your body need to control the right muscles, telling them when to contract and when to release in order to allow urine and feces to be eliminated when you want them to.

This happens when the nerves in the spinal cord send messages from the brain to the bladder and sphincter muscles to control the flow of urine. The muscles within the rectum and anus help control your bowels, and sphincter muscles control or release stool.

Urinary problems

A number of conditions may affect the nerves and muscles that control the bladder and bowel, resulting in dysfunction and possible incontinence.

For the bladder, these conditions include:

  • Overactive bladder. As the name suggests, you may have to go much more frequently than you would like. This can include an urgent need to urinate or having to urinate up to eight times or more a day and twice at night.

  • Difficulty controlling sphincter muscles. If the nerves to these muscles have been damaged, they may not cooperate when you want to tighten or release them to pass urine.

  • Holding urine in too long (urine retention). Sometimes nerve damage means that the bladder muscles don't get the chemical message that it's time for you to go. If the urine stays in the bladder too long, pressure may build up and lead to infection or damage of the bladder or kidneys.

Bowel problems

Fecal incontinence means you may not make it to the bathroom when you have a bowel movement, or you may "leak" a little when you pass gas. 

Conditions that raise the risk for fecal incontinence include:

  • Diarrhea

  • Constipation

  • Damage to the nervous system from disease or injury

  • Poor health

  • Vaginal childbirth

  • Rectal prolapse (when the rectum protrudes into the anus)

  • Rectocele (when the rectum pushes into the vagina)

Other conditions

These are other health issues that may contribute to bladder and/or bowel dysfunction:

  • Medication side effects

  • Stress

  • Multiple sclerosis

  • Stroke

  • Alzheimer's disease

  • Diabetes

  • Infections, including spinal cord or brain infections

  • Hemorrhoids

  • Problems with the pelvic floor

  • Digestive problems, such as constipation or diarrhea

  • Abnormalities that affect the urinary or digestive tract

  • Problems affecting the nerves that control the urinary or digestive tract

You could also have metal poisoning, congenital nerve-related problems, or injury or damage to the rectum caused by surgery or by conditions, such as Crohn's disease or ulcerative colitis.

Managing bladder and bowel dysfunction

Depending on the nature of your problem and your symptoms, your health care provider will work with you to create a plan of action. Here are some common treatments:

  • Changing your diet. Gradually increasing your fiber intake can help manage the diarrhea and constipation that can lead to fecal incontinence. Drinking plenty of fluids can also ease constipation, and restricting fluids at times can help manage overactive bladder or urinary incontinence.

  • Exercises. Kegel exercises can strengthen the sphincter muscles and pelvic floor. This can provide better control and ease bladder and bowel dysfunction. Ask your doctor whether they might help in your case and, if so, how to do them.

  • Medications. Some medications, including fiber supplements, can help control bowel dysfunction, and antidiarrheal medications can help manage diarrhea. Prescription medications are also available to help bladder muscles relax to promote better bladder control.

  • Training. Programs that "train" the bowels and bladder can give you better control and manage dysfunction. This includes setting a regular schedule for using the toilet and attempting to urinate or have bowel movements at the same time each day.

  • Electrical stimulation. This therapy can stimulate damaged nerves and promote better muscle control and control over urine and feces.

  • Surgery. In rare cases, you may need surgery to repair damage to the muscles or nerves that are causing bladder or bowel dysfunction.

You don't have to suffer in silence. Finding the right therapy and management techniques can help you overcome bladder or bowel problems and avoid embarrassing incidents.