Incontinence after a Stroke
Incontinence is a very common problem following a stroke, but fortunately these problems are often short lived as the brain and body recover and the patient adapts to their new post-stroke lifestyle. Around 40-60% of people who are admitted to hospital after having a stroke will experience incontinence problems of the bladder or bowel, or often both. However, the good news is that only 25% of stroke patients will still have continence issues on discharge from hospital, dropping to around 15% after one year and 10% after two years.
What causes incontinence after a stroke?
There are a number of issues surrounding continence post-stroke, including:
- Initial lack of awareness – in the days immediately following your stroke you may not be fully conscious and so void your bladder or bowel without realising. Even when you regain consciousness, you may still be unaware of the need to go or the fact that you have soiled yourself
- Damage to the brain – the stroke may have caused temporary or permanent damage to the areas of the brain that interpret signals from the bladder and bowel and control your voluntary voiding responses
- Loss of mobility – being unable to get to the toilet quickly enough, or even get out of bed to use a commode can cause continence problems
- Loss of dexterity – being unable to remove clothing quickly enough can also cause problems, especially with urge incontinence
- Lack of communication – many stroke victims are initially unable to communicate clearly and so cannot let staff know they need the toilet
- Constipation – being laid up in bed can cause constipation, which can lead to overflow incontinence. Some stroke medication can also cause constipation
- Existing problems – if you had continence issues prior to your stroke, chances are these will be made worse by both the stroke and the extended period of inactivity
Most patients will experience a combination of these issues, with a loss of control coupled with a lack of mobility exacerbating the issue.
Recovering from stroke-related incontinence
According to the Stroke Association, more people are surviving strokes in the UK than ever before, with 90% returning to live at home within six months and a quarter of these managing to live alone. With the right multi-disciplinary support, stroke survivors can make remarkable recoveries through physiotherapy, occupational therapy, and speech and language therapy, along with support from dieticians and specialist community nurses.
As the list of causes above demonstrates, each of these disciplines has a role to play in helping with post-stroke incontinence. As your mobility and dexterity increases through physiotherapy, so you will be able to get to the toilet easier, while occupational therapists can work with you to make it easier to get there and suggest clothing styles that are easier to remove, without buttons or other fastenings. Physiotherapists can also help with pelvic floor exercises to strengthen the muscles that control your bladder and bowel. Dieticians can help you change what you eat and drink to give you the best chance of regaining control.
Living with stroke-related incontinence
In many cases, your brain and body will slowly recover, and you will gradually find new ways of doing things that help you return to a normal bladder and bowel function. Unfortunately, for a small percentage of people, the incontinence will be permanent. In either case, there are a wide range of products available to support you and help you to manage incontinence as part of your daily life. With IncoDirect, you can have the products you need delivered discreetly direct to your door, which is ideal for those dealing with reduced mobility. These products are normally supplied free of charge via the NHS for stroke survivors and IncoDirect can deal with your GP directly for prescriptions. As a stroke survivor, you can also gain access to the RADAR National Key Scheme, giving you access to 9000 dedicated toilets for people with special needs.
More than 100,000 people suffer from a stroke in the UK every year, but those numbers are in decline with 19% fewer strokes in 2010 compared to 1990. As stroke numbers decrease and stroke support services and associated products improve, the outlook for stroke victims is getting better all the time.