Incontinence refers to a lack of ability to control bladder and/or bowel movements. Incontinence affects 40 to 60 percent of patients admitted to a hospital after having a stroke.

The severity of post-stroke incontinence depends on the following factors.

• Severity of the stroke
• Age
• Diabetes
• Sensory loss
• Over-responsiveness (hyperreflexia) or under-responsiveness (hyporeflexia)

Symptoms

Incontinence will either be termed urinary incontinence, referring to bladder control, or fecal incontinence, referring to bowel control. Urinary incontinence is more common than fecal incontinence among stroke survivors. Both types of incontinence are characterized by involuntary leakage.

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Treatment

In many cases incontinence is overcome in a relatively short period after a stroke. This can happen as a natural part of the recovery process or as a result of treatment or therapy. Treatment options include:

• Medication
• Bladder and bowel training
• Surgery
• Use of a catheter
• Behavioral and physical therapies

Individualized strategies for overcoming incontinence can be determined by a healthcare professional conducting an evaluation. Early diagnosis and treatment are important to prevent possible complications such as urinary tract infections or skin breakdown.

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Management

Some people, particularly the elderly, live with chronic incontinence. In some cases, especially with fecal incontinence, modifying bowel habits, diet and fluid intake can minimize the number of dysfunctional bowel movements.

Bladder and bowel training can permanently improve incontinence and help manage chronic symptoms. Bladder and bowel training programs are usually customized to individual needs. The following are common training techniques and exercises.

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Additional Resources

Publications

Fact
Sheets

Multimedia

• National Institute of Diabetes and Digestive and Kidney Diseases Clearinghouses
• HOPE Guide

• Bladder & Bowel Function
• Healthy Eating

• iHOPE: Nutrition
• iHOPE: Navigating the Nutrition Facts Label and the Grocery Store

Download the Careliving Guide, a how-to resource designed to help caregivers and family members of stroke survivors navigate the post-stroke recovery journey.

Chapter 6: Managing Recovery

See page 38 for more information about incontinence.

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