Bowel and Bladder Retraining

Bowel and
Bladder Retraining

Bowel and Bladder Retraining: What to Expect

Incontinence can be embarrassing and depressing for patients and a challenge for caregivers because it involves the loss of bowel or bladder control. Unfortunately, it’s a common side effect for many seniors who experience a stroke, Alzheimer’s disease, dementia, multiple sclerosis, and other conditions. According to the Centers for Disease Control, more than half of seniors 65 and over experience bladder or bowel incontinence of some kind.There are many factors to consider when looking for help with this sensitive issue. Here are some of the most common concerns and solutions.

Incontinence can result from injury or illness, physical or neurological disabilities and, in some cases, poor overall health and diet. Gastrointestinal conditions like diarrhea and constipation can be factors in bowel incontinence as well.

Weakened bladder or bowel muscles are chief causes of incontinence. In cases of functional incontinence, another disability or neurological condition may prevent the patient from promptly getting to the toilet.

Some of the most successful treatments for incontinence include behavioral therapies, rebuilding bladder and bowel muscles, and occupational therapy. There are several proven techniques for helping most patients regain control over bowel and bladder function.

Setting a schedule for elimination is an effective way to treat incontinence. Many experts recommend keeping a journal as the first step in developing a healthy elimination routine. A journal, which can be kept by the patient or caregiver, involves recording all trips to the bathroom and keeping track of diet and liquids. Patients and caregivers can then work with a therapist to set a schedule for elimination, helping patients avoid emergencies by going to the toilet even when they may not have an urge.

Bladder retraining is another important technique in addressing incontinence. Bladder retraining involves delaying urination with the goal of redeveloping bladder muscles. Patients gradually extend the time between urination to rebuild bladder capacity and control.

Pelvic floor exercises and muscle rehabilitation are also options for helping patients rebuild bladder and bowel control. Using Kegel exercises that involve lifting the pelvic floor,  patients can rebuild muscles weakened by childbirth, illness or injury. However, therapies that focus on retraining pelvic floor muscles do require a certain level of cognitive ability.

According to the American Occupational Therapy Association, occupational therapists can play a major role in improving self-care skills that contribute to incontinence.

Occupational therapists (OTs) help patients manage clothing snags (buttons, zippers) that may prevent patients from reaching the toilet in time. OTs help patients with injuries or disabilities to develop ways to get to the bathroom, using special rails and other support systems.

OTs often work with patients with cognitive impairments to rebuild basic skills like remembering where the toilet is and listening to prompts from their bodies. Occupational therapists also help caregivers create toileting schedules for patients with dementia or cognitive disabilities.

Your therapist may also recommend necessary lifestyle changes that can make a difference in bladder and bowel control.

Changing the diet can have a positive impact in bladder and bowel control. In many cases, bowel incontinence may be the result of a low-fiber diet and inadequate water intake.  Making an effort to drink more water and eat high fiber foods can increase regularity and help patients set a schedule and regain control. Reducing or eliminating coffee and tea can help manage bladder incontinence as well.

In cooperation with your loved one’s physician, you and your therapist can review any medications that contribute to constipation, diarrhea or excessive urination. Making changes to a patient’s medication regime can positively affect elimination habits.

At Evergreen Health and Rehab, many of our clients offer living proof of the success of behavioral, occupational and physical therapies in helping treat incontinence. Our professional therapists are highly skilled at taking the stigma out of incontinence and helping caregivers adapt. With a few necessary steps, we can improve the quality of life of patients and caregivers.