Emotional Concerns - Managing Urinary Incontinence: Bladder Conditions

Preventing urinary or fecal incontinence

Not all incontinence is avoidable. But there are some lifestyle choices you can make that reduce the risk of developing either urinary or fecal incontinence.

Don't smoke. Smoking nearly doubles the likelihood that a woman will develop stress incontinence, perhaps because it can lead to frequent and violent coughing. Compared with other incontinent women, female smokers develop incontinence at a younger age, despite having relatively stronger sphincter muscles. Nicotine has also been linked to urge incontinence. In studies involving men, current or former smoking is associated with several bothersome urinary symptoms, including urge incontinence, but the increase in risk (about 39%) is not as striking as that for stress incontinence in women.

Maintain a healthy weight. Particularly for women, obesity is linked with incontinence. Women with a higher body mass index (BMI) are more likely to become incontinent. In people with obesity, the pelvic floor muscles must support excess abdominal fat as well as the pelvic organs, which can lead to stress incontinence. In addition, obesity may place pressure on the bladder and interfere with its blood and nerve supply. Weight loss can sometimes improve incontinence without other treatment.

A connection between obesity and urinary incontinence is less well-documented in men. However, in some surveys, obese men report more urinary tract symptoms, including urgency and nocturia. In the large Health Professionals Follow-up Study, men with large amounts of abdominal fat (waist measurements of 43 inches or more) were twice as likely to have urinary tract symptoms and to require surgery for an enlarged prostate (a procedure that sometimes results in incontinence) than were men carrying less abdominal fat (waist circumference less than 35 inches).

For men as well as women, many surgeries to counter incontinence are less successful in those who are obese.

Don't ignore the call. When you get your body's signal that the rectum is full, it's normal to wait until you can conveniently reach a bathroom. But when you routinely put off having a bowel movement as long as possible, it can lead to constipation and ultimately to urinary or fecal incontinence.

Don't strain with bowel movements. Years of forcing can weaken a man's or a woman's pelvic floor muscles. Even when you have regular bowel movements, if your stools are frequently hard or take considerable effort to pass, you have constipation and could benefit from medical advice. In a study involving people age 65 and older, treating constipation improved a variety of urinary symptoms, including frequency, urgency, and burning. Increasing the fiber in your diet and drinking adequate fluids can help prevent constipation.

Minimize bladder irritants. Several foods have been linked to urge incontinence, at least in some people. Caffeine and alcohol are diuretics that result in rapid filling of the bladder and a powerful urge to urinate, even when the bladder is not full. Carbonated drinks, the artificial sweetener aspartame (NutraSweet), spicy foods, and citrus fruits and juices cause urgency in some people.

Consider incontinence when making medical decisions. When you are considering any type of pelvic or abdominal surgery, such as a hysterectomy or prostate removal, ask about the risk for subsequent incontinence for the proposed procedure and its alternatives. For example, prostate removal may result in urinary stress incontinence (an estimated 14% of men still have frequent urine leakage five years after the procedure), but alternative treatment with radiation seed therapy may cause urge incontinence, and external beam radiation can lead to bowel problems including fecal incontinence. When a medication is prescribed, inquire about incontinence as a possible side effect and whether alternatives are available if symptoms occur.