What’s the difference between incontinence and continence?

In this article, we define the difference between incontinence and continence as well as explain the different types of incontinence, what you can do to prevent it, and how it can be managed.

 

What does the term continence mean?

The term ‘continence’ refers to the ability to control your bladder and/or your bowel.

What does the term incontinence mean?

‘Incontinence’ refers to the condition of not being able to control your bladder and/or bowel and hold back the loss of urine or faeces. More than 5 million Australians have some form of incontinence. More than 60% of women will be affected sometime during their lives, while about 30% of men will be affected. Incontinence is more common in women during and after pregnancy or as they get older.

Types of incontinence

There are two main types of incontinence — urinary incontinence (of which there are four types) and faecal incontinence.

Urinary incontinence

Urinary incontinence refers to the loss of bladder control which is a common but embarrassing problem. There are four types of urinary incontinence:

Stress incontinence — This is where small amounts of urine leak when pressure is exerted on the bladder. This often occurs when coughing, sneezing, laughing, exercising (i.e. running or jumping) or lifting something heavy. Stress incontinence is common in women after childbirth or menopause and may also occur in people with diabetes, a chronic cough, constipation or obesity.

Urge incontinence — This is characterised by a sudden, urgent need to urinate followed by involuntary loss of urine. People with this kind of incontinence often feel as if their bladder is fuller than it really is. It is sometimes referred to as an unstable or overactive bladder. Urge incontinence usually gets worse with age. It has also been linked to stroke, Parkinson’s disease, multiple sclerosis and other neurological conditions.

Overflow incontinence — This occurs because the bladder doesn’t empty properly. As a result, it continues to leak small amounts of urine. This type of urinary incontinence is linked to diabetes, multiple sclerosis, stroke and Parkinson’s disease. It may also be caused by a blockage in the urethra, enlarged prostate, prolapse or nerve damage.

Functional incontinence — This relates to a person’s inability to go to the toilet due to a physical or intellectual disability, or a condition that prevents you from getting to the toilet quickly enough (e.g. arthritis).

It’s also possible to have mixed urinary incontinence, which is often a combination of stress incontinence and urge incontinence.

 

Faecal incontinence

Faecal incontinence refers to poor bowel control which results in people emptying their bowels (either fully or partially) at the wrong time or in the wrong place. It often occurs temporarily during a bout of diarrhoea related to a gastrointestinal illness. However, some people have chronic fecal incontinence which may be caused by the following:

  • Damage to the muscles around the anal sphincter which makes it hard to hold stool bac. This may occur during childbirth.
  • Nerve damage that controls the anal sphincter. This can be caused by childbirth, constantly straining when having a bowel movement, stroke or spinal cord injury. Diseases that affect nerves such as diabetes and multiple sclerosis may also contribute.
  • Sometimes a hard mass of faeces impacted in the bowel can become too large to pass. This causes the rectum to stretch causing watery stool to leak out.
  • Medications
  • Prostate cancer treatment
  • Dementia
  • Other health conditions that can affect bowel control such as bowel cancer, such as Crohn’s disease, colitis, diverticulitis, haemorrhoids, and irritable bowel syndrome.

Preventing incontinence

For some people, it may not be possible to prevent incontinence. However, there are a number of lifestyle measures that can make a difference. Practicing good toilet habits is one of them. This involves:

  • only going to the toilet when your bladder is full
  • going to the toilet when you have an urge to pass a bowel motion, as hanging on can lead to constipation
  • allowing enough time to go to the toilet so you don’t rush and strain
  • using correct posture on the toilet (foot on a stool, elbows on your knees, straighten your back and bulge your stomach)
  • only using laxatives as a short-term measure and treating constipation with other lifestyle measures instead.

Other things that you can do to promote good bowel and bladder function include:

  • drinking plenty of fluids
  • eating a high-fibre diet
  • getting regular exercise where possible
  • maintaining a healthy weight
  • avoiding smoking
  • treating urinary tract infections (UTIs) promptly
  • seeking medical advice to treat constipation.

Managing incontinence

Some people may not be able to prevent incontinence and may need to learn to manage their condition. Fortunately, there is a lot of support available.

Continence Products 

Some people may need to manage their incontinence issues with continence products, like continence pads. These products (designed for men, women and children) help manage the symptoms of poor bladder and bowel control and provide confidence for the person with incontinence. There are a range of different continence products to suit different needs which include:

  • absorbent pads and pants (either reusable or disposable)
  • absorbent bed pads and chair pads
  • urinary penile sheath for men
  • catheters, which can be used short-term and long-term. These are usually only used if necessary and if prescribed by a doctor or specialist.

Bedpans, female and male urinals, and commode chairs can also be helpful in managing toileting issues.

Continence Resources

Having bowel and bladder control problems can be challenging but there is a lot of support available. Our Online Incontinence Guide has a wealth of information about managing, understanding and living with incontinence, and where to go for help.

NDIS Financial Assistance 

Continence products can be costly, especially if you need to use them on a long-term or permanent basis. However, if you have a permanent or significant disability which contributes to your incontinence, you may be eligible for funding through the National Disability Insurance Scheme (NDIS). You can find out more information here.

Other financial assistance

There are also a number of other National Funding Schemes to help support people with incontinence. These include:

  • Continence Aids Payment Scheme (CAPS)
  • Rehabilitation Appliances Program (DVA RAP)
  • National Epidermolysis Bullosa Dressing Scheme (NEBDS)

Each scheme has different eligibility criteria and funding allocations and you may be eligible to apply for assistance through several schemes. More detail can be found here.

 

While having incontinence issues may feel overwhelming, you can regain your confidence so you can participate in your daily activities, without feeling worried or embarrassed.

Looking for more continence health advice?

Check out our wide range of health articles, support resources and information.

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