Continence is your ability to control your bladder and bowels. It’s very common for people to have problems with this after a stroke, especially in the very early stages. 

Why do they happen?

There are a number of different reasons why you may have continence problems after a stroke. 
  • Your stroke may have damaged part of your brain that controls your bladder and bowels. 
  • If you’re not fully conscious or are very ill after your stroke, you may wet or soil yourself without realising it. 
  • If your stroke has affected your ability to walk you may not be able to get to the toilet in time. Communication problems may make it difficult for you to let others know that you need the toilet as well.
  • Changes to your diet and not being able to get about very much can cause constipation, which can lead to continence problems. 
  • If you had mild continence problems before your stroke, spending a lot of time in bed is likely to make them worse. 

What kind of problems do people have?

You may have problems with your bladder, bowels or both. If you have problems with both your bladder and bowels, this is known as double incontinence.
 
If you have continence problems it may mean that:
  • you need to go to the toilet more often 
  • your need to go may be sudden and you may not have time to get to the toilet
  • you wet yourself when you cough, sneeze or do something physical
  • you wet or soil yourself whilst you are sleeping
  • you wet or soil yourself at any time without realising it.

Do they get better?

Continence problems tend to be worst in the very early stages after stroke. 
 
They usually improve very quickly, and most people recover their control within the first few weeks. 
 
Only around 15% of stroke survivors will still have continence problems a year after their stroke. Even if you do continue to have longer term problems, there is still a lot that can be done to help you manage them.

Are there treatments that can help?

There are a number of treatments that can help with continence problems. 
 
Your stroke team will complete an assessment with you to determine exactly what kind of problems you’re having and what may be causing them. They will then be able to recommend the best treatments for you. They could include:
  • bladder training to gradually retrain your bladder to hold more urine. This can help to you need to go to the toilet less often and give you more warning when you do​
  • bowel training to learn how to delay bowel movements and improve your control over them
  • pelvic floor exercises can help to strengthen the muscles that support your bladder, giving you better control 
  • bladder stimulation uses vibrating devices to help you empty your bladder
  • medication can help to reduce the amount of urine your body produces or control the urge to go to the toilet. It can also help to reduce movement in your bowels and improve your control
  • treating constipation, as this can sometimes cause continence problems
  • making changes to your diet, as this can help to improve constipation or diarrhoea​
  • losing weight, as being overweight can affect your ability to control your bladder.

Find out more

Read our leaflet Continence problems after stroke for tips about living with longer term problems and how you can get support. 

 

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