People with diabetes commonly experience problems with controlling their bladder and bowel. This can involve accidental leakage, incomplete emptying, passing urine frequently (frequency) or feeling the need to rush to the toilet (urgency).
There are four main ways that diabetes may cause problems with bladder and bowel control:
Obesity: This is a key factor in people developing Type 2 (non-insulin dependant) diabetes and it is also a major risk factor for developing incontinence. The pelvic floor muscles support most of your body weight. Any excess weight further strains these muscles, weakening them. Weak pelvic floor muscles do not support the bladder and bowel as it should. If this happens you may notice leakage when coughing and sneezing (also known as stress incontinence) or the need to frequently or urgently visit the toilet.
Nerve damage: Poorly controlled or long-term diabetes may cause damage to the nerves, (neuropathy) and commonly occurs in the feet. Similarly, it may affect the bladder and bowel. Nerve damage to the bladder and bowel causes loss of sensation so there may be little warning of needing to go to the toilet or lack of awareness of the bladder filling. The bladder and bowel may not empty well, increasing the risk of developing urinary tract infections, kidney damage or constipation.
Reduced immunity - Diabetes interferes with the immune system increasing the risk to infections. A common infection experienced by people with diabetes is urinary tract infection (UTI). It is the combination of the immune system changes and the poor bladder emptying that causes these infections and often they keep reoccurring. Treatment includes antibiotics and strategies to promote bladder emptying. In addition personal hygiene is particularly important and all women should wipe from front to back to avoid transferring bowel bacteria to the vagina. Cranberry juice (drink or capsules) may help prevent urinary tract infections
Medication - the medications used to control Type 2diabetes may cause loose bowel actions (diarrhoea). The combination of weak pelvic floor muscles and loose bowel actions may cause bowel incontinence. If these problems are experienced talk to the doctor or diabetes nurse or dietician. Soluble fibre can help firm up the diarrhoea and slow down the bowel motions. Sources of soluble fibre are oats, barley, rye, peeled fruit and vegetables.
Keeping your diabetes well-controlled is the best way to prevent nerve damage or further damage happening.
There are five things you can do to regain control of your bladder or bowel:
For more information, download the Diabetes and bladder and bowel control fact sheet.
Phone National Continence Helpline 1800 33 00 66 – continence nurse advisors provide information about bowel and bladder function, products and local continence clinics.
Visit Diabetes Australia website or phone the Diabetes Infoline on 1300 136 588