Incontinence Advice
Parkinson’s and Incontinence: Managing Bladder and Bowel Problems
There has been a notable correlation between Parkinson's disease and incontinence. Parkinson's mainly affects motor functions in the body and can therefore cause incontinence. In this article, you will learn about the parallels between Parkinson’s and incontinence, as we highlight the association with urinary and bowel incontinence alongside the condition. We will explore the underlying causes, symptoms, ways of managing the condition, and treatment options.
What Is Parkinson's Disease
Parkinson's disease is a complex condition that extends beyond its well-known impact on movement, such as tremors and stiffness. It also encompasses a range of non-motor symptoms, significantly affecting the autonomic nervous system. This system is responsible for regulating involuntary bodily functions like heart rate, blood pressure, and the operations of the gastrointestinal and urinary systems.
Parkinsons and Incontinence Managing Bladder and Bowel Problems
Symptoms of Parkinsons Disease
Parkinson's disease can cause a wide variety of symptoms, and the ones that affect mobility are often the most recognisable. These common symptoms are known as motor symptoms and include:
Involuntary shaking of certain parts of the body (tremors)
Stiff and inflexible muscles (rigidity)
Slowness of movement, sometimes described as a ‘shuffle'
Parkinson’s disease can also cause a variety of what are known as non-motor symptoms; these are symptoms that are not associated with mobility. They can also significantly affect quality of life. Common non-motor symptoms include:
Bladder and bowel incontinence
Eating and swallowing difficulties
Visual disturbances, such as blurred or double vision
Fatigue and energy depletion
Muscle cramps and discomfort
Challenges with speech and communication
Parkinson's Disease and Incontinence
Parkinson's disease can impair the brain's ability to control muscle movements, which can therefore lead to difficulty controlling the muscles surrounding the bladder and bowels. Not everyone with Parkinson’s will develop incontinence, but bladder and bowel disorders are more common in people of the same age with Parkinson’s than those without.
Urinary Incontinence
Parkinson’s disease can cause difficulties with both urine storage and release.
Key urinary symptoms include:
Urge Incontinence: The need to urinate frequently
Nocturnal enuresis: A frequent need to urinate at night
Nighttime can be particularly challenging, due to frequent waking up to urinate. Those with Parkinson's may face frequent urges to urinate along with the involuntary release of urine. This is compounded by mobility challenges that make it difficult to get to a toilet. In some cases, dystonia (involuntary muscle contractions) can affect people with Parkinson’s, further complicating the situation.
If you or someone you care for is experiencing unexpected bed wetting in the night, MoliCare recommends trying a incontinence bed sheets or water resistant mattress protector for an added layer of protection.
Learn more about Urinary Incontinence in our detailed guide.
Bowel Incontinence
As Parkinson’s disease can impair the brain's ability to control muscle movements, this can also lead to difficulty controlling the muscles surrounding the bowel. Bowel incontinence is usually only seen in advanced Parkinson's disease. It can be a distressing symptom and profoundly affect the dignity and quality of life for those with the condition. Bowel incontinence may arise due to various factors, but can be managed using various techniques and bowel incontinence pads. In some cases, it can be due to complications unrelated to Parkinson’s disease. However, within the context of Parkinson’s disease, the following scenarios are common:
Constipation: Constipation is a common issue and can lead to severe abdominal pain. It requires active management to prevent complications like bowel obstruction, a potentially life-threatening condition necessitating urgent medical intervention.
Constipation-induced incontinence: Severe constipation can also lead to faecal impaction, where hard stool blocks the bowel. This blockage can force softer stool to leak around the impacted faece.
Gastroparesis: This is a long-term condition where food passes through the stomach slower than it should. Symptoms include nausea, fullness, and pain. Gastroparesis can delay the movement of medication from the stomach to the small intestine, affecting drug efficacy and potentially causing 'off' periods where symptoms return or worsen. Managing gastroparesis [1] involves dietary adjustments, such as eating smaller, more frequent meals and avoiding high-fat foods.
Neurogenic incontinence: Parkinson’s disease can impair the nerve function controlling the anal sphincter, leading to involuntary stool release.
In advanced Parkinson’s disease, these gastrointestinal issues are intertwined with the motor symptoms of the condition, making it harder to get to a toilet. Effective management requires a holistic approach, addressing both the symptoms and the underlying causes. Carers and healthcare professionals must be vigilant in monitoring these symptoms and implementing appropriate interventions to enhance the wellbeing and comfort of those affected.
Consult a healthcare professional
Due to the complex nature of Parkinson’s disease, managing the condition requires a professional approach that may include medical, surgical, and/or lifestyle interventions. Tailored treatments and regular consultations with healthcare professionals can significantly improve quality of life, allowing individuals to manage symptoms effectively to maintain their dignity and wellbeing.
Seeing a physiotherapist is often recommended as they can provide tailored exercises to help maintain mobility and functionality. They can also offer advice about pelvic floor exercises.
Medication and specialist consultation
There are various medications that can help manage the main symptoms of Parkinson’s disease, such as shaking (tremors), and movement problems. Medication can also be recommended for other common symptoms associated with the condition such as urinary problems and constipation, for example, laxatives can be used to regulate bowel movements.
As medication can improve the speed and coordination of movement or lessen a tremor, it can lead to increased mobility making it easier to physically get to the toilet. This can lead to a reduction in episodes of incontinence as people are more likely to reach the toilet in time.
Dietary considerations and routine
Maintaining a balanced diet rich in fibre and fluids is vital for bowel health, helping to prevent constipation and regulate bowel movements. Limiting irritants like caffeine, carbonated drinks, and alcohol can also alleviate bladder irritation. Establishing a routine for toileting, especially after meals, and regulating fluid intake can significantly reduce episodes of incontinence.
To manage bowel incontinence, dietary adjustments are crucial. High-fat and low-fibre diets should be avoided, as they can worsen stool consistency. A daily fibre supplement and maintaining a food diary can help manage bowel movements. Pelvic floor exercises and the use of appropriate incontinence products are also beneficial for managing symptoms.
Read our guidance, which focuses on foods that irritate the bladder and bowels, as well as bladder cleansing foods, for further details about what to eat and drink (and what not to eat and drink) to alleviate incontinence symptoms.
Adaptations And Continence Products
As people with Parkinson’s disease can struggle with mobility, adaptations to get to the toilet easily can greatly reduce episodes of incontinence and improve quality of life. Adaptations such as easy-to-remove clothing and modifications to the home environment like handrails and accessible toilet equipment can greatly assist those with Parkinson's in managing incontinence and enhancing independence and safety.
Continence products and protective bedding can also help to manage incontinence, as they can assist in maintaining hygiene, and improving comfort. For nighttime, use these mobile pants 8 drops.
Indwelling Catheterisation
A catheter may be recommended by a healthcare professional if other treatments, such as pelvic floor exercises and medication, have not improved continence or are not appropriate. This involves the insertion of a catheter through the urethra into the bladder, allowing urine to drain into a bag or through a valve. Catheters can be used for short or long periods of time. Regular replacement of the catheter, typically every few weeks, is essential to prevent infections and maintain hygiene.
Surgical Solutions
Suprapubic catheterisation is a long-term solution for managing urinary incontinence. This surgical procedure involves placing a catheter directly into the bladder through the abdomen, providing an alternative urine drainage route. Like the indwelling catheter, it connects to a drainage system and requires regular monitoring and care.
To keep yourself comfortable when managing the condition, find the ideal products from HARTMANN Direct UK. Remember to subscribe to our mailing list to receive exclusive offers and articles direct to your email.
FAQs
In what stage of Parkinson's disease does incontinence start?
Incontinence typically starts in the later stages of Parkinson's disease. Motor symptoms often worsen as the disease progresses, affecting the control of bladder functions.
What are the signs that Parkinson's disease is getting worse?
These include increased severity and frequency of tremors, rigidity, and bradykinesia (slowness of movement), greater difficulty with balance, changes in speech and writing, more pronounced cognitive decline, and increased difficulties with activities of daily living.
How do you manage incontinence with Parkinson's disease?
This can involve pelvic floor exercises, bladder training, scheduled toileting, medication to control bladder function, and using absorbent products or devices. Consulting a healthcare provider for individualised management is also important.
Does Parkinson's disease affect your bladder?
Yes, Parkinson's can affect the bladder, leading to issues such as overactive bladder, urgency, frequency, nocturia (frequent nighttime urination), and difficulty emptying the bladder fully, contributing to incontinence.
What causes Parkinson’s disease?
It's important to consider the recent update about pesticides which are now linked to Parkinson’s disease risk[1]. Learn more now.
Sources
NHS. (n.d.) Parkinson’s Disease. [online] Available at: https://www.nhs.uk/conditions/parkinsons-disease/ [accessed 12/03/24]
Flynn, H., (2024) Another 3 common pesticides are now linked to Parkinson’s disease risk. Medical News Today. [online] Available at: https://www.medicalnewstoday.com/articles/another-3-common-pesticides-are-now-linked-to-parkinsons-disease-risk [accessed 12/03/24]
NHS. (n.d.) Gastroparesis. [online] Available at: https://www.nhs.uk/conditions/gastroparesis/ [accessed 12/03/24]
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