Continence care: your options for better bladder and bowel health

Continence issues are common and there is support to help you manage them. Many people find that with the right advice and treatment their symptoms improve. If you or someone you support is experiencing leaks, urgency or changes in bladder or bowel control, help is available. You do not have to manage this alone, and getting the right support can make a real difference to comfort and confidence.

Understanding and diagnosing incontinence

Urinary and bowel incontinence can have different causes. Understanding the type of incontinence you have helps determine the right treatment.

Urinary incontinence

Urinary incontinence may take several forms:

• stress incontinence (leaking when coughing, laughing or exercising)
• urge incontinence (a sudden, strong need to pass urine)
• overflow incontinence (where the bladder does not empty fully)
• mixed incontinence (a combination of symptoms)

A GP may suggest keeping a bladder diary to track how often you use the toilet, what you drink and when leaks occur. They may check for infection or other causes and refer you to a continence service if you need further assessment.

NHS guidance explains the causes, tests and types in more detail. Learn more at https://www.nhs.uk/conditions/urinary-incontinence/diagnosis.

Bowel incontinence

Bowel incontinence can involve leakage, urgency or difficulty fully emptying the bowels. A GP assessment may include a physical examination, tests for infection or referral for specialist investigations if needed.

NHS guidance explains symptoms, causes and assessment:

Find out more about bowel incontinence
 

Where to get help

Speak with your GP

Your GP is a good first step if you have concerns about bladder or bowel health. They can talk with you about symptoms, check for infections and offer early advice. If you need more specialised support, they can refer you to a local continence service.

Continence services in North Yorkshire

Local continence teams include specialist nurses and therapists who can offer fuller assessments and support. They can help you understand symptoms, explore treatment options and find products that suit your needs.

These NHS providers offer bladder and bowel services for people:

• York and Scarborough Teaching Hospitals NHS Foundation Trust
• Harrogate and District NHS Foundation Trust
• South Tees Hospitals NHS Foundation Trust (Hambleton and Richmondshire)
• Bradford District Care NHS Foundation Trust (also covers Craven)

Support for children and young people

If a child or young person needs help, your GP or school nurse can offer guidance and refer you to appropriate services. ERIC, the children’s continence charity, offers trusted guidance for children, young people and families. Learn more at https://eric.org.uk.

Treatment and management options

Lifestyle and daily routines

Simple changes such as adjusting how much you drink, reviewing your diet or creating regular toilet routines can help improve bladder and bowel health. Continence teams and physiotherapists can guide you through these steps.

Medication and clinical treatments

If lifestyle changes, bladder or bowel training and continence products are not enough on their own, your GP or continence specialist may recommend clinical treatments. The options depend on the type of incontinence you have and what is causing your symptoms.

Medication

Medication may be used to

• relax the bladder
• reduce urgency and frequency
• improve bladder capacity
• support bowel function
• help manage stool consistency

Your GP or specialist will explain how the medicine works, how long it may take to notice changes and any possible side effects. You may need to try more than one medicine to find the one that works best for you.

Targeted bladder and bowel treatments

Some people benefit from treatments that directly support bladder or bowel control. These may include

• pelvic health physiotherapy
• biofeedback therapy
• electrical stimulation to strengthen muscles or improve nerve signals
• bowel retraining programmes
• specialist interventions to help the bowel empty more fully

These treatments are usually provided through continence services or pelvic health teams.

Injections and advanced therapies

If other treatments have not helped, a specialist may discuss additional options such as

• bladder injections to reduce overactivity
• nerve stimulation treatments to improve bladder or bowel control

These options are only offered after careful assessment and discussion.

Continence products

A wide range of products is available to support comfort and daily living, including pads, pants, bed protection, skincare products and toileting aids. Continence services can recommend suitable options. Many products can also be bought privately if preferred.

You can visit the website of the independent product advice for advice at https://www.continenceproductadvisor.org.

Guidance on storing and disposing of continence products safely and discreetly can be found at https://www.continenceproductadvisor.org/storageanddisposal

Surgical options

Surgery is usually considered when other treatments have not helped or are not suitable. The type of surgery offered will depend on whether you have urinary or bowel incontinence and the underlying cause. A specialist will explain the benefits, risks and any alternative treatments so you can make an informed decision.

Visit the NHS website guidance on urinary incontinence treatment or bowel incontinence treatment.

Support in different situations

Care homes and care at home

People living in care homes or receiving care at home should receive the same standard of continence support as anyone else. Good continence care in these settings includes regular support with toileting, including prompts and assisted visits access to suitable continence products in the right size and absorbency level care plans that take account of personal routines and dignity
skin care to prevent soreness or infection good hydration and nutrition privacy during toileting and personal care respectful conversations about changes in needs

Families and carers can ask how continence needs are assessed, recorded and monitored, and how staff will respond if needs change.

Living with a stoma or urinary diversion

People living with a stoma or urinary diversion may need support with daily routines, changes to the stoma, leakage, equipment choice or confidence when away from home.

Hospital stoma nurses can offer tailored advice, product recommendations and regular follow up care.

Visit the Urostomy Association website for more information and advice.

Support for carers

Caring for someone with continence needs can be physically and emotionally demanding. Carers may support with toileting, laundry, product choices, skin care and conversations that feel sensitive or personal.

Helpful support for carers can include learning how to help someone use products safely and comfortably protecting their own posture and reducing strain during personal care knowing when and how to seek professional advice being included in continence assessments and care planning reliable emotional support when feeling stressed or overwhelmed

For advice, visit the Carers UK website or contact MIND, the mental health support charity.

Good continence care protects dignity, independence and quality of life. You are not alone, and support is available. If you are unsure where to start, begin by speaking with your GP or by exploring local and national services.

Practical next steps

• speak with your GP
• ask about referral to your local continence service or check for self referral
• keep a bladder or bowel diary to track symptoms
• seek advice from trusted charities
• if you are a carer, look after your own wellbeing as well as the person you support and seek support from an organisation like Carers Plus or Carers Resource.