Faecal incontinence (FI) is any bowel (poo) leakage, also known as ‘soiling’ or poor bowel control. About one in twenty Australians experience faecal incontinence, including thousands of young people. There are various causes for poor bowel control, and although it can be uncomfortable there are many ways to treat and manage the condition.

There are lots of causes for poor bowel control, including chronic constipation, problems with your pelvic floor muscles or underlying bowel diseases.

Constipation
Constipation is the term for when your bowel doesn’t empty well. Sometimes your bowel motions (faeces/stool/poo) are less frequent, and sometimes you can have trouble going to the toilet because your bowel motions might be too hard and dry.

Severe constipation is the most common cause of faecal incontinence. This is because hard bowel motions may cause a small blockage high up the bowel, making watery bowel motions flow around the constipated stool (poo/faeces) without warning. A constipated bowel can also put pressure on the bladder and make urinary incontinence worse.

Other causes
There are many other bowel diseases and conditions which contribute to faecal incontinence, like Crohn’s, Coeliac, ulcerative colitis and irritable bowel syndrome. Sometimes neurological (brain) or spinal disorders or injuries can affect bowel health too.

Treatments
If the doctor thinks constipation might be causing faecal incontinence, then a combination of laxatives (a type of medication that makes going to the toilet easier) and a toileting regime and dietary advice will often make up the treatment plan.

Treatments and management plans are different for everyone so it’s important to talk to your doctor to work out what’s best for you.

Nocturnal Enuresis (NE) is the medical name for bedwetting. It’s very common in children and continues to be an issue for many people as they get older. There are a few different causes and lots of different treatments that can help you stay dry at night.

What causes bedwetting?

The three main causes are:

• Not being able to wake up when you feel like you need to go to the toilet
• When the bladder becomes overactive at night and cannot store urine (wee)
• When the kidneys make a large amount of urine at night and the bladder has trouble holding it

Bedwetting is NOT caused by:

• being young for your age
• laziness
• bad behaviour
• drinking after dinner

Treatments
See your doctor before trying any of these treatments at home.
Depending on your situation, there are lots of treatments that can help with bedwetting. A few are:

• Bedwetting alarms that work by waking you up when they notice moisture
• Medications that assist with producing less urine at night
• Training programs that help the bladder to store more urine

Alarms and medications should only be used with the support and guidance of a doctor or health professional, so talk to a doctor if you’d like to find out more. Research tells us that you have a better chance at succeeding if you use an alarm program with the support from a health professional. Some continence products like mattress protectors and specially designed bedwetting pants are also helpful.

Daytime urinary incontinence (DUI) is any bladder (wee) leakage that happens while you’re awake. It’s sometimes also called daytime wetting. It’s a very common condition across Australia and around the world, and can be caused by lots of different things.

Daytime urinary incontinence (DUI) is experienced by many young people, and up to 1 in 4 adults too. Here’s some reasons why it happens.

Pelvic Floor problems

The pelvic floor is the group of muscles that support your bladder and bowels. Learning to use and control your pelvic floor is often an important part of treating urinary (wee) incontinence. Sometimes people need to do pelvic floor exercises, which a doctor or continence physio helps with.
You can learn more about the pelvic floor here.
Or to learn more about the female pelvic floor in teenage girls, visit Go Against the Flow.

Overactive bladder
The bladder is a muscle which squeezes (or contracts) to empty itself when it’s full. An overactive bladder means the bladder squeezes before it’s full. It can sometimes do this when you’re not ready. You might go to the toilet often, feel the urge to go very suddenly and find it hard to hold on until you get to a toilet. There are bladder training techniques and some medications that can help with DUI caused by an overactive bladder, but it’s important to discuss any treatments with your doctor.

Other causes
There are lots of other causes of DUI so it’s important to talk to a doctor if you’re not already in treatment or want to know more.

There are various products use can use to help you with managing incontinence, like:

• continence pads
• continence pants
• mattress protectors
• products for skin care
• products for odour control

Pads can be disposable (single use only) or reusable (can be washed and used again). You should be able to buy disposable pads at most supermarkets and pharmacies.

Check out more info from us on continence products or or call the National Continence Helpline on 1800 33 00 66.

What’s mental health?
The term ‘mental health’ is sometimes associated with certain conditions such as anxiety or depression, but it really just refers to how you feel in your everyday life.

Good mental health can mean:

• being able to work and study to your full potential
• coping with the stress of everyday life
• being involved in your community
• feeling like you can live life in a free and satisfying way.

How’s my mental health?
If incontinence making you feel down or anxious, or stressing you out a lot of the time, it’s best to talk to someone about it. Bringing it up with your doctor, parents or a trusted adult, a teacher or school counsellor can be good places to start.

Where to go for help
There are lots of ways you can get support for mental health. The best place to start is to talk to someone you trust, like your parents/guardians, a doctor or other health professional.

You can also check out these great websites:

• ReachOut
• headspace
• Youthbeyondblue

Remember: you’re not alone. There is always someone who can help.

Dating can be exciting, awkward and even a little intimidating. It can be even more daunting if you experience incontinence though.

If you feel comfortable, it can be good to talk to the person you’re dating about incontinence, especially if things are starting to get serious. As with any medical condition, your expectation should be that the important people in your life (including your partner) are understanding, supportive, and positive. This is not always the way it goes, but it helps to be open and honest about any issues.

ReachOut has some more great advice on healthy relationships, dating and intimacy.

Your GP (Doctor)
Your GP (General Practitioner) is the doctor you or your family regularly sees. They should be the first health professional you talk to about any bladder or bowel issues you’re having. They can help you manage or treat your problems, and can also introduce you to other health professionals if they need to.
If you’re not happy with your GP or think they don’t really understand your issues, ask them to put you in touch with another doctor or health professional, or talk to your parents or other trusted adults about trying a different doctor.

Nurse Continence Specialist
If you don’t want to go to the doctor to talk about incontinence but you’d still like to chat with a health professional, you can call the National Helpline (8am-8pm Monday to Friday) on 1800 33 00 66 and speak to a Nurse Continence Specialist.
Nurse Continence Specialist are specially trained in bladder and bowel health. They’re experts and can give you all the information you need about incontinence.
Specialist (Doctor)
Depending on what is causing your incontinence, your doctor may put you in touch with another specialist, like a urologist or urogynaecologist (for bladder issues), or gastroenterologist (for bowel issues).

Continence Physiotherapist (Pelvic Floor)
Physiotherapists (‘physio’ for short) are health professionals that are experts in everything to do with muscles. A continence physio is trained to assess incontinence and specialises in the muscles around the bladder and bowel. These are known as the pelvic floor muscles. If incontinence is being caused by something to do with your pelvic floor muscles, your doctor might recommend you see a continence physio.

Psychologist
Incontinence can have negative impacts on our mental health as well as our physical health. If you’re struggling with your mental health, it’s important to talk to your GP about this. They might want to put you in touch with a psychologist who is specially trained to give you the right mental health support.

Specialised Continence Clinics
There are some clinics that are experts in treating incontinence. They have several health professionals all working together in the same place. These clinics can be very good when it comes to treating bladder and bowel control issues, but there aren’t a lot around and they often have long waiting lists. It’s still a good idea to talk to your doctor or a trusted adult if you think a specialist clinic might be helpful for you.

Building confidence
It isn’t always easy, but things like challenging negative self-talk and learning to appreciate your achievements can help make you feel more confident.

Take a look at ReachOut’s great tips for improving your confidence, especially for things like handling nervous situations and building self-esteem.

Going out
Be prepared, be comfortable and be confident. It’s a lot easier to enjoy yourself when you’re out and about or over at a friend’s place if you feel ready for any accidents that might occur.

Tips to better prepare when heading out

• Don’t blame yourself! It’s not your fault if you do experience incontinence in a public place or anywhere else. If you did happen to have an accident, just clean yourself up and try your best to continue having fun with your friends.
• Bring appropriate supplies like pads, a change of underwear, a disposal bag or whatever you think you need to make yourself feel as comfortable as possible when you’re hanging out or going to events.
• Practise what you might say to people if you do have to go to the bathroom more frequently than others or if they ask about your supplies.
• Have a support person (or support people) – whether that’s a parent or a friend that you’ve confided in. It can make life a lot easier if you know there is someone that has got your back in any situation.

Bullying
When people don’t understand something properly, sometimes this can play out as teasing or bullying. Sadly this can happen with bladder and bowel control issues. It’s important to remember that bullying is never OK, and that there are people you can reach out to if you need support. Here’s some advice for dealing with bullying situations.

Persisting with treatments can be hard. You might wonder if you’re the only person your age having to go through this, but it’s really important to never give up.

if you have tried treatments before and they haven’t helped, you can’t always rule them out. Your brain, bladder and bowel all change as you grow so sometimes treatments can become more effective over time.

if it takes a long time, treatment can help make things so much better. It can help improve your bladder and bowel control and help you be more confident when going out and doing the things you want to. It can even help lessen the chances of it happening altogether.

Breaking down the barriers
The benefits of staying on top of your treatment can be life changing. But, like most things in life, there are always pros and cons. Sticking to your treatment involves commitment, hard work and can sometimes make you feel like you’re missing out on things. It’s always your choice whether you want to stick with your treatment plan or not, but there are almost always benefits to sticking with it. Even if it takes a while to reach your treatment goals. Check out some more tips from us on staying motivated.

Sport
There are some activities that can increase your chances of experiencing incontinence. You might need to think about which sports you enjoy and which sports are right for you.
Being worried about having an accident while playing sport can make you feel like you don’t want to have a go, but being active is an important part of being healthy. It’s also a great way to meet new people and have some fun.
You should speak to your doctor about the best ways for you to manage incontinence while being active, but here’s a few helpful strategies to think about:

• Try and go to the toilet before you start to play
• Tailor your fluid intake around exercise
• If you take medication, take some before exercise
• Try some continence products

Sleepovers and school camps
Staying the night at a friend’s place or school camp can be the first time you’re away from your parents and having to deal with incontinence experiences on your own. Here’s some tips to help you feel more confident when you’re staying away from home:

• Have a trusted teacher or friend’s parent that is aware of your issue as your go-to support person.
• Practise being as independent as possible at home when it comes to things like cleaning yourself up and throwing away used continence products.
• Bring your supplies – things like pads, liners, a disposal bag or whatever you think you need to make yourself feel as comfortable as possible.
• Prepare for how you would deal with an incontinence episode during a sleepover or school camp. Think about where the bathrooms are, practise how you would dispose your used continence products in a more private way or how you might let your support person know if you need a hand.