Toilet Training for Adults
Adult incontinence is a life-altering and distressing condition. Some individuals are hesitant to seek help due to the embarrassing nature of the problem. However, toilet training and other treatments are available, and people experiencing this problem should seek medical advice.
According to the National Digestive Diseases Information Clearinghouse, an estimated 5.5 million Americans suffer from fecal incontinence. The U.S. Department of Health and Human Services states that 10 percent to 40 percent of women have experienced urinary incontinence at some point in their lives, and approximately 2 percent of adults suffer from chronic nocturnal incontinence--adult bed-wetting 12.
According to the National Kidney and Urologic Diseases Information Clearinghouse, three types of urinary incontinence exist: stress, urge and overflow incontinence 12. Stress incontinence is involuntary urine output when pressure is placed on the abdomen, such as when a person coughs. Urge incontinence is experienced when the urge to urinate cannot be voluntarily controlled, and overflow incontinence is the constant dribbling of small amounts of urine. According to Mayo Clinic urologist Erik Castle, M.D., some reasons for these conditions include:
- urinary tract infections or stones
- cancers of the bladder or prostrate
- obstructive sleep apnea
- in rare cases
- neurological disorders 1
The National Digestive Diseases Information Clearinghouse states that fecal incontinence most commonly affects women and older adults, but it is not a normal part of the aging process. According to the Mayo Clinic, fecal incontinence can be caused by a number of conditions including muscle damage to the anal sphincter, nerve damage, rectal cancer, or loss of accommodation--muscle damage to the rectum affecting its ability to stretch 1. Hemorrhoids can also result in fecal incontinence if they interfere with the complete closure of the anal sphincter. Incontinence is also associated with dementia and Alzheimer's disease. When the condition progresses to a certain point, a patient can "forget" the toilet training learned in early childhood and incontinence occurs.
According to WebMD, bladder retraining focuses on a schedule for voiding, and individuals are encouraged to resist the urge to urinate until the scheduled time. After a certain level of success is achieved, the amount of time between scheduled trips to the toilet is increased. The National Institutes of Health state that continence restoration can be achieved by increasing the strength of sphincter muscles through exercises.
Toilet training for adults experiencing fecal incontinence is a somewhat more daunting task, as this is normally the result of damage to various rectal muscles. The National Institutes of Health state that kegal exercises can be very helpful to promote bowel training. Setting a specific time for visiting the toilet can be helpful for those suffering from fecal incontinence, and according to Healthcentral.com, the best time for this is 20 to 40 minutes after a meal. Biofeedback has also been shown to be helpful for this disorder. For fecal incontinence caused by severe muscle damage, toilet training is not helpful and surgery may be required.
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- Mayo Clinic: Urinary Incontinence
- Family Doctor: Urinary Incontinence
- National Institute of Diabetes and Digestive and Kidney Diseases. The urinary tract & how it works. June 2020.
- Urology Care Foundation, American Urological Society. What is stress urinary incontinence? Updated September 2020.
- McIntosh L, Andersen E, Reekie M. Conservative treatment of stress urinary incontinence in women: A 10-year (2004-2013) scoping review of the literature. Urol Nurs. 2015;35:179-203.
- Urology Care Foundation, American Urological Association. It's time to talk about OAB.
- Hersh L, Salzman B. Clinical management of urinary incontinence in women. Am Fam Physician. 2013;87:634-640.
- Michigan Medicine, University of Michigan. Overflow incontinence. Updated August 21, 2019.
- Harvard Men's Health Watch. Try these techniques to relieve common urinary symptoms without medication. Updated September 19, 2019.
- Urology Care Foundation, American Urological Society. What is urinary incontinence? Updated April 2020.
- Wakamatsu M. 4 behavioral changes to tame urinary incontinence. Harvard Health Publishing. July 10, 2019.
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