Bladder and bowel problems, including incontinence, are common after a stroke.
What is incontinence?
Incontinence is a loss of bladder or bowel control. For many people, it is a very sensitive and personal issue that can affect their quality of life. You may feel embarrassed, upset or like you have lost your dignity, and it can impact family members involved in your care too.
How long does incontinence last?
It often improves in the early weeks after the stroke, but up to a third of stroke survivors may have longer-term difficulties.
But there are treatments and support that can help and many problems can improve. If your daily life is being affected, there are often practical solutions to the problems.
On this page:
Aphasia-friendly video on continence problems
How does a stroke affect bladder and bowel control?
Types of bladder problems after stroke
Types of bowel problems after stroke
Where to get help and information
Accessible resources
The most important thing is to seek help.
Tell a healthcare professional about any difficulties. Remember, even if it feels hard to talk about it, continence problems are common so you’re not alone. Keeping problems hidden could mean missing out on treatment and support that can improve your wellbeing and help with your recovery.
Aphasia-friendly video on continence problems
aphasia-friendly information page click here.
How does a stroke affect bladder and bowel control?
Damage to brain cells
A stroke can damage part of the brain that controls your bladder or bowel. Signals between your brain and bladder and bowel muscles can be disrupted and affect your bladder or bowel control.
Urine retention can also happen soon after a stroke. You may find it difficult to empty your bladder and it may become very full, but this usually only lasts a short time for most people.
Movement, communication and cognitive problems
Some effects of a stroke can affect your continence. If you’re having difficulty walking, you may not always get to the toilet in time. If you have to work harder to move around, the extra exertion can make it more difficult to maintain bladder or bowel control.
If you have hand weakness, you might find it hard to unfasten or lower your clothes to go to the toilet. If you have communication problems, it may be hard to ask for help in time to get to the toilet. If you have cognitive (memory and thinking) problems, you might not be aware when you need to go to the toilet, or struggle to find and use the toilet.
Constipation
Being less mobile than usual can make you more prone to constipation (not emptying your bowels regularly or finding it hard to poo). This may cause continence problems because a full bowel can put pressure on your bladder.
Stroke can sometimes change how you eat and drink. Not having enough fibre from your diet or not drinking enough can also lead to constipation.
Medication
Some medications can affect your bladder and bowels. For example, some types of blood pressure medication may affect bladder control or cause constipation when you start taking them. If you have any questions about your medication, ask your pharmacist. Do not stop taking any medication before speaking to a healthcare professional.
Being immobile or inactive
If you already had mild bladder or bowel problems before your stroke due to other reasons, these may be made worse by long periods of sitting or lying down.
Other pages in this section
Types of bladder problems after stroke
- Frequency: needing to pass urine (wee) more often than is usual for you.
- Urgency incontinence: feeling a sudden, urgent and uncontrollable need to wee. Often there is no time to get to the toilet, so you may wet yourself.
- Stress incontinence: small dribbles of wee leak when you cough, sneeze or laugh. This usually happens because the muscles in your pelvic floor are weak or damaged. It’s possible to have a mix of stress and urgency incontinence.
- Nocturia: waking from sleep with an urgent need to wee.
- Nocturnal enuresis: wetting the bed while still asleep.
- Functional incontinence: when the physical effects of your stroke make it difficult for you to reach the toilet or unfasten your clothes in time.
- Reflex incontinence: passing urine without realising it. This happens when a stroke has affected the part of the brain that senses and controls bladder movement.
- Overflow incontinence: where the bladder leaks due to being too full. This can happen if you have lost feeling in your bladder and cannot tell you need to pass urine, or because you have difficulty emptying the bladder fully (known as urine retention).
Types of bowel problems after stroke
- Faecal incontinence: uncontrolled bowel movement. This can be caused by damage to the part of the brain controlling the bowel. It can also happen if you cannot get to the toilet in time, or if you have diarrhoea or constipation.
- Constipation with overflow: large stools (poo) can get stuck and block the bowel. Liquid stools may flow around it, causing watery stools to leak.
- Faecal impaction: dry, hard stools collect in the bowel. They can press on your bladder and make you feel you need to wee more often, or they can make it more difficult to empty your bladder.
Where to get help and information
Stroke Support Helpline
Our Stroke Support Helpline offers information and support for anyone affected by stroke, including family, friends and carers. Call us on 0303 3033 100, from a textphone 18001 0303 3033 100 or email helpline@stroke.org.uk.
- Age UK Incontinence is an online shop and advice service owned by Age UK. It sells a wide range of products to support with bladder and bowel problems. Tel: 0800 046 1501.
- Bladder and Bowel Community sells products and gives information about continence and finding help. They offer RADAR keys and a free, downloadable ‘Just Can’t Wait’ toilet card, to help you get access to toilets while out and about. Home delivery line: 0800 031 5406.
- Bladder & Bowel UK offers a confidential helpline providing advice, information and support for adults and children with bladder and bowel problems. They provide details of products, equipment and services for people with continence problems. Helpline: 0161 214 4591.
- Changing Places offers a tool to search for public toilets accessible to people with complex disabilities.
- Continence Product Adviser introduces and explains a range of products for men and women living with bladder and bowel problems.
- Disability Rights UK gives information on the National Key Scheme for wheelchair accessible toilets and sells RADAR keys at a small cost.
- Great British Public Toilet Map is a searchable database of UK public toilets, including accessible toilets.
- Living Made Easy offers information and products for personal care. Helpline: 0300 999 0004.
Accessible Resources
The information in this section can be accessed in the following formats:
- Download this information as a
- Order a printed copy from our Shop
- To request a braille copy, email feedback@stroke.org.uk
Acknowledgements
Thanks to Bladder & Bowel UK for their help with reviewing this information.