For several years obesity has been linked as a risk factor for incontinence. Numerous studies link both pathologies, especially in women, although it affects both sexes and from an early age. According to experts, overweight and obesity are the main risk factor for urinary incontinence (UI), although they point out that weight loss can be solved and its effects reversed.
It has been proven that there is a relationship between the increase in the Body Mass Index (BMI) and the increase in the risk of urinary incontinence, between 20% and 70%. In addition, for each increase of 5 units of the BMI in a period of 5 to 10 years increases the risk of suffering UI between 30% to 60%.
It is also established that weight gain is more related to stress incontinence, including mixed incontinence, than to urge incontinence and overactive bladder syndrome. Obesity can also lead to a deformation of the pelvic area, stretching and weakening the muscles of this area, which could contribute to the development of urinary incontinence.
Several years with obesity is associated with an increased risk of developing postmenopausal urinary incontinence. The severity of urinary incontinence is also associated with a greater excess of weight in relation to the duration of overweight and obesity. Women with obesity at 18 years have a higher risk of developing postmenopausal urinary incontinence compared to those that developed it at a later stage.
However, there is a solution for urinary incontinence related to overweight. With the reduction of body weight from 10% to 5% there would be a noticeable improvement in the urinary incontinence, and from 13% the pressure on the bladder would begin to decrease. In addition, it has been observed that women with severe obesity (more than 45 kg above ideal weight) with incontinence who had a drastic weight loss after bariatric surgery (45 to 50 kg) had a significant improvement in urinary incontinence. The prevalence of UTI due to stress decreased from 61% at the beginning of the study to 12% after weight stabilisation in 2 to 5 years.
People with diabetes can experience challenges with controlling their bladder and bowel. This can involve accidental leakage of urine, incomplete emptying of the bladder, passing urine frequently (frequency) or feeling the need to rush to the toilet (urge). There are three types of Diabetes, Type 1, Type 2 and Gestational Diabetes which is diabetes that develops during pregnancy. Although the causes and treatments for the types of diabetes can be different the complications or damage to the organs of the body resulting from a high blood glucose levels are similar. There are four main ways that diabetes may cause problems with bladder and bowel control:
Obesity is a major factor in people developing Diabetes. It is also a major risk factor for developing bladder and bowel control problems. The pelvic floor muscles support most of your body weight. Any excess weight further strains these muscles, weakening them. Weak pelvic floor muscles do not support the bladder the way it should. If this happens you may notice leakage when coughing and sneezing (also known as stress incontinence) or the need to frequently or urgently visit the toilet.
People with diabetes can, over time, develop nerve damage throughout the body including the urinary tract causing problems in passing urine. This nerve damage is call Diabetic Neuropathy. The highest rate of nerve damage are in people with long-term diabetes or who have problem controlling their blood glucose, also called blood sugar.
The nerve damage can prevent the bladder from emptying completely, allowing bacteria to grow in the bladder and kidneys causing urinary tract infections. Urinary incontinence may result when the nerves of the bladder are damaged because the person may not be able to sense when the bladder is full or have control over the muscles that release urine.
Diabetes can also have an effect on the function of the immune system putting you at greater risk to infections. A common infection experienced by people with diabetes is urinary tract infection (UTI). It is the combination of the immune system changes and the poor bladder emptying that causes these infections and often they keep reoccurring. Treatment includes antibiotics and strategies to promote bladder emptying. In addition personal hygiene is particularly important and all women should wipe from front to back to avoid transferring bowel bacteria to the vagina.
Some of the medications used to control diabetes may cause loose bowel actions (diarrhoea). The combination of weak pelvic floor muscles and loose bowel actions may cause bowel incontinence. If you are experiencing these problems talk to your Doctor, Dietician or Diabetes Nurse Educator.
Atnip, S. (2014). About Incontinence – Contributing Factors – Diabetes. Retrieved from www.simonfoundation.org/About_Incontinence_Contributing_Factors_Diabetes.html