It’s time to speak about leaks – and find what works

Incontinence isn’t something many of us talk about. If it’s part of your life, you’re far from alone.  

In Australia, millions of people experience urinary and/or bowel (faecal) incontinence, from small leaks when you move or cough to more frequent episodes that affect daily life. 

It’s common to assume leaks are “just ageing” or an inevitable result of childbirth or surgery. In reality, incontinence is a medical condition.  

It occurs when the normal communication between the brain, bladder or bowel, and pelvic floor is disrupted, so the muscles or nerves that control continence don’t work as they should. 

What types of incontinence are there? 

Incontinence can affect the bladder, the bowel or both. Knowing which type you’re dealing with helps your GP or physiotherapist match you to the right treatment. 

Urinary incontinence 

Urinary incontinence is any unplanned leaking of urine. It ranges from small leaks with movement to sudden, hard-to-defer urges and can have more than one cause at the same time. 

• Stress incontinence: Leaks with pressure (coughing, sneezing, lifting, exercising). 
• Urge incontinence (overactive bladder): A sudden, strong need to pass urine that’s hard to defer. 
• Mixed incontinence: A combination of stress and urge symptoms. 
• Overflow/functional incontinence: Leakage due to incomplete bladder emptying or difficulty getting to the toilet in time. 

Bowel (faecal) incontinence 

Bowel incontinence is leaking from the bowel. It can follow long-term constipation or diarrhoea, pelvic floor issues or nerve changes and often improves with the right plan. 

• Urge faecal incontinence: A sudden, hard-to-defer need to open your bowels. 
• Passive incontinence: Leaking without the sensation of needing to go. 
• Soiling and smearing: Often linked to chronic constipation, diarrhoea or pelvic floor dysfunction. 

Why does incontinence happen? 

Incontinence is usually the result of changes to muscles, nerves, hormones or habits, not a personal failing. A GP can help pinpoint the drivers and match you to the right treatment.  

Common contributors include: 

• pregnancy and childbirth which can stretch and weaken the pelvic floor 
• menopause-related hormone changes that lower oestrogen and may affect bladder and urethral tissues  
• pelvic floor muscle weakness 
• chronic constipation/diarrhoea 
• pelvic or prostate surgery 
• medical or neurological conditions such diabetes, multiple sclerosis, spinal cord injury 
• medications such as diuretics, sedatives or muscle relaxants 

Sometimes there’s no single clear cause, but the condition is still real and treatable, something colorectal surgeon Dr Xavier Harvey, who treats faecal incontinence, wishes more people knew.  

“Many people, not just in the general population but also in the medical community, don’t appreciate how effective treatments can be. Once we drill down into what their problem is and help them work through it, people often wish they had sought help earlier.”  

Don’t suffer in silence 

Leaks don’t only bring practical hassles. They can affect confidence, relationships, social life and mental wellbeing, particularly when it comes to faecal incontinence.  

“I think faecal incontinence is one of the worst types of suffering,” says Dr Harvey. “The impact that can have on your ability to function professionally and socially can’t be underestimated.” 

You’re not alone if you’ve kept this to yourself. Many people delay speaking to a doctor. In fact, a 2024 study found only around one-third sought treatment for incontinence, while many others delayed seeking care for years.  

Getting help early can make a meaningful difference. 

Understanding your options 

The good news is there are several effective treatments available, and your GP can help you find what’s right for you. These may include: 

1. Lifestyle changes 

Simple tweaks to everyday habits can make a difference. For urinary incontinence, this might include adjusting how much and when you drink fluids, avoiding bladder irritants such as caffeine and alcohol, and maintaining a healthy weight to reduce pressure on the bladder. Managing constipation is also important, as straining can weaken pelvic floor muscles over time. 

2. Pelvic floor muscle training 

Strong pelvic floor muscles help control the bladder and can also be an effective treatment for faecal incontinence. Learning how to activate these muscles correctly is key and many women benefit from guidance from a physiotherapist who specialises in urinary and/or faecal incontinence. 

3. Medications 

For some types of urinary incontinence, your doctor may recommend medicines that relax the bladder muscle, reduce urgency, or increase the bladder’s capacity to hold urine. These are usually considered when lifestyle changes and pelvic floor training alone haven’t brought enough improvement. Similarly, for faecal incontinence, the medication loperamide (otherwise known as Gastro Stop or Imodium) can help people regain control.  

“People are often told to avoid constipation, but if you’re losing control of your bowels, a bit of constipation can actually be very helpful,” says Dr Harvey, noting that this is a very individualised approach that needs to be worked through with a trained professional in a medical setting. He also adds that in some cases of faecal incontinence, putting the patient on a low-fibre diet can also be beneficial. 

4. Sacral neuromodulation (SNM) 

For certain bladder conditions and cases of faecal incontinence, this treatment involves placing a small device under the skin in the lower back or upper buttock. It sends gentle electrical pulses to the sacral nerves, which help control bladder and bowel function, restoring normal communication between the brain and bladder or bowel. It’s typically considered when other treatments haven’t worked, and your specialist can explain whether it’s right for you. 

“You can think of it like a pelvic pacemaker, and in the right patient, it can be a really effective treatment strategy,” explains Dr Harvey.  

Taking the next step with your GP 

If talking to your doctor has felt daunting, here are some practical ways to feel more prepared: 

• Book a dedicated appointment so you have enough time to discuss your symptoms. 
• Keep a diary for a few days, noting when leaks happen and what you were doing. 
• Be open and honest. Chances are your doctor has heard it all before and is there to help. 

If you don’t feel comfortable with the first doctor you see, it’s perfectly okay to seek a second opinion. You deserve to be heard and supported. 

Get back to your best self again 

Help is available and reaching out is the first move towards feeling like yourself again.  

For more information, visit the Speak About Leaks website. It’s a dedicated resource that helps you understand the different types of incontinence, explore practical treatment options, and prepare for a productive appointment with your GP.  

You don’t have to live with incontinence. With the right help, you can reclaim your confidence and get back to being you. 

At Prevention, we only collaborate with trusted brands. To bring you this article we have partnered with Medtronic.