Supporting bladder and bowel health for adults with cerebral palsy (plain language)
Bladder and bowel problems are common in adults with cerebral palsy (CP). Continence means being able to control when you wee or poo.
Changes in bladder or bowel control can affect your comfort, confidence and daily life. They can also affect work, study, relationships and taking part in your community.
It can feel hard to talk about bladder or bowel concerns. But support is available. If you notice changes or find continence harder to manage, talk to your healthcare team.
What can affect bladder and bowel control?
These can include:
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how your bladder or bowel works
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muscle tone and movement
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mobility
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pain or tiredness
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constipation
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medicines
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communication needs
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ageing
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difficulty getting to or using a toilet.
Understanding what is causing the change can help you and your healthcare team find support that suits you.
What is urinary incontinence?
Urinary incontinence means having trouble controlling your wee. It may happen sometimes or more often.
As you get older, you may notice changes. You may need to wee more often or have less time to get to the toilet.
Different bladder problems can include:
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Overactive bladder or urge incontinence: You may suddenly need to wee or need to go often. You may leak before reaching the toilet.
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Stress incontinence: You may leak when you cough, sneeze, laugh, exercise or lift something.
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Overflow incontinence: Your bladder may not empty fully, which can cause leaking.
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Functional incontinence: Mobility, clothing, transfers, communication or access barriers may make getting to or using the toilet harder.
Urinary tract infections or constipation can also make bladder symptoms worse.
Bowel health and constipation
Bowel problems can include:
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constipation
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soiling
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leaking loose poo
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difficulty doing a poo.
Constipation is common in adults with cerebral palsy. Many things can contribute to it, including movement and mobility, muscle tightness or weakness, diet, fluid intake, some medicines and pain. Sitting comfortably and safely on the toilet can also make a difference.
Constipation can cause:
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pain or discomfort
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bloating or tummy pain
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poor appetite
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nausea or vomiting
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soiling or leaking
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urinary tract infections
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more difficulty controlling your bladder
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problems with how some medicines are absorbed.
Keep track of changes
Knowing your usual bladder and bowel patterns can help you notice changes.
You may find it useful to keep track of:
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how often you wee
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how often you poo
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any leaking or accidents
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whether your poo is hard or painful to pass
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any tummy pain
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whether you avoid using the toilet.
Who can help?
You do not have to manage bladder or bowel concerns on your own.
A GP, urologist, continence nurse or other health professional can assess your needs and help you develop a continence plan.
Depending on what works for you, your team may also include:
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an occupational therapist
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a physiotherapist
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a dietitian
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a psychologist
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a support worker.
What can a continence plan include?
Your continence plan should reflect your symptoms, goals, lifestyle and support needs.
It may include:
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a regular toilet routine
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a bladder or bowel diary
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ways to manage constipation
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support to drink enough fluid and eat enough fibre
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comfortable and safe toilet seating and positioning
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equipment or easier-to-use clothing
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communication or transfer support
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pelvic floor exercises, when suitable
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medicines, when needed
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biofeedback training, when suitable
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surgery or other specialist treatment in some cases.
Getting support early can improve your comfort, dignity, independence and ability to take part in everyday life.
Learn more about bladder and bowel health
Watch the Bladder and bowel health for people with cerebral palsy webinar for practical information about continence and cerebral palsy.
