Managing bladder and bowel problems after a stroke

Some people who have a stroke suffer loss of bladder control (urinary incontinence) after the stroke. However, this is usually temporary, and it can have many causes, including infection, constipation, and the effects of medicines.

If you have problems controlling your bladder, your doctor may:

• Test a urine sample to see if you have an infection.
• Do tests to see how you urinate, which can help you and your doctor decide what treatment might work best for you.
• Help you develop a schedule of regular bathroom use that fits your abilities.
• Suggest that you wear protective clothing or a pad.
• Prescribe medicines, depending on the cause of your bladder problems.

Some things you can do to prevent bladder leakage include:

• Emptying your bladder at regular intervals, including when you first wake up and at bedtime.
• Controlling your liquid intake, such as drinking liquids at regular intervals and limiting fluid intake after dinner.

Urinary retention

You may have trouble emptying your bladder completely (urinary retention). Urinary retention is common, especially right after a stroke, but it usually improves over time. About half of people who have had a stroke have urinary retention problems for the first 3 days after a stroke. However, the problem usually gets better quickly. Less than one-fourth of people have retention problems 3 weeks after their stroke.¹

If you have urinary retention problems, your doctor may:

• Place a tube (catheter) into your bladder to prevent too much urine from building up. This is used only if absolutely needed. (For more information, see the topic Urinary Incontinence in Men or Urinary Incontinence in Women.)
• Have you avoid medicines with certain side effects that cause the bladder to retain urine.
• Prescribe medicines, depending on the cause of your bladder problems.
• Test a urine sample to see if you have an infection (common with urinary retention problems).

Constipation

Stroke by itself does not cause constipation. However, constipation often develops after a stroke because you are not drinking enough liquids, are in bed most of the time, or are taking certain medicines as part of your treatment. If your constipation is severe, stool can become lodged (impacted) in the bowel.

If you are constipated:

• Drink extra liquids, especially water.
• Set a regular time for using the toilet.

If you continue to have problems with constipation, your doctor may recommend a bulking agent (such as Metamucil), a stool softener, or regular use of a laxative or enema.

Citations

1. Browne BJ (2005). Rehabilitation of the stroke patient. In HF Conn et al., eds., Conn's Current Therapy, pp. 1016–1021. Philadelphia: Saunders.