Incontinence: Bowel and Bladder Problems

Reviewed by: HU Medical Review Board | Last reviewed: November 2021

People may not give it much thought, but going to the bathroom is a complex body process. The bladder, bowels, spinal cord, and brain all work together to control when you release urine or stools.

Epilepsy is a brain disease that may lead to many complications, including incontinence. Incontinence is the medical term for a loss of bladder or bowel control. About 4 out of every 10 people with epilepsy have incontinence. This makes it one of the more common complications of the condition.1

Bladder and bowel accidents can be intensely embarrassing. Anticipating that these accidents will happen causes anxiety and impacts a person’s social life. Some people with epilepsy avoid being around others because they are afraid of having an accident. This can make incontinence 1 of the more challenging issues of epilepsy.

How epilepsy leads to incontinence

Epilepsy and incontinence may be connected in 3 ways:1

  • People may lose muscle control during a seizure, which causes them to wet themselves
  • Epilepsy seizures may cause neuron over-excitability in areas of the brain involved in bladder or bowel control
  • Urination may trigger seizures in some people with reflex epilepsy

Some people with epilepsy may have only 1 of these problems. Others can have all 3 types of epilepsy-linked incontinence. It is not unusual for people to report only wetting or soiling themselves during a seizure at first and later becoming consistently incontinent.1,2

Seizures and bladder and bowel accidents

Incontinence can happen with any seizure depending on which part of the brain is impacted. However, it is most often linked to tonic-clonic seizures.2

Some people report feeling the need to go or feeling like they wet or soiled themselves as part of their aura. This gives them time to get to a safe place before the seizure hits.2

Interestingly, urinating may also trigger seizures in some people. This may be called reflex epilepsy, or epilepsy triggered by a specific event like urination.

How incontinence is treated

There are several ways to manage incontinence. The first is to take your anti-seizure drugs as prescribed. Being consistent with your medicine helps reduce the number and severity of seizures. This may mean fewer bathroom accidents.1-3

When incontinence is caused by a problem other than epilepsy, such as nerve damage or spinal cord injury, medicine or surgery may help reduce the number of accidents. However, not everyone with epilepsy can take incontinence drugs. Some people may need to use a collection device called a catheter.1

People who lose control of their bladder or bowels during a seizure may want to wear special pads or underwear. It may also help to keep extra incontinence products at school, work, or in the car. This gives you clean, back-up underwear to change into after a seizure or accident.2

People who have seizures at night may add mattress and sheet protectors. Others find keeping the bladder and bowels empty by going to the bathroom more often helps reduce accidents.2

Those who have seizures while using the toilet may need to install grab bars beside the toilet. It may also help to change the bathroom door to open so it is easier for others to get in and help.3

More research is needed into how seizures impact the bladder and bowel. Along with incontinence, epilepsy may cause other bladder and bowel issues such as:1,2

  • Urgency (feeling more need to go)
  • Needing to go more often (frequency)
  • Not recognizing the need to go (retention)
  • Problems starting or maintaining urine flow (hesitancy)
  • Emptying fully or leaking

It is important to manage the incontinence issues of epilepsy. This eases the burden of caregiving if someone needs help cleaning up after an event. It also eases the expense of paying for incontinence products and home health support.2

In addition to incontinence, other complications may also occur with epilepsy. These include:

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