Urinary and Fecal Incontinence
Ronald C Hamdy
Larry B Hudgins
They say man has succeeded where the animals
fail because of the clever use of his hands, yet
when compared to the hands, the sphincter ani
is far superior. If you place into your cupped
hands a mixture of fluid, solid and gas and then
through an opening at the bottom, try to let only
the gas escape, you will fail. Yet the sphincter ani
can do it. The sphincter apparently can differenti-
ate between solid, fluid and gas. It apparently can
tell whether its owner is alone or with someone,
whether standing up or sitting down, whether his
owner has his pants on or off. No other muscle in
the body is such a protector of the dignity of
man, yet so ready to come to his relief. A muscle
like this is worth protecting.
—Walter C. Bornemeier
Urinary incontinence is the inappropriate and involuntary passage of urine. Its exact prevalence is difficult to establish because it can occur in varying degrees and the patient may deny having the problem. Its prevalence is particularly difficult to determine in patients with Alzheimer's disease.
Although the underlymg dementia may be responsible for some of the incontinence, other conditions that are treatable and reversible are often present. Thus the caregiver has the initial burden of recognizing incontinence and arranging for further evaluation of the patient. Urinary incontinence is an issue of quality of life that should be neither ignored nor denied.
In the early stages of Alzheimer's disease, when the patient still has insight into his condition, he may try to conceal his incontinence so as not to draw the