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This article is evidence-based, verified by Dr. Ahmed Zayed.
You might not be sure which one to choose, but it’s important that you do. Millions of people worldwide suffer from incontinence, and there are two different options for dealing with this issue: pads or diapers. You could use either of these products depending on your preference and needs; however, to figure out what you need, it’s important to consider a few things before deciding.
Incontinence pads are used for mild to moderate urinary and fecal incontinence and are preferred by many because they are a more mobile option. On the other hand, adult diapers are ideal for heavy incontinence users but offer less mobility than incontinence pads.
This article delves into the merits and demerits of each type of incontinence product. It also explains what incontinence is and how it can affect you or your loved ones. Keep reading for a detailed guide to incontinence.
Why People Might Use Incontinence Products
Incontinence pads and diapers are both products that you might use to deal with incontinence. Most people deal with two types of incontinence – urinary or fecal incontinence. Let’s explore each type in more depth.
Urine is made by the kidneys and stored in the bladder until it can be expelled out of the body via the urethra. This movement is tightly regulated by bladder and sphincter muscles. When you are urinating, your bladder muscles tighten while your sphincter muscles relax, creating a pressure that pushes urine through the urethra into the toilet bowl.
In urinary incontinence, this process is disrupted because your body cannot ‘hold’ the urine. If you’ve ever been outside needing to take a leak with no bathroom in sight, you’ll be familiar with the feeling of controlling your bladder. As you do so, your sphincter muscles stay contracted so that you don’t involuntarily release urine. This process cannot be fulfilled in incontinence because the sphincter muscles are not strong enough to remain contracted.
There are three primary types of urinary incontinence:
- Stress incontinence refers to urine leakage when you perform any activity that puts pressure or stress on your bladder, such as laughing, sneezing, and coughing. People suffer from stress incontinence due to weak pelvic floor muscles, which put pressure on the urethra and bladder, making them work harder. This problem can be resolved by doing the appropriate exercises to strengthen your pelvic floor muscles.
- Urge incontinence – Individuals suffering from urge incontinence experience a sudden, intense urge to urinate with the almost immediate involuntary release of urine. Urge incontinence is caused by various diseases that range from mild to severe, such as a urinary tract infection or diabetes.
- Functional incontinence – People suffering from functional incontinence face no problems with their bladder or urethra muscles. Still, they suffer from another illness that prevents them from getting to the bathroom in time. One example could be an arthritic individual who was unable to unzip his pants in time.
Here are some factors that could cause urinary incontinence:
- Being overweight. Being above the healthy BMI range puts pressure on your bladder, weakening the muscles over time.
- Constipation. Bladder problems can arise due to long-term constipation because it puts stress on your bladder muscles and weakens the pelvic floor.
- Nervous issues. Nerve damage in the brain and bladder means that signals to and from specific body parts get lost in communication, resulting in the muscles that you should be able to control working unconsciously. Patients of Parkinson’s disease, multiple sclerosis, stroke, brain, or spinal cord injury have damaged nerves resulting in incontinence.
- Enlarged prostate. This condition is known as benign prostatic hyperplasia and is typically found in older men.
- Hysterectomy. A lot of the same ligaments and muscles are used to support a woman’s uterus and her bladder. Operating to remove the woman’s uterus means that the surrounding muscles can be damaged, with the pelvic floor growing weaker, resulting in urinary incontinence.
Fecal or bowel incontinence refers to the inability to control one’s bowels resulting in defecation.
There are two types of fecal incontinence that you might be affected by:
- Urge fecal incontinence – In urge fecal incontinence, you will feel an intense urge to pass stool, but you will not be able to get to a toilet in time.
- Passive fecal incontinence – Sufferers of passive fecal incontinence will pass stool or mucus from their anus without realizing it.
Here is a list of possible causes for reasons why fecal incontinence can occur:
- Damaged muscles. When the rings of muscle at the end of your rectum become damaged, it is difficult to properly hold stool. This damage can occur due to episiotomy or forceps use during childbirth, rectal surgery, Crohn’s disease, and general trauma.
- Damaged nerves. When the nerves in your anus, pelvic floor, or rectum are damaged, your bowels’ muscles will work improperly, resulting in fecal incontinence. Nerve damage can be caused by childbirth, constant straining during a bowel movement, head or spinal cord injury, diabetes, and multiple sclerosis, amongst other things.
- Digestive issues. Digestive problems such as constipation or diarrhea can result in both passive and urge fecal incontinence. In diarrhea, watery stools fill up your rectum very quickly and are much more challenging to hold in than regular stools, with people suffering from urge incontinence. In constipation, forcing out hard stool repeatedly over time will cause damage to the anal muscles resulting in passive fecal incontinence.
What Is an Incontinence Pad?
An incontinence pad is made up of various polymers and paper pulp to create an absorbent material designed for light to medium leakage. It is possible to use incontinence pads for both fecal and urinary incontinence.
Here are the types of incontinence pads that can be used:
- Shaped pad
- Incontinence slips
- Belted incontinence pads
- Insert pads
This is a traditional pad that resembles a sanitary pad. It can be used for both urinary and fecal incontinence, but the latter’s shaped pads have a different shape and are flared out in the back.
When buying an incontinence pad, be sure to verify that the product you have chosen can be used for your specific type of incontinence; otherwise, you might end up buying the wrong kind of pad. The shaped pad is designed for light to medium flow.
Here is a breakdown of an incontinence pad and what it contains:
- Absorbent core – Arguably, the most crucial part of an incontinence pad, the absorbent core absorbs and stores urine. It is usually made from paper pulp and super absorbent polymer(SAP). Different manufacturers have pads with varying degrees of absorption based on the composition ratio of paper pulp to SAP and the overall amount of both materials in a pad.
- Acquisition layer – This layer moves the liquid from the pad’s surface layer to the absorbent core. It is made of wood and polyester fibers.
- Surface material – Along with the acquisition layer, the surface material draws water away from the pad’s surface so that your skin stays dry.
- Adhesive strip – Made from polymers and synthetic resins, the adhesive strip is on the back of an incontinence pad and is meant to be stuck to your underwear, much like a sanitary pad.
- Release paper – A silicone-coated paper, the release paper, protects the adhesive on the pad’s back. It is meant to be peeled off.
Incontinence Slips & Belted Incontinence Pads
Incontinence slips and belted incontinence pads are similar in many ways. They are both suited for severe fecal and urinary incontinence, are made up of similar materials, and are meant to be worn by themselves for immobile use. However, the one area that they differ in is how they are intended to be worn.
Regular incontinence slips have fixation tabs that can be affixed at the side of the waist. On the other hand, a belted incontinence pad has a single belt that is meant to be worn around the waist before it is pulled through.
Here is a short video to show how to wear a belted incontinence pad:
An insert pad can be called a mini pad only suitable for very light urinary incontinence use. It has the same sticky backing, but it comes in a more rectangular shape than a regular pad. However, most people don’t use it because it is not widely available and also because the concept of standard pads is more familiar to them than an insert pad.
Which Type of Incontinence Pad Should I Choose?
The type of incontinence pad you choose depends on several factors:
- Mobility. If you are a mobile person who likes to go on runs regularly, you will profit from the use of shaped pads that you can discreetly and comfortably wear out in public without any suspicion or judgment. However, if you are mostly sedentary or bedbound, you can wear a belted pad or an incontinence slip.
- The severity of incontinence. Depending on whether you’re facing mild or heavy incontinence, you can opt for a smaller shaped pad with a lower absorption degree or look for an incontinence slip.
Here are some other things to look out for when buying an incontinence pad that is not as essential but could still come in handy, especially if you are a first-time user of incontinence pads:
- Odor control. Some brands sell incontinence pads with odor control, which prevents the smell of urine from being detectable. They do this by adding a light fragrance to the pad containing pH neutral compounds, which means that the acidic components in urine, such as ammonia that produce a smell, will be neutralized.
- Wetness indicator. Pads with a built-in wetness indicator function will turn a different color when the pad’s maximum absorption limit has been reached. This prevents the possibility of leakage and subsequent humiliation.
- Skin-friendly. If you have sensitive skin, the chemicals in some of these pads can cause irritation and rashes. Look for a hypoallergenic pad.
Incontinence pads should be changed every 3 to 4 hours or as soon as they start feeling uncomfortable. This prevents extended skin contact with fecal matter or urine and decreases the possibility of skin irritation.
To dispose of an incontinence pad, always throw it away in a dustbin. You can tie it up in a separate plastic bag if you think it causes an unsanitary smell in your house when you throw it away.
Now that you know all about incontinence pads let’s learn more about adult diapers.
What Is a Diaper?
Adult diapers are thought to be products that only the elderly use. However, this stereotype is incorrect. They can be worn by anybody – from pilots who cannot use the bathroom during long flights, to youth temporarily suffering from incontinence caused by surgery.
Diapers contain absorbent pads sandwiched between nonwoven fabric sheets, designed to give a comfortable shape and prevent leakage. It contains:
- Absorbent core – The absorbent core includes materials like SAP, which absorbs moisture up to 300 times its weight. Along with SAP, other carefully moderated amounts of fiber can be found in the core. For briefs, the entire diaper is made out of absorbent materials.
- The surface layer – contains absorbent gelling materials(AGM) made from polymers that prevent skin irritation by pulling moisture away from the skin.
- Nonwoven fabric sheets – These hold the absorbent pad at the diaper’s center and go around the waist. They are made of plastic resins like nylon and polyester.
- Tabs – Depending on the type of diaper you wear, it could come with tabs or velcro fasteners at the side to fasten the diaper so that it fits snugly around your waist.
A brief is a type of adult diaper with tabs on the side of the waist and near the legs. This lets you customize the fit to ensure that it fits snugly and minimizes leaks. However, the tabs’ presence could also make briefs a bit tricky to put on as you need nimble fingers to attach and fasten it properly.
Briefs can be worn without removing your clothes from the waist down as they can just be attached around whatever pants or garment someone is wearing. This comes in handy with bed-bound patients. Unlike pull-ups, briefs can support heavy urinary and fecal incontinence. They are also fully absorbent, whereas pull-ups only have an absorbent core right in the center.
These diapers should only be worn by bed-bound or mostly sedentary individuals because mobility will result in leakage. As briefs are more commonly worn than pull-ups, there are various options to choose from:
- Cloth backing – These types of briefs make less noise than plastic briefs.
- Refastenable tabs – Although briefs with refastenable tabs are valued at a higher price than those without, The cost is well worth it because these tabs can be continuously readjusted to prevent leakage.
- Overnight – Overnight briefs have a higher absorption ratio than those that are worn in the day. Always check the degree of absorbency on a brief before you buy it.
Pull-ups are diapers that can be directly pulled up and worn just like underwear. Unlike briefs, they have no tabs at the side to be fastened and are ideal for overnight or long-term use. Most pull-ups are shaped like regular underwear and cling to the body, so they have a more discreet and less detectable appearance, giving back users some form of dignity.
Pull-ups are suitable for light to moderate urinary incontinence use and can retain urine volume that most bladders hold when full. A drawback of pull-ups is that you need to remove your pants altogether to change a soiled pull-up. This would ordinarily not be a problem at home, but when you’re trying to change a pull up in a public bathroom, things can get tricky and unsanitary.
Like shaped incontinence pads, pull-ups can also be worn while doing light exercise. If you like to go on jogs or walk around the neighborhood with your dog, you should opt for pull-ups.
Which One Should I Use?
Both diapers and incontinence pads have their pros and cons. Here are some factors that you might want to consider when picking which one is better for you.
Despite being securely fixed to your underwear via the adhesive backing, incontinence pads tend to shift around. This could result in them being improperly fixed in position and cause some leakage. As a result, you need to be extra cautious whenever you’re using an incontinence pad.
However, they would still be a better choice than pull-ups, where you cannot adjust the product if it is not snug enough.
This is not the case for briefs that have fasteners around the legs to ensure that everything is securely affixed.
Intensity of Incontinence
For the more severe fecal incontinence cases, you should always be using briefs because an incontinence pad is not designed to support a significant amount of stool.
Incontinence pads are great for problems of small amounts of stool, watery mucus, or watery stool being released, but their small size means that if you suffer from urge incontinence, you will stain your pants. However, if you’re only suffering from urinary incontinence, incontinence pads will serve you and any adult diaper.
Other Health Issues
Depending on the individual’s issues using an incontinence product, different products would serve them better.
For example, for individuals who have dementia or Alzheimer’s, an adult diaper would be a better idea because it requires less frequent changes than an incontinence pad, meaning less disturbance and fewer problems getting them to wear an incontinence product.
For others suffering from arthritis leg pain, wearing a pull-up would be a better idea because it would be easier to get on.
Are Incontinence Pads Better Than Pads?
If you’re talking about sanitary pads, the answer to that is a hard yes. Incontinence pads will beat every time. They are much more absorbent because they use super absorbent polymers, whereas menstrual pads are not that absorbent. If you try to urinate in a menstrual pad, you will look everywhere and end up wetting your clothes.
In addition to this, incontinence pads are pH neutral. They neutralize acidic urine well, simultaneously drawing it away from the pad’s surface with the use of special polymers, while sanitary pads don’t do that. This is important because if your skin is left in contact with acidic urine for long, you will develop rashes and other forms of irritated skin.
Just use each product for their advertised function because they will not work if you try to swap their use.
Depending on your mobility, the type and severity of incontinence that you suffer from, and any other external health problems that you have, the choice of using an incontinence pad or a diaper is one that you have to make after evaluating all of these factors. This article has provided you with all of the necessary information that you need to make a choice, so consider your options carefully and pick a relevant product.
Dr. Ahmed Zayed, MD, holds a baccalaureate of Medicine and Surgery. An avid contributor to the Huffington Post and Chicago Tribune, Dr. Zayed believes in providing accurate and accessible information to general readers. With years of writing and editing content in the medical niche, Dr. Zayed likes to think of himself as a man with a mission, keeping the internet free of false medical information.
- MayoClinic: Urinary Incontinence
- OWH: Urinary Incontinence
- Patient: Pelvic Floor Exercises
- NIH: Urinary Incontinence in Older Adults
- MayoClinic: Fecal Incontinence
- NIH: Symptoms & Causes of Fecal Incontinence
- Incontinence UK: How do Incontinence Pads Work
- Incontinence UK: The Best Pads for Bowel Incontinence: Our Guide
- YouTube: iD Expert Belted Incontinence Pads
- iDiaper: Types of Adult Diapers
- How Products Are Made: Disposable Diaper
- Shield Healthcare: Pull-ups vs Briefs
- AvaCare Medical: Incontinence Pads vs Menstrual Pads