Managing neurological bladder and bowel symptoms

Created on

14/9/2026

Last updated on

12/10/2026

Written by Hannah Gray, Women's and Men's Health Specialist Physiotherapist.
Medically reviewed by James Walker, Service Development Director & Senior Physiotherapist, on 14/09/26.

Bladder and bowel symptoms from neurological conditions can be difficult to talk about, but they are more common than many people realise.

Changes in nerve signalling caused by a neurological condition can affect bladder and bowel function, giving rise to symptoms such as urgency, leakage, or difficulty emptying. These symptoms are common: research bringing together 40 studies found that 59% of people with Parkinson's disease experience nocturia, or waking in the night to pass urine¹.

Symptoms like these can disturb daily routines and independence, particularly if left unaddressed. At the White House Clinic, we know that being assessed and starting treatment sooner can make a real difference to everyday life. Our specialist women's health physiotherapists see patients at Sheffield West and Chesterfield, and our men's health service runs at Chesterfield, and you can read more about what we offer on our Women's Health and Men's Health pages. You could be feeling more confident and comfortable sooner.

What causes bladder and bowel symptoms in neurological conditions?

The bladder and bowel depend on nerve signals travelling between the brain, the spinal cord and the muscles of the pelvis. When a neurological condition disrupts those signals, the muscles can become overactive, underactive or poorly coordinated. That may produce urgency, leakage, difficulty emptying, constipation or reduced sensation, and often more than one at a time.

Symptoms of this kind are sometimes called a neurogenic bladder or a neurogenic bowel, which simply means the nerves controlling them are not sending or receiving the usual messages. Conditions that commonly affect bladder and bowel control include stroke, spinal cord injury, multiple sclerosis and Parkinson's disease.

Movement, balance and strength are often affected alongside continence, and those are treated by a different team. Our neurological physiotherapy service works with people living with conditions including stroke, spinal cord and traumatic brain injuries, multiple sclerosis and Parkinson's, and runs at seven of our clinics. Bladder and bowel symptoms are seen by our women's and men's health physiotherapists: women's health at Sheffield West and Chesterfield, men's health at Chesterfield.

Neurological bladder symptoms

Incontinence may be the first bladder problem that comes to mind. However, an underactive bladder is as dysfunctional as an overactive one, and both are worth raising.

Overactive bladder (bladder spasm)

An overactive bladder causes symptoms of needing to go to the toilet very frequently and very urgently. At times it can be difficult to hold on, which can lead to urinary incontinence, or leakage.

Stroke is one condition where this pattern is well described, and for many people it improves. In a UK study of stroke survivors, urinary incontinence was recorded in 40% of people within the first ten days after their stroke, 19% at three months, and 15% at one year².

Underactive bladder (weak bladder)

An underactive bladder causes symptoms such as difficulty starting the flow of urine, or a slow, weak stream. Patients may describe needing to strain or push to pass urine, or having a strong urge to pass urine but then finding it difficult to go.

This symptom can cause urinary retention and frequent urinary tract infections. Please speak to your GP in the first instance if you experience these symptoms.

Nocturia

Nocturia is when you wake up frequently in the night to pass urine, or wake more than twice at night. It is one of the most common lower urinary tract symptoms seen in Parkinson's disease¹.

If bladder symptoms are your main concern, you can read more about the different types of bladder symptoms and what sits behind them in our article on bladder symptoms.

Neurological bowel symptoms

Bowel symptoms can affect your comfort, confidence and independence in everyday life. While faecal incontinence is one possible symptom, some people may also experience constipation or reduced sensation. Around two-thirds of people with multiple sclerosis experience constipation, faecal incontinence, or both^{3 4}.

Constipation

Many neurological conditions cause slow transit time in the bowels, which may cause symptoms of constipation. In addition, some medications cause constipation by further slowing gut motility. Constipation is as much about how easily you can pass stool as it is about how often you go.

How often it occurs depends on the condition. A review of neurogenic bowel dysfunction reports that up to 95% of people with a spinal cord injury experience constipation, and that it affects an estimated 25% to 63% of people with Parkinson's disease, depending on how it is defined³.

Reduced sensation

This symptom can cause an inability to feel when the rectum is full, and the signals that say "you need to go to the toilet now" can be altered.

Faecal incontinence (leakage)

Changes in nerve signalling can affect how the bowel muscles and rectum work, which may lead to reduced sensation or difficulty controlling bowel movements. This can result in accidental leakage or difficulty holding stool, known as faecal incontinence.

Around 75% of people with a spinal cord injury have experienced episodes of faecal incontinence³.

Functional incontinence

Functional incontinence is any physical, mental, or environmental limitation that prevents someone from reaching the toilet in time. The bladder and bowel themselves may be working perfectly well; the difficulty is getting there.

Some neurological conditions can cause functional incontinence in the following ways.

Reduced mobility

Changes to mobility, for example an inability to move quickly, reliance on walking aids, or the use of a wheelchair.

Cognitive disorders

Some neurological conditions cause confusion, disorientation or reduced motivation to get up and move.

Environmental barriers

This includes anything related to the environment, such as stairs, distance to the nearest bathroom, and lighting. Environmental barriers can be more problematic in new environments.

Difficulty with clothing

Some neurological conditions affect how the hands and arms function, making it harder to remove clothing to use the toilet. This includes difficulties with buttons or zips.

How physiotherapy can help

Physiotherapy can help you improve bladder and bowel control, helping you feel more confident and comfortable in your daily life.

At the White House Clinic, our specialist physiotherapists concentrate on practical, personalised strategies to help you regain control and independence. This may include tailored pelvic floor exercises, bladder or bowel retraining, and simple habit changes that fit around your routine. Where functional incontinence is part of the picture, that work can also cover how you move, what you wear and how your home is set up.

With appropriate support, many people see improvements that allow them to return to normal activities with greater confidence. If continued input is needed, your physiotherapist will guide you through the next measures with your GP as part of your ongoing care.

You can see what a first appointment involves, and how long it lasts, on our women's health physiotherapy page. The same specialist service treats male patients.

Discuss your symptoms with the White House Clinic

Bladder and bowel symptoms can feel difficult to manage, but with appropriate support many people see improvements in their confidence and comfort.

At the White House Clinic, our specialist physiotherapists provide personalised care to help you regain control and return to your usual activities. With rapid access to appointments and skilled guidance throughout your treatment, we support you at every stage.

This article is general information and not a substitute for individual assessment. Book an appointment or call 0114 230 2030 to speak to our team. For women's health at Sheffield West, ask to book in with Jackie Gibbon, Specialist Women's Health Physiotherapist; at Chesterfield, ask for Hannah Gray. If you are not sure which service you need, call the same number or email info@whitehouse-clinic.co.uk and the team will briefly go over your concerns first and help you find the right person to see.