Too Embarrassed to Ask?

This article was reviewed by Senior Director of Community Engagement and COPD360social Community Manager, Bill Clark, as well as certified staff Respiratory Therapists on January 29, 2020.

Dear COPD Coach,
I have a rather embarrassing question to ask you. I was diagnosed with moderate COPD just a few years ago. While I am still able to get around fairly well and am just on oxygen at night, I have noticed that lately when I get out of breath during activity I get this huge urge to either urinate or have a bowel movement. Sometimes this urge is over-powering and I am embarrassed to say that it has on a couple occasions resulted in having an “accident.”

My first question is why this happens, and secondly, what can I do about it?

-Need To Go

Dear Need To Go,

This problem is fairly common with those with respiratory problems and often one we do not discuss outside our COPD circle of friends. What is actually occurring is that when you get out of breath, your brain goes into (for lack of a better term) survival mode. In this mode, the brain triggers blood to the most essential organs that must keep working for us to remain alive. Unfortunately, this does not include the bladder or sphincter muscles. The result is the sudden need to either urinate or have a bowel movement. Often times after experiencing this urge, when you are finally able to eliminate, you might be somewhat surprised how little is actually eliminated.

With that said, there are some things you can do. Personally, my COPD philosophy is that I have never met a restroom I didn’t like, and rarely pass up an opportunity to visit when I am out and about. In fact, I have gotten in the habit and become somewhat an expert in scouting out locations of convenient restroom facilities. While use of the facilities whenever possible does not reduce the urge to eliminate, it does significantly reduce the chances of a major accident!

Since I travel in excess of 100,000 miles a year this has become a major concern - especially in airports. Just before boarding, and often times before deplaning, I make it a point to use the restroom whether I feel the urge or not. Since regaining my usual oxygen saturations after a flight takes a little time (even though I use oxygen), I find that making my way up the jet way incline often causes me to get out of breath, so it just makes sense to anticipate what is most probably inevitable. I have spoken with others in similar circumstances who tell me when they anticipate excursions that might cause them to get short of breath, they actually use adult incontinence products. There are new products becoming available all the time, most with very little bulk, so you can be reasonably assured that nobody will know but you.

The other thing I have found is that the quicker I rush to find a bathroom, the more I get out of breath and consequently, the greater the urge “to go.” In many cases I find that if I stop, relax and concentrate on regaining my breath, the urge often subsides. This only really works when you first sense that you are getting out of breath, and the urge to eliminate is not really strong.

Avoiding beverages, especially those with caffeine or alcohol prior to and during situations where you might get out of breath can really help. I find that if I avoid beverages prior to and during a flight, the urge is not nearly as bad.

The important thing to remember is that while this problem might be embarrassing, it is something that often you do not have a lot of control over. The important thing is not to go into a panic mode as that will often cause the problem to get worse. Plan ahead, use facilities when they are available, and avoid liquids when out and about and you should not experience any unpleasant situations.

Best regards,
-The COPD Coach

Coaches Corner is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to The COPD Coach.


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  • And check your pulse oximeter!! When mine hits '90' and my pulse is over 105, I know the urge is about to happen.....I stop and do PLB slowly to raise my sat and the urge resolves. Each person is different. It is not always when you are short of breath, but you can have a low sat for other reasons and the urge will be there. I always carry a pair of underpants in my purse. It happens to men too.
    • Thank you! I never thought of that but will give it a try starting today!

  • Thank You soooo much for addressing this little issue need to go, as I asked my pulmo dr about this... he kinda snickered and said he never heard that one before. I am starting to think I need a new pulmo dr. as he has also told me i will not, period...progress with this disease of COPD since I stopped smoking, but it is ok to try to work in construction as I have for 30 yrs.
    • Yes, definitely time for a change and the sooner the better.
    • Yep - I agree with Mark S. Find another pulmonary doctor, soon!!
    • Unfortunately that pulmo experience is very common from what I have seen. A lot of questions we have should be addressed by our pulmos and not by copd forum members, yet that is not the case. I have had pulmos give me information that is so far from the truth, and in such a detached manner, that I feel as if I am with a robot.
      And mine goes a step further, listing things like that as "anxiety", which is a detriment to getting proper healthcare, since many in healthcare only know the basics and look to a pulmo's notes.
  • Thank you for discussing this problem. I have become quite familiar with the incontinence products in the last few months. Thanks for these other suggestions. This has been very helpful with the most embarrassing part of COPD.
    • Thank you for asking the question Donna. I never associated incontinence with Copd
  • I like to think that concern about peeing or pooping in my pants one the treadmill or the street wouldn't bother me all that much, but of course insult to one's vanity couldn't be worse than to be caught by a whole crowd observing you take an uncontrolled dump in public. I'm just thankful it hasn't been that often, but the few times it happened I felt like I was going to die. There you are; you already can't breathe worth a d%*n, and you got to get organized and find a clever way to clean up without making too much of a stir. You're afraid some joker's gonna' call an ambulance for no reason except they can't think what else to do and you got a $2000 ride for nothing.
  • Edi
    So glad someone asked and got answer to this....I too have felt this urgency upon SOB issues! At least now I know why!

  • Okay, now I know it's just not me...I have never mentioned it because it is so embarrassing for me. My husband up until now has been the only one I have mentioned it to.

  • Happens to me too. I find when I am very short of breath I panic, which makes me even more short of breath.
    Then the incontinence. I spoke with my pulmonologist about my panic making my breathing worse, leading to the
    " leakage". He put me on .25mg of clonazepam. It helps with the panic, and so the severity of my shortness of breath
    which in turn lessens the embarrassing episodes. Hope this helps.

  • I've learned to always take a bathroom break before engaging in any kind of semi-strenuous activity. When "the tank is empty," you don't have to worry about springing a leak.....
  • I'm really happy so many put in their own input. There is little these days that I won't talk about with this disease.
    Thanks to everypne else who made me feel better about the whole subject.

  • Thank you for addressing this important issue! Before I connected with my present Pulmo doctor, I had been using only the Albuterol inhaler. I had sudden urges seemingly too often, and really struggled with it. I also felt like I was going to die, unable to breathe. After I started taking the prescription for Anoro Elipta and oxygen therapy, all of those panicked situations disappeared. I am so grateful for these products, they have improved my life considerably. Sure, the need "to go" is alive and well, it is just so much less pressing as I have the control back again. (I know, I sound like a commercial.) BTW, I have tried all various and sundry of public restrooms since I travel a bit by car. I will never go near a gas station! But by far, the cleanest public restrooms have been Starbucks. Yep!
  • There is a phone app called " bathroom finder" it is wonderful, hugs!

    • good information

      Personally, I never pass up a perfectly good bathroom. That is always my last stop before I leave the house or anywhere else.

  • Thank you so much so much for bringing the peeanpoo issue into the light!!! Talking about divine intervention I just started having this problem the last few week's, found this wonderful website and awnsers to so many c.o.p.d. ?'s....
  • Exercises to reduce urinary stress incontinence.
  • If possible, carry with you a shirt or sweater/jacket that you can use the sleeves to tie the shirt around you to hide the wet spot. Hopefully you have another pair of panties in your purse. Don't know about men (and they too have the same issue) but maybe a thin pair of boxer shorts stuffed in a pocket. Also carry a plastic bag to put in the soiled clothing.

    When traveling in your car long distances and no highway restrooms around, consider keeping a small urinal or bedpan inside a pillow case & with a large plastic bag, dry panties, etc. Think of it as part of your emergency COPD kit.

    As the article stated, this sudden urge cannot be controlled per se, but it means 'stop, sit (if possible), PLB, wait until you get your sat back up before walking. This is NOT the same mechanism that women experience after childbirth.

    Last summer, I was pushing my rolator with 2 O2 tanks out on the neighborhood sidewalk for fresh air and exercise. Just as I got back to my driveway, my sat was low and I could only get as far as the door from the garage into the house. Luckily I was wearing a maximum thick incontinent pad. I was amazed at how it absorbed all that urine! I was so worried it would run down my legs and ruin my new & costly athletic shoes, but all was dry! So now I use that thick pad if I think I might be overexerting myself when out and about.

    PLEASE, COPDF, put a date on these articles!!! We have no way of knowing how old the information is and that might be important! thank you.
  • I have this situation also. The first time I was like what the heck is going on. I just told myself forget it I just have to pee on myself lol. I always wear the pads and have extra with me. If I feel the urge I stand still, breath and get myself together sometimes that helps most times not. I'm getting use to how much I can do, I think that is the key, knowing your symptoms and triggers. My grandkids thinks it's real funny, so I just have to understand its all part of our disease. Stay prepared, know your triggers and we will get thru this.