Millions of people in the UK with bladder and bowel problems face a "life sentence" of suffering because of the poor quality of care, say doctors.

A Royal College of Physicians audit of services in England, Wales and Northern Ireland said diagnosis and treatment was often poor or non-existent.

It blamed inadequate training and bad organisation and said incontinence should be given a higher priority.

The government said the audit would be a spur to offering higher quality care.

The audit looked at the cases of more than 18,000 people with incontinence, making it the most detailed evaluation of its kind in Europe.

One in five adults suffers from incontinence, a condition that causes great distress but which health staff and patients often find difficult to discuss.

The authors concluded that services often fail to meet the standards set out by the National Institute for Health and Clinical Excellence (NICE).

'Social isolation'

Dr Adrian Wagg, clinical director of the National Audit of Continence Care, said bladder and bowel incontinence causes ill health, depression and social isolation, costing the NHS millions of pounds.

"Although these are treatable conditions, people of all ages, and vulnerable groups in particular continue to suffer unnecessarily and often in silence with a life sentence of bladder and/or bowel incontinence."

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