Living With Bowel Or Bladder Incontinence
There is no single, right way to cope with bladder or bowel incontinence. The challenge is to find what is best for your situation, so you can get the help you need and return to a normal daily life. Talk with your health care team if you notice a change in bowel or bladder habits, and about the best ways to manage incontinence, if it is a problem. You might find it helpful to talk with other people who are dealing with incontinence, too. Ask a member of your cancer care team about support groups in your area.
Here are some things you can do that may help make incontinence less of a problem:
- Empty your bladder every 3 to 4 hours while awake, to avoid accidents.
- Empty your bladder before bedtime or before strenuous activity.
- Limit drinks with caffeine, or and avoid alcohol and citrus juices, which can irritate the bladder and make you have to go more often.
- Avoid hygiene products that may irritate you Women should avoid feminine spray or over-the-counter vaginal suppositories.
- Because belly fat can push on the bladder, avoiding weight gain or losing needed weight sometimes helps improve bladder control.
- Avoid tobacco use which can cause coughing and bladder irritation due to harmful substances in tobacco products.
- Talk to your doctor about all medicines, vitamins, herbs, and supplements youre taking. Some may affect urine control.
Q Why Do Younger Women Suffer From Urinary Incontinence
Teenagers and young women involved in sports are more likely to suffer from urinary incontinence. Women who are parachuters and gymnasts suffer from urinary incontinence as hitting the ground might cause weakening of the pelvic muscles. Some pre-existing or genetic issues also cause this problem. Weak pelvic muscles can run in the family. Activities like running or weightlifting can also make the pelvic floor muscles weak.
According to research, women who are sexually active also are more likely to report similar issues than women who are sexually inactive.
This clears up the common misconception that only pregnant and older women can suffer from this issue. Women who have not experienced childbirth can have weaker pelvic muscles too. But their issue can get worse after pregnancy. The risks of urinary incontinence are more among young women whose mothers suffer from similar problems.
Why Does Pregnancy Cause Incontinence
During pregnancy, your body goes through a lot of physical changes. As your uterus stretches to hold the growing baby, a few things happen. Your bladder can be squished by the expanding baby, making your bladder hold less than before. You might experience an increased urgency to pee during pregnancy because your bladder cannot hold as much as before. This might become even more challenging towards the end of pregnancy when the baby is at its largest.
Another reason for incontinence during pregnancy is the weakening of your pelvic floor muscles. These muscles are the support structures for all of the organs in your pelvis. During pregnancy, they can be stretched and weakened as your uterus expands.
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Treatment Options For Urinary Incontinence During Menopause
Your doctor may recommend a number of different treatment options depending on the severity of your condition, and what type of incontinence you have.
If youve found that bladder leaks have become a problem for you, whether youre going through menopause or not, we urge you to learn more about your condition and the treatment options out there and then talk to your doctor to figure out a plan to manage it together.
What Steps Can I Take At Home To Treat Urinary Incontinence
Your doctor or nurse may suggest some things you can do at home to help treat urinary incontinence. Some people do not think that such simple actions can treat urinary incontinence. But for many women, these steps make urinary incontinence go away entirely, or help leak less urine. These steps may include:
You can also buy pads or protective underwear while you take other steps to treat urinary incontinence. These are sold in many stores that also sell feminine hygiene products like tampons and pads.
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Botulinum Toxin A Injections
Botulinum toxin A can be injected into the sides of your bladder to treat urge incontinence and overactive bladder syndrome .
This medication can sometimes help relieve these problems by relaxing your bladder. This effect can last for several months and the injections can be repeated if they help.
Although the symptoms of incontinence may improve after the injections, you may find it difficult to fully empty your bladder. If this happens, you will need to be taught how to insert a catheter into your urethra to drain the urine from your bladder.
Botulinum toxin A is not currently licensed to treat urge incontinence or OAB, so you should be made aware of any risks before deciding to have the treatment. The long-term effects of this treatment are not yet known.
Incontinence And Alzheimers Disease
People in the later stages of Alzheimers disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. To minimize the chance of accidents, the caregiver can:
- Avoid giving drinks like caffeinated coffee, tea, and sodas, which may increase urination. But dont limit water.
- Keep pathways clear and the bathroom clutter-free, with a light on at all times.
- Make sure you provide regular bathroom breaks.
- Supply underwear that is easy to get on and off.
- Use absorbent underclothes for trips away from home.
For more ways to deal with incontinence and other common medical problems in someone with Alzheimers, visit Alzheimers Disease: Common Medical Problems.
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Does Your Menstrual Cycle Affect Bladder Control
A range of hormones govern your menstrual cycle, and a number of ailments and conditions have been blamed on these hormones through the years. One of these conditions is leaking urine, known as urinary incontinence, which some women experience around the time of their menstrual cycles.
Urinary incontinence takes several forms. There is stress incontinence, which is when a woman leaks a bit of urine when sneezing, coughing, laughing, jumping, or engaging in other movements. There is also urge incontinence, or the sudden need or desire to urinate. Some women experience both types, which is called mixed incontinence.
Early theories on why this incontinence occurs centered on the hormones involved in menstruation. Was it estrogen? Progesterone? Something else?
Why Do I Have Urinary Incontinence
More than three-quarters of the 25 million adults in the United States who suffer from urinary incontinence are women. Although the risk for urinary incontinence increases with age, one in four women over age 18 have some form of urinary incontinence.
Whether you leak small amounts of urine while sneezing or coughing, or whether you have a persistent urge to urinate and sometimes just barely make it to the bathroom on time, you dont have to live with the embarrassment and inconvenience of incontinence. Our expert OB/GYNs Daniel McDyer, MD, FACOG, and diagnose and treat urinary incontinence at our two Florida Woman Care of Jacksonville offices in Jacksonville, Florida. Below, well tell you why youre struggling with urinary incontinence and how to take control of your bladder again.
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In This Video Dmx Displays Prolotherapy Before And After Treatments
- In this video, we are using a Digital Motion X-Ray to illustrate a complete resolution of a pinched nerve in the neck and accompanying symptoms of cervical radiculopathy.
- A before digital motion x-ray at 0:11
- At 0:18 the DMX reveals a completely closed neural foramina and a partially closed neural foramina
- At 0:34 DXM three months later after this patient had received two Prolotherapy treatments
- At 0:46 the previously completely closed neural foramina is now opening more, releasing pressure on the nerve
- At 1:00 another DMX two months later and after this patient had received four Prolotherapy treatments
- At 1:14 the previously completely closed neural foramina is now opening normally during motion
When Should I See A Health Care Professional
See a health care professional if you have symptoms of a bladder problem, such as trouble urinating, a loss of bladder control, waking to use the bathroom, pelvic pain, or leaking urine.
Bladder problems can affect your quality of life and cause other health problems. Your health care professional may be able to treat your UI by recommending lifestyle changes or a change in medicine.
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Medication Triggers Of Urinary Incontinence
Check the Medicine Cabinet
Certain medications may trigger urinary incontinence or make it worse. Drugs that affect the brain, nervous system, muscle tone, and fluid balance may trigger the problem. Never stop taking a prescription or change the dose without speaking with your health professional. If you have concerns that a medicine you’re taking may be contributing to your symptoms, discuss the issue with your physician. It may be possible to substitute a problematic drug with another drug that does not cause side effects.
Some Medications Worsen The Problem
Certain classes of medicine increase the risk of incontinence symptoms. Blood pressure medications may relax the bladder, increase coughing, or decrease the tone of the urethral sphincter, all of which may contribute to this health concern. Pain relievers may increase fluid retention or relax or inhibit contraction of the bladder. Drugs to treat depression, Parkinson’s disease, or psychosis may increase the retention of urine. When you really need to urinate badly, some of that urine may leak. Antihistamines and anticholinergic drugs may have similar effects.
What Causes Urinary Incontinence
Urinary incontinence is not an inevitable result of aging, but it is particularly common in older people. It is often caused by specific changes in body function that may result from diseases, use of medications and/or the onset of an illness. Sometimes it is the first and only symptom of a urinary tract infection. Women are most likely to develop urinary incontinence during pregnancy and after childbirth, or after the hormonal changes of menopause.
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Alternative And Complementary Therapies
The treatment of urinary incontinence varies depending on the cause of the bladder control problem. In most cases, a physician will try the simplest treatment approach before resorting to medication or surgery.
Bladder habit training This is the first approach for treating most incontinence issues. The goal is to establish a regular urination schedule with set intervals between urination. A doctor will usually recommend urinating at one-hour intervals and gradually increasing the intervals between urination over time.
Pelvic muscle exercises Also called Kegel exercises , this exercise routine helps strengthen weak pelvic muscles and improve bladder control.
The person contracts the muscles used to keep in urine, holds the contraction for 4 to 10 seconds, then relaxes the muscles for the same amount of time.
It may take weeks or months of regular pelvic exercise to show improvement.
Another way to perform Kegel exercises is to interrupt the flow of urine for several seconds while urinating.
Are There Other Ways To Treat Incontinence
Yes. Medicines or medical devices can treat some types of urinary incontinence. For example, estrogen cream to put in the vagina can be helpful for some women who have mild stress incontinence. Several prescription medicines are available to treat urge incontinence. For men, prescription medicine is available to shrink the prostate and improve flow of urine through the prostate. Talk to your doctor about possible medicine options for your type of incontinence.
In some cases, surgery may be an option. Treatment depends on what type of urinary incontinence you have and what is causing it.
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Who Is At Risk For Urinary Incontinence
In adults, you are at higher risk of developing UI if you:
- Are female, especially after going through pregnancy, childbirth, and/or menopause
- Are older. As you age, your urinary tract muscles weaken, making it harder to hold in urine.
- Are a man with prostate problems
- Have certain health problems, such as diabetes, obesity, or long-lasting constipation
- Are a smoker
- Have a birth defect that affects the structure of your urinary tract
In children, bedwetting is more common in younger children, boys, and those whose parents wet the bed when they were children.
Causes Of Overflow Incontinence
Overflow incontinence, also called chronic urinary retention, is often caused by a blockage or obstruction to your bladder. Your bladder may fill up as usual, but as it is obstructed you will not be able to empty it completely, even when you try.
At the same time, pressure from the urine that is still in your bladder builds up behind the obstruction, causing frequent leaks.
Your bladder can become obstructed as a result of:
Overflow incontinence may also be caused by your detrusor muscle not fully contracting, which means that your bladder does not completely empty when you go to the toilet. As a result, the bladder becomes stretched. Your detrusor muscles may not fully contract if:
- there is damage to your nerves, for example as a result of surgery to part of your bowel or a spinal cord injury
- you are taking certain medications
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Questions To Ask Your Doctor
- What type of urinary incontinence do I have?
- What is the likely cause of my urinary incontinence? Can this condition be treated?
- If so, will treating the condition cure my urinary incontinence? When can I expect relief from my symptoms?
- Should I start doing Kegel exercises? How often?
- Would a bladder training program help manage my urinary incontinence?
- Will any lifestyle changes help manage my urinary incontinence?
- Im embarrassed by my urinary incontinence. Until my symptoms improve, what else can I do to help manage my condition?
Medication For Stress Incontinence
If stress incontinence does not significantly improve, surgery for urinary incontinence will often be recommended as the next step.
However, if you are unsuitable for surgery or you want to avoid having an operation, you may benefit from a medication called duloxetine. This can help increase the muscle tone of the urethra, which should help keep it closed.
You will need to take duloxetine by mouth twice a day and will be assessed after two to four weeks to see if the medicine is beneficial or if it is causing any side effects.
Possible side effects of duloxetine can include:
Do not suddenly stop taking duloxetine as this can also cause unpleasant effects. Your GP will reduce your dose gradually.
Duloxetine is not suitable for everyone, however, so your GP will discuss any other medical conditions you have to determine if you can take it.
Nearly Half Of All Patients Undergoing Elective Cervical Spine Surgery Had Moderate
- The prevalence of moderate lower urinary tract symptoms in the patient sample was 40%
- The prevalence of severe lower urinary tract symptoms in the patient sample was 8%
- Clinically relevant urinary bother was reported in 18% of patients
- The odds of moderate-to-severe lower urinary tract symptoms among patients with myelopathy was greater than that observed in patients without myelopathy
- The prevalence of clinically relevant urinary bother was higher in patients with myelopathy compared with those with no myelopathy .
Nearly half of all patients undergoing elective cervical spine surgery had moderate-to-severe lower urinary tract symptoms. This is more than double the prevalence that has been reported in a community-dwelling adult population. These symptoms can impair quality of life, lead to surgical complications , and may be mistaken for cauda equina , prompting potentially unnecessary imaging and studies.
Dr. Albert also suggested:
When To Seek Medical Help
Any instance of incontinence is reason to seek medical help. It may be a symptom of a more serious condition that needs to be treated.
Even if the underlying cause isnt serious, incontinence can be a major disruption in your life. Its important to get an accurate diagnosis and discuss treatment options with your healthcare provider.
In some cases, incontinence is a sign of a medical emergency.
You should seek immediate medical attention if you lose control of your bladder and experience any of the following symptoms:
- trouble speaking or walking
Surgery For Stress Incontinence
If the less invasive treatments dont help you, your GP will refer you to a specialist to discuss surgery. The main types of surgery for stress incontinence include the following.
- Colposuspension. Your surgeon will lift the neck of your bladder by stitching the top of your vagina to the back of your pubic bone.
- Sling surgery. In this procedure, your surgeon will place a piece of your own tissue under your urethra. This acts as a sling to support it.
- Injections of bulking agents into the wall of the urethra. This narrows your urethra, helping it to stay closed and so hold urine in your bladder. The effects of this procedure may wear off over time. So, you may need to have further injections.
- Artificial sphincters. If youve already had surgery for stress incontinence and this hasnt worked, you may be offered an artificial urinary sphincter.
Each procedure comes with risks and benefits. Its important to discuss these with your doctor before you agree to go ahead with the procedure.
How Soon After Starting Kegel Exercises Will Urinary Incontinence Get Better
It may take 4 to 6 weeks before you notice any improvement in your symptoms.10
Kegel exercises work differently for each person. Your symptoms may go away totally, you may notice an improvement in your symptoms but still have some leakage, or you may not see any improvement at all. But even if your symptoms dont get better, Kegel exercises can help prevent your incontinence from getting worse.
You may need to continue doing Kegel exercises for the rest of your life. Even if your symptoms improve, urinary incontinence can come back if you stop doing the exercises.
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