Incontinence

Temuco, Chile(Zone 9b)

Several million of people experience bladder and bowel control problems during their lifetime. Most of them never seek the professional help that could give them back their quality of life.If you're too scared to play sport or attend social occasions because you're afraid of not being able to control your bladder or bowel, you're not alone.

If you have accidents where you wet yourself (even just a little bit), or pass faeces (poo) at the wrong time or in the wrong place, you suffer from incontinence.

Leakage of urine is called urinary incontinence, while accidents involving faeces are known as faecal incontinence.

Sadly, many people with incontinence problems suffer in silence. These people don't seek help because they are embarrassed or, mistakenly, believe that nothing can be done to help them. Many people think this loss of bladder and bowel control is just a normal part of ageing.

Yet in most cases the condition can be cured, or at least better managed, so that it has less impact on your life. Staying home or wearing absorbent pads are not the only options, if you can, see your doctor to find out what your options are. If you cannot perhaps you can find courage to discuss it and see if we can help each other.

The range of normal bladder and bowel function is quite broad, with most people needing to empty their bladder four to eight times a day, or about every three to four hours. You may also wake once at night to pass urine, or perhaps twice if you are over 65.

For bowel function, the normal range is from three times a day to once every three days. Stools should be smooth and sausage-shaped and easy to pass.

But people with incontinence problems may find they are going to the toilet much more often than this or that they have unexpected leakage between visits, especially with sudden movements such as a cough or sneeze. Others experience an urgent need that does not give them enough time to get to the toilet.

I am going to leave it til here and see if there is any interest to continue. There are many ways to help each other so let's move this thread and try to be free of this little problem that may be upsetting many.

cristina

Milton, MA(Zone 6a)

I am one of approx. 3% of MS patients whose presenting symptom was urinary incontinence. Most people with MS have other symptoms first, but for me, that was the one that brought me to the doctor. OTOH, incontinence is probably NOT MS, but more likely weakening of pelvic floor muscles. Don't be scared; I was terrified of being catheterized. Knowledge is power!

Temuco, Chile(Zone 9b)

That is very well put,carrielamont . Many syndromes, disorders or diseases of the nervous system get diagnose by mild event or periodical incontinence.

Thanks for your input.

Some active, young people that do extreme sports also may present incontinence.


Causes of incontinence

Many people think of incontinence as a problem of old age but, although it becomes more common as we get older, it can affect people at any stage of life and is not an inevitable part of ageing.

There are many possible causes associated with the different types of incontinence (see below).

One of the most common causes is weakening of the pelvic floor muscles as a result of childbirth or surgery. The pelvic floor muscles form a sling-like band at the base of the pelvis. They support the bladder and bowel and help control the openings to these organs (ie the uretha and anus).

The impact of pregnancy and childbirth on the pelvic floor muscles is the main reason incontinence is more common in women: an estimated one in three women experience some loss of bladder control after childbirth. (However, it's thought the bulk of the pelvic floor weakness occurs during pregnancy rather than the birth itself.)

On top of that, declining oestrogen levels around the time of menopause can affect bladder control.

Men's pelvic floor muscles can also be weakened after procedures such as surgery on the prostate (a gland at the base of the bladder).

Other factors that can cause or aggravate incontinence include excess weight (this is a major risk factor), an enlarged prostate (because it places pressure on the tube connecting the bladder to the outside) and various conditions that affect the brain's ability to communicate with the bladder or bowel.
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Let see if we can have more opinions and movement into this very special subject, that we may like to ignore but it may be there.

As Carrie said, knowledge is power.

Cristina

Deep East Texas, TX(Zone 8a)

I was amazed when twice in the past 2 months, different doctors (regularly scheduled maintenance visits) inquired if I had any problem with incontinence.

I do not mean to belittle a serious health issue but I thought ~ Aha! The new disease of the day and sure enough within a few days I began to see ads for a new medicine that is used to treat incontinence. It is too predictable with the US medical industry.

If I had problems with that, I would certainly not hesitate to contact a health care provider but to have a GP and a gynecologist ( located about 50 miles apart and unknown to each other ) ask the same question for the first time in my 61 years of health care life made me say HUH?

I suppose they do that in case a person would be to shy to say so but surely not with a gynecologist...

Milton, MA(Zone 6a)

I was definitely too shy - I was too shy to tell my MOTHER, no way I was gonna tell some doctor!

Temuco, Chile(Zone 9b)

carrie, that is exactly what usually happens.

That is why I started this thread.

Thanks for your input
Cristina

Temuco, Chile(Zone 9b)

Pelvic floor exercises

Step 1: Identify pelvic floor muscles. These are the same muscles you use if you try to stop (or slow) the flow of urine when you are going to the toilet. Don't stop and start urine flow regularly, as this can cause damage. Just do it a few times initially to get the feel of the muscles to use.

Step 2: Try sitting, standing or lying down and see if you can squeeze and relax those same muscles you used to control urine flow. Nothing above the belly button should tighten although some tensing and flattening of the lower abdomen is fine. Practise squeezing and lifting and then letting go.

Step 3: When you feel you are doing the exercise correctly, try holding the upward squeeze for longer up to 10 seconds before relaxing. Make sure you can still breathe while squeezing. Repeat 10 times and try to do the set of 10 lifts daily.

Milton, MA(Zone 6a)

Herr Kegel, I presume!

Temuco, Chile(Zone 9b)

Yes, kegel exercises for the pelvic floor.

Also if you could remember to squeeze those muscles every time you pass through a door. That would do it too.

And it does work.

Cristina

Temuco, Chile(Zone 9b)

Types of urinary incontinence include:

Stress incontinence (often experienced in combination with urge incontinence): This is when small amounts of urine leak from the bladder during activities that increase pressure inside the abdomen, such as coughing, sneezing or jumping. A weak pelvic floor (especially during pregnancy and after childbirth), prostate surgery, being overweight, constipated or having a chronic cough are all risk factors. Stress incontinence can generally be improved by addressing its causes or through pelvic floor exercises (see Pelvic Floor Exercises box).

Urge incontinence (often experienced in combination with stress incontinence): This is when a sudden urge to urinate allows little time to get to the toilet, so leakage occurs. Often due to an over-active or unstable bladder, this type of incontinence becomes more common with age. The cause is not always identifiable, but it can result from a urinary tract infection, constipation, an enlarged prostate, poor toilet habits, medication side-effects or a range of conditions that can impede communication between brain and bladder. Treatments may include medication, pelvic floor exercises, reducing alcohol and caffeine consumption and practising better toilet habits (see Good bladder and bowel habits box).

Overflow incontinence: This is when the bladder does not empty completely during urination, leading to later leakage. Possible causes include a partial blockage in the tube connecting the bladder to the outside (in men, this might be due to an enlarged prostate). Occasionally conditions such as multiple sclerosis cause miscommunication between the bladder and the muscles that relax and allow the urine to flow. Changes to medication or toilet practices may help. Some people with a blockage may benefit from surgery.

Functional incontinence: In elderly or disabled people, incontinence may be "functional" rather than physical. Their bladder control may be normal but they have difficulty getting to the toilet in time for physical or environmental reasons or because of disorientation associated with dementia. Continence can often be improved by changes to the environment or teaching carers to provide assistance, although it is important to check for other possible causes of the incontinence, such as constipation or a urinary tract infection.

Milton, MA(Zone 6a)

How about dysuria (?)? There are two muscles involved in successful urination, the SPHINCTER, where the urine leaves the body, via the "pee hole" or urinary meatus or urethra, and the DETRUSOR, which is the bladder muscle itself, whose function is for our purposes to store the urine until we're ready. Each of these two muscles has a squeeze, or tighten, or contract position, and a relax, let go, loosen position. For successful urination, everything has to happen like clockwork, and the detrusor (or bladder) has to CONTRACT while the sphincter is RELAXING. If the detrusor contracts but the sphincter doesn't relax you'll be sitting on the toilet knowing you have to pee, trying to pee, waiting to pee, and nothing will come out. Then sometimes the detrusor gets so FULL its contraction can override the sphincter contraction and cause incontinence, but your bladder will not be empty, because the sphincter put the brakes on aas soon as it could. Also the sphincter can relax when the detrusor is relaxed -- even though your bladder is not contracting, it's like turning on a spout.

Temuco, Chile(Zone 9b)

carrie, you are more or less right, but there is a little but...

Dysuria is painful urination and that is cause mainly for UTI= urinary tract infection most common in women. In men it happens usually in urethritis and certain prostate conditions.

Detrusor Instability and Irritable Bladder also called overactive bladder syndrome involve the detrusor muscle and it is a cause of incontinence, but Detrusor overactivity may be associated with Parkinson's disease, spinal cord injury, diabetic neuropathy, multiple sclerosis, dementia or stroke. For this reason is treated as a pathological condition that requires medical treatment and will not respond to pelvic floor exercises.

Neurogenic bladder here it gets a bit complicated, detrusor underactivity to overactivity, depending on the site of neurologic insult. The urinary sphincter also may be affected, resulting in sphincter underactivity or overactivity and loss of coordination with bladder function. Needs careful medical treatmentl and voiding history together with a variety of clinical examinations, including urodynamics and radiographic imaging studies.

Milton, MA(Zone 6a)

Well what I had was a complicated neurogenic bladder.:)

Temuco, Chile(Zone 9b)

carrie I hope you are ok now and that your Urologist keep on eye on you. Take care.

cristina

Temuco, Chile(Zone 9b)

Faecal incontinence

There are two main types of faecal incontinence:

Structural: This is where there is physical damage to the muscles controlling the emptying of the bowel,(this is usually either present from birth, or a result of childbirth or surgery).

Non-structural: This is associated with age, constipation and a range of medical conditions.

It may sound unlikely, but by far the most common cause of faecal incontinence, especially in older people, is actually chronic constipation. This is because a hard piece of faeces can become stuck in the bowel, stretching and weakening the muscles in the bowel walls. Watery faeces can then flow around the blockage and emerge without warning. So, even though the result looks like diarrhoea, it may need to be treated as constipation. One of the best ways to combat constipation is through lifestyle measures. Constipation can also be caused by some medications and by various bowel or neurological diseases. Your doctor will be able to advise you about this.

Pelvic floor exercises and medication may also help to control faecal incontinence, with surgery a possible option in more severe cases, particularly where there is structural damage.

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