Health Care and Urinary Incontinence

Controlling the urge to use the restroom can be difficult for some people. Part of the problem can be caused by urinary incontinence and bladder control. Many Americans suffer from this often embarrassing physical problem, and it can become a more severe issue if left untreated over time. As a matter of fact, urinary incontinence, or UI, is a common occurrence.

According to the Mayo Clinic, the severity of urinary incontinence ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. If urinary incontinence affects your day-to-day activities, don't hesitate to see your doctor. In most cases, simple lifestyle changes or medical treatment can ease your discomfort or stop urinary incontinence. Urinary incontinence isn't a disease, it's a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what's behind your incontinence.

Most bladder control problems happen when muscles are too weak or too active, according to the National Institutes of Health (NIH). If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh or lift a heavy object. This is stress incontinence. If bladder muscles become too active, you may feel a strong urge to go to the bathroom when you have little urine in your bladder. This is urge incontinence or overactive bladder. There are other causes of incontinence, such as prostate problems and nerve damage. More information can be found at this website: http://www.nlm.nih.gov/medlineplus/urinaryincontinence.html .

Here are the Types of Urinary Incontinence, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

--Stress Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).

--Urge Leakage of large amounts of urine at unexpected times, including during sleep.

--Overactive Bladder Urinary frequency and urgency, with or without urge incontinence.

--Functional Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.

--Overflow Unexpected leakage of small amounts of urine because of a full bladder.

--Mixed Usually the occurrence of stress and urge incontinence together.

--Transient Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing).

UI is twice as common in women as in men. Pregnancy, childbirth, and menopause are major reasons why. But both women and men can become incontinent from brain injury, birth defects, stroke, diabetes, multiple sclerosis, and physical changes associated with aging, according to WomensHealth.gov.

• Pregnancy — Unborn babies push down on the bladder, urethra (tube that you urinate from), and pelvic floor muscles. This pressure may weaken the pelvic floor support and lead to leaks or problems passing urine.

• Childbirth — Many women leak urine after giving birth. Labor and vaginal birth can weaken pelvic floor support and damage nerves that control the bladder. Most problems with bladder control during pregnancy and childbirth go away after the muscles have time to heal. Talk to your doctor if you still have bladder problems 6 weeks after childbirth.

• Menopause — Some women have bladder control problems after they stop having periods. After menopause, the body stops making the female hormone estrogen. Some experts think this loss of estrogen weakens the urethral tissue.

Other causes of UI that can affect women and men, according to WomensHealth.gov, are:

• Constipation — Problems with bladder control can happen to people with long-term (chronic) constipation.

• Medicines — UI may be a side effect of medicines such as diuretics (“water pills” used to treat heart failure, liver cirrhosis, hypertension, and certain kidney diseases). Hormone replacement has been shown to cause worsening UI.

• Caffeine and alcohol — Drinks with caffeine, such as coffee or soda, cause the bladder to fill quickly and sometimes leak.

• Infection — Infections of the urinary tract and bladder may cause incontinence for a short time. Bladder control returns when the illness goes away.

• Nerve damage — Damaged nerves may send signals to the bladder at the wrong time, or not at all. Trauma or diseases such as diabetes and multiple sclerosis can cause nerve damage. Nerves may also become damaged during childbirth.

• Excess weight — Being overweight is also known to put pressure on the bladder and make incontinence worse.

Much more info can be found at their site: http://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.cfm .

For treatment, expect the health professional to be concerned about your complaint and to be attentive to the information you bring, according to the National Association for Continence (NAFC). Be ready to give a complete history, which will include the questions we have listed for you and probably many more. Expect to have a complete physical examination. You will be asked to give a urine specimen, and you should be tested within 15 minutes after that to see if there is still urine in the bladder. Sometimes this is done by passing a small thin tube (catheter) into your bladder. Other times it is done with a small sensor that is rubbed over your lower abdomen. This is called an ultrasound. A sample of your blood may also be taken.

The doctor may begin treatment immediately or do some other tests called urodynamics. These tests show how your bladder acts when it is filling and emptying. The reason for all tests should be explained, and you should know when, how, and where you will get the results. Once the specialist has made a diagnosis of your bladder or bowel problem, you should expect to have the treatment choices explained to you with the risks and benefits and estimated cost of each.

And finally, expect to participate in your care to get the best results. Your treatment will be most successful when you help choose the solution and when you do all that you need to do in the way of record-keeping, going to the toilet regularly, drinking the recommended amount and type of fluids, and performing exercises if you are told to do so. Of course, you should report any side-effects of medicines or treatments and discuss any concerns you have about your treatment with your healthcare professional, according to the NAFC. Much more detailed information can be found at their website: http://www.nafc.org/ .

Incontinence is embarrassing to most all people who suffer from it. Men, women, and children all experience UI. However, with proper diagnosis and treatment, you can experience better lifestyle options. If you or someone you know are having issues with UI, seek professional medical help.

Until next time.