In this issue of HEALTHbeat:
  • Taming incontinence
  • Improve your symptoms

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Harvard Health Publications -- Harvard Medical School HEALTHbeat
March 10, 2009

Taming incontinence

Most people take bladder and bowel control for granted — until something goes wrong. Then, you may find yourself worrying about getting to a bathroom on time, avoiding certain situations for fear of leakage, or relying on absorbent pads for protection. If so, you are not alone.

An estimated 25 million adults have incontinence, the unintended loss of urine or feces that is significant enough to make it difficult for them to maintain good hygiene and carry on ordinary social and work lives. What’s the cause? For women, it’s a rarely discussed but common result of childbirth. For men, it’s most often the result of treatment for prostate problems.

Sometimes incontinence is minor, and all you need is an occasional absorbent pad to keep enjoying your normal activities. But when you begin organizing your life around easy access to a bathroom or start giving up the activities that are important to you — your daily walk, travel, work opportunities, or sex — because you can’t control leakage, it may be time to take action.

Besides disrupting daily activities and nighttime sleep, incontinence can also chip away at your health. If you have stopped exercising, for example, you are giving up one of the most effective strategies for maintaining health. Getting up several times a night can lead to sleep deprivation. And incontinence that causes withdrawal from social interactions can contribute to depression.

Older women who frequently must rush to the bathroom are 26% more likely to fall and 34% more likely to break a bone. Incontinence is also a leading cause of nursing home placement, and that prospect drives some people to try to hide their condition rather than seek help.

While it engenders fear and embarrassment, rest assured that incontinence is not a psychological problem or a personal failure. Incontinence is a medical symptom, and it deserves the same attention you would give to any other medical concern.

For example, easier-to-take medications are now available for urinary incontinence.  Specific exercises can help strengthen the muscles of the pelvic floor, shoring up the muscles that control both bladder and bowel. Surgical options now include outpatient procedures that work as well as major surgery. There are even treatments for the most severe cases of fecal incontinence, including sphincter repair. One warning: manufacturers have discovered that there is money to be made in selling products for incontinence. Your best bet is to choose products or treatments recommended by your doctor.

Improve your symptoms

Unless you engage in strenuous exercise or have a medical condition (for example, if you’re prone to kidney stones) that requires more fluid consumption, you can try these guidelines to improve symptoms of urinary incontinence:

  • Aim for no more than 6–8 cups of fluid (from all sources) each day.
  • Don’t drink more than 8 ounces at a time.
  • Don’t guzzle. The faster your bladder fills, the more likely you are to feel urgency.
  • Minimize caffeinated and carbonated drinks.
  • Decrease or eliminate alcohol consumption.
  • If you are thirsty because it is hot or you have exercised, don’t hesitate to drink water.
  • Urinary incontinence
  • Types of urinary incontinence
  • Treating urinary incontinence: lifestyle changes; medication to treat urinary incontinence
  • Managing urinary incontinence
  • Fecal incontinence
  • Treating fecal incontinence: diet and medication; surgical treatments
Reprinted from Better Bladder and Bowel Control, a Special Health Report from Harvard Medical School, © 2009 by Harvard University. All rights reserved.

** Get your copy of Better Bladder and Bowel Control

Better Bladder and Bowel Control
Whether sitting on an airplane, attending a business meeting, or just gardening in the yard, the sudden or urgent need to get to a bathroom is a distressing and all-too-frequent disruption in the lives of millions of people. Bladder or bowel incontinence is surprisingly common. Middle aged and older people are particularly susceptible to these conditions. Better Bladder and Bowel Control describes the causes of urinary and bowel incontinence and treatments tailored to the specific cause. Click here to read more or buy online.

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