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Better Bladder and Bowel Control
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Urinary Incontinence & Bladder Control
Urinary incontinence is surprisingly common.
Surgery, medications, childbirth, or injury can
interfere with the muscles, nerves and other
tissues that work together for bladder control
and urinary and rectal function. Middle aged
and older people are particularly susceptible
to these conditions. But there are a variety
of treatments available including exercise programs,
medications and surgery. This Special Health
Report, Better Bladder and
Bowel Control, describes
the causes of urinary and bowel or fecal incontinence
and treatments tailored to the specific cause.
Better Bladder and Bowel Control was
prepared by the editors of the Harvard Health
Publications in consultation with May M. Wakamatsu,
M.D., assistant professor of obstetrics gynecology
and reproductive biology at Harvard Medical School
and Massachusetts General Hospital and Joseph
A. Grocela, M.D., Instructor in surgery, Harvard
Medical school and Massachusetts General Hospital.
47 pages. (updated: 2007)
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Table of Contents:
- Urinary incontinence
- Anatomy of urinary
continence
- Types of urinary
incontinence
- Evaluating urinary
incontinence
- Treating urinary
incontinence
- Lifestyle changes
- Medication to
treat urinary incontinence
- Neurological
strategies
- Surgery
- Managing urinary
incontinence
- Containment options
- Collection devices
- Leakage barriers
- Catheterization
- Vaginal support
devices
- Skin care
- Odor control
- Emotional concerns
- Fecal incontinence
- Anatomy of fecal
continence
- What can go wrong?
- Evaluating fecal
incontinence
- Physical exam
- Testing
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- Treating fecal incontinence
- Diet and medication
- Pelvic muscle
exercises and biofeedback
- Surgical treatments
- Managing fecal incontinence
- Containment and
collection options
- Enemas and suppositories
- Skin care
- Reducing odor
- Emotional concerns
- Glossary
- Resources
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Here's an
Excerpt from this Incontinence Special Health
Report
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, career, 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 raises
the risk of injury from falls. And incontinence
that causes withdrawal from social interactions
can contribute to result in 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 problem.
This report describes the common causes of urinary
and fecal incontinence for men and women and
the treatments for these conditions. No matter
how serious or longstanding the problem, there
is assistance available—you may not find
a total cure, but you can get help. Even if you
have not had success in the past, advances in
medical care provide a good reason to try again.
For example, easier-to-take medications are now
available for urinary incontinence. 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, using this report as a guide.
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