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Bladder & Bowel Archive


IBS in the crosshairs

Irritable bowel syndrome (IBS) affects up to 45 million Americans, two-thirds of whom are women. IBS is categorized into three types depending on which symptoms dominate: diarrhea, constipation, or a mix of both. Possible contributors include changes in gut bacteria, faulty nerve signals between brain and intestine, pelvic floor problems, and genetics. Newer treatment approaches target pathways involved in symptoms. Doctors are also repurposing older drugs for IBS, including certain antidepressants and the antibiotic rifaximin (Xifaxan).

Why you keep waking up to go to the bathroom

Making one or more trips to the bathroom every night is the defining characteristic of a medical condition called nocturia. It can be caused by aging, lifestyle habits, or underlying conditions such as an overactive bladder or (in men) an enlarged prostate. Treating nocturia starts with lifestyle changes such as avoiding fluids several hours before bedtime, eliminating caffeinated drinks 10 hours before bedtime, and limiting evening alcohol intake. Medications, pelvic floor exercises, injections of botulinum toxin (Botox), or nerve stimulation treatments may also help.

Bladder problems that warrant a doctor’s visit

Bladder problems in women can increase due to childbirth, menopause, and aging. Additional contributors to bladder symptoms include weight gain, pelvic organ prolapse, and the types of beverages people drink, as well as how much and how often. Women should see a doctor about increasing leakage, urgency, frequency, or nighttime urination; cloudy or strong-smelling urine; pain or burning while urinating; pain during sex; or lower abdominal pain.

Leaking a little urine: It’s not just a female problem

Men often have a hard time coping with incontinence (urine leakage). It can leave them feeling depressed or socially isolated. Types of leakage problems in men include urge, stress, and overflow incontinence. Treatment depends on the type of incontinence a man is experiencing. For example, overflow incontinence may get better with a procedure to reduce the size of the prostate; medications, injections in the bladder muscle, and pelvic floor exercises can help with urge incontinence.

Pregnancy's lasting toll

Pregnancy and childbirth effects on the body can linger or develop years or decades after the birth. Muscles, ligaments, and nerves in the pelvis can be damaged, leading to urine or stool leakage or sagging pelvic organs. Treatment approaches include a pessary, various surgical procedures, or pelvic floor physical therapy. Women can protect their pelvic floor from weakening further by maintaining a healthy weight, preventing constipation, and managing conditions that contribute to chronic cough.

Novel telehealth approach may improve overactive bladder symptoms

A 2022 study found that women with overactive bladder showed significant improvement in urinary symptoms, such as urgency and leakage, after they engaged in a type of telehealth care.

Bracing for incontinence

Among US women ages 60 or older, the prevalence of urge incontinence (a sudden, unprovoked need to urinate) and stress incontinence (leaking urine with physical activity or pressure on the bladder) appeared to increase between 2005 and 2018. Treatments for urge incontinence include lifestyle modifications (such as avoiding caffeinated drinks or scheduling bathroom breaks), pelvic floor exercises, medications, and Botox injections. Treatments for stress incontinence include pelvic floor exercises, weight loss, vaginal pessaries, bulking agent injections, and bladder sling surgery.

You don't say? Can your bladder burst from "holding it" too long?

While men sometimes hold off urinating until absolutely necessary, waiting too long won’t cause serious damage to their bladder. Still, over time, the practice could possibly raise the risk for urinary tract infections and make urinating difficult.

The dos and don’ts of managing diverticular disease

People who have diverticular disease have tiny pouches (diverticula) in the lining of the colon that can bleed or perforate and develop infection (called diverticulitis). People with diverticular disease should eat a healthy diet rich in fiber, drink lots of water, exercise regularly, maintain a healthy weight, not smoke, avoid straining in the bathroom, and report bleeding or pain to a doctor. However, it’s not necessary to avoid eating nuts, seeds, or popcorn, which were once believed to lodge in diverticula and cause problems. That old advice turned out to be wrong.

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