Bladder & Bowel Archive

Exercises, lifestyle change, medications, and procedures can alleviate incontinence and give you your life back.

A leaky bladder or a sudden urge to go to the bathroom is uncomfortable andembarrassing. But you can take steps to alleviate the problem. "Some people tell me they would have sought treatment sooner if they'd known it was this simple," says Dr. Anurag Das, director of the Center for Neurourology and Continence at Harvard-affiliated Beth Israel Deaconess Medical Center.

Lifestyle changes

One of the first lines of defense is pill-free and costs nothing: lifestyle change. For urge incontinence (see "Types of incontinence"), you can try timed voiding (urinating on a schedule) and bladder guarding, which teaches you to cope with triggers that set off the urge to go, such as washing dishes or hearing water. "You squeeze your muscles to hold in urine before a trigger, which sends a message to the brain that this is not the time to go," says Dr. Das. Other lifestyle changes include watching fluid intake; quitting smoking, to reduce coughing and pressure on the bladder; and minimizing bladder irritants such as caffeine, alcohol, and carbonated drinks.

If you feel a strong urge to urinate even when your bladder isn't full, it might be related to overactive bladder, sometimes called urge incontinence. This condition occurs in both men and women and involves an overwhelming urge to urinate immediately, frequently followed by loss of urine before you can reach a bathroom. Even if you never have an accident, urgency and urinary frequency can interfere with your work and social life because of the need to keep running to the bathroom.

Urgency is caused when the bladder muscle, the detrusor, begins to contract and signals a need to urinate, even when the bladder is not full. Another name for this phenomenon is detrusor overactivity.

When the skin comes in contact with fecal material for a length of time, it can become irritated and inflamed. That means proper care of the skin in the anal area is essential to maintaining comfort and preventing skin deterioration. Skin irritation is more than a misery. It can invite infection and even compromise your treatment if the skin becomes too sore for your muscles to work well. 

Skin should be cleansed after each episode of incontinence. Choose an extremely mild, nonalkaline soap — such as Dove or Basis — or buy one of the special cleansers designed to gently dissolve and remove stool and urine (such as Aplicare Antiseptic Perineal Wash). These are nonirritating, soap-free cleansing lotions; some are available in portable disposable wipes (Clinell Continence Care Wipes). They eliminate the need to scrub areas of tender skin, and some do not require that you rinse the skin after use.

Image: iStock

Being checked for hidden colorectal cancer is a smart bet, though it's hard to say whether it will ultimately extend your life span.

Recently, the National Colorectal Cancer Roundtable—a national organization of medical groups, health care providers, government agencies, and patient advocates—launched the "80% by 2018" initiative. The goal is to convince more people to get screened for hidden colorectal cancer. Right now, about 65% of Americans do so.

Image: Thinkstock

Ask the doctor

Q. Your recent article on recurrent urinary tract infections (UTIs) didn't mention much about urination. One of my friends told me that it could influence my chance of getting a UTI. Is that true?

A. Actually, your urination habits are a good place to start if you're trying to prevent UTIs. When sitting on the toilet, make yourself as comfortable as possible in a relaxed seated position—not a squat. Start the stream of urine by relaxing your pelvic floor muscles, rather than straining to urinate. Allow enough time for your bladder to empty completely.

Improve digestive health by addressing underlying causes of irregularity, as well as fluids, diet, and exercise.

You may drink coffee because it tastes good or helps you wake up. But the popular brew is also associated with health benefits, such as reducing the risk for heart disease, stroke, and type 2 diabetes. Now a study from Harvard-affiliated Dana-Farber Cancer Institute published Aug. 17, 2015, in the Journal of Clinical Oncology suggests that regular consumption of caffeinated coffee may be associated with a reduced recurrence of colon cancer, and even a reduced risk of death. The study included nearly 1,000 people with stage 3 colon cancer. They filled out questionnaires about their dietary patterns during chemotherapy, and then again six months after treatment was completed. People who drank four or more cups of coffee per day were 42% less likely to have cancer return than non-coffee drinkers, and were 34% less likely to die from cancer or any other cause.

This type of study doesn't prove that coffee drinking caused the lower chance of cancer recurrence and death. A randomized trial is needed to show cause and effect. But researchers are encouraged by the results. "Regular coffee intake has been associated with a reduced risk of type 2 diabetes, and it may be that through a similar mechanism, coffee may also improve outcomes for people with advanced colon cancer," says Dr. Charles Fuchs, senior author on the paper.

Ask the Doctor

Q. I had a colonoscopy recently and it detected hemorrhoids. I don't have any symptoms. Should I be doing something to get rid of them?

A. Like you, approximately 40% of people with hemorrhoids have none of the common symptoms—bleeding, anal itching, and pain. Their hemorrhoids may be found on a routine physical examination or during a test done for other reasons, such as a colonoscopy for colon cancer screening.

Repeated nocturnal bathroom calls are bothersome, but self-help steps and targeted treatment offer relief.

Get to know your triggers and ways to prevent flare-ups.