Family Doctor 2007 - (Page 227) INCONTINENCE Incontinence: Embarrassing but treatable Many Americans suffer the stress of incontinence unnecessarily — 80% of all cases can be cured or improved. By Amy Ronek hold up your uterus and bladder to prevent urine leakage. Surgery may be an option if incontinence is severe or other treatments haven’t helped. DID YOU KNOW? There are several types of urinary incontinence: ■ Stress incontinence is when urine leaks because of sudden pressure on your lower stomach muscles, such as when you cough, laugh, lift something or exercise. ■ Urge incontinence occurs when the need to urinate comes on too fast and you can’t get to a toilet in time. ■ Overflow incontinence is a constant dripping of urine caused by an overfilled bladder. You may feel like you can’t empty your bladder all the way and you may strain when you urinate. ■ Functional incontinence occurs when you have normal urine control but can’t get to the bathroom in time because you have difficulty moving around. ■ Mixed incontinence is when you have more than 1 of the types of incontinence listed above, which is not that unusual. Fecal incontinence People who have fecal incontinence can’t control their bowels. They may not be able to hold their bowel movement until they get to a toilet. Or stool can leak from their rectum. This type of incontinence is most common in women and older adults. However, it can affect people of all ages. Common causes of fecal incontinence include the following: ● Constipation or diarrhea. ● Damage to the muscles that hold stool inside I ncontinence affects as many as 25 million Americans. If you are dealing with the rectum (called anal sphincter muscles). ● Damage to the nerves of the anal sphincter incontinence, you may feel embarrassed. But don’t let that keep you from seeking your doctor’s help. Approximately 80% of all cases of incontinence can be cured or improved with treatment. Urinary incontinence is most common in women. muscles or the rectum. ● A rectum that can’t stretch enough to hold stool. Help is available Depending on what’s causing your fecal incontinence, your doctor may recommend dietary changes, medicine, bowel training or surgery. In some cases, more than one treatment may be necessary. Your doctor may work with you to prevent diarrhea and to set a regular bowel movement schedule. If anal sphincter muscles are weak or damaged, a bowel training technique called anorectal biofeedback can help strengthen the muscles. Urinary incontinence Loss of bladder control is called urinary incontinence. Urinary incontinence is most common in women, especially after menopause. However, it can affect men and women of all ages. A treatable problem Treatment for urinary incontinence depends on what’s causing the problem and what type of incontinence you have. Behavioral techniques can treat some types of urinary incontinence. For example, a technique called bladder training involves urinating at set times, whether you feel the need to go or not. Then you gradually lengthen the time between bathroom trips. This works best for urge incontinence. Another behavioral technique is doing special exercises to strengthen the muscles that control the flow of urine. This works best for stress incontinence. Medicines are another option for treating urinary incontinence. In some cases, your doctor may recommend medicine and behavioral techniques. Your doctor will work with you to choose the right medicine for your specific symptoms. Medical devices are available to help treat incontinence in women. Urethral inserts are small disposable plugs that keep urine from leaking out of the urethra (the tube through which urine exits the body). A pessary is a device that helps Don’t suffer in silence If you hide your incontinence, you risk getting rashes, sores, and skin and urinary tract infec- tions. But you don’t have to live like this. Your family doctor can help you find a way to deal with your incontinence and get back to a life free of fear and embarrassment. Amy Ronek is an editor living in Dubuque, Iowa. ADDITIONAL INFORMATION American Academy of Family Physicians http://familydoctor.org National Association for Continence http://www.nafc.org/about_incontinence/ Mayo Clinic http://www.mayoclinic.com familydoctor 2007 227 http://familydoctor.org http://www.nafc.org/about_incontinence/ http://www.mayoclinic.com
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