At one time, people merely coped with incontinence. Today, however, there are medications and therapies that can help, and you shouldn t be embarrassed about seeking assistance. Nor should you feel alone. More than three million Canadians are affected by incontinence. In fact, if you believe the various television and magazine advertisements it may seem like even more.
Incontinence is the involuntary leakage of urine. It can be transient that is, it comes and goes or it can be chronic. Chronic incontinence is classified as urge, overflow, or stress. If you are bothered by incontinence all the time and if you can identify the type, then there are medications that can help.
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In urge incontinence the detrusor muscle, which is responsible for the propulsion that empties your bladder, doesn t function properly and you end up with uncontrolled contractions and urine leakage. Because the muscle is controlled by the nervous system, drugs like oxybutynin work through the nervous system to block muscle contractions, reducing this type of incontinence.
Overflow incontinence is like your kitchen sink overflowing because the drain is clogged and you don t know it. You wet yourself without realizing you re doing it. Men with enlarged prostates are susceptible to this type of incontinence, and treating the prostate problem will help.
Another cause of overflow incontinence is something called a large neuropathic bladder, such as people with diabetes may have. Think of this type of bladder like an athlete that s gone to seed. It s oversized and flabby, unable to flex its muscles.
Stress incontinence is most common in postmenopausal women. There is leakage upon physical exertion such as coughing, sneezing, climbing stairs, or even turning over in bed. It is attributed to a weakening of the bladder neck and pelvic floor relaxation. Incontinence during pregnancy or because of multiple pregnancies is stress incontinence. Exercise to strengthen the pelvic floor is useful, for example walking, running, yoga and aquacise.
Specialized exercises known as Kegel exercises are specific for strengthening pelvic floor muscles and will help with most types of incontinence, for both men and women.
First, locate the right muscles by stopping the flow of urine while you are urinating. However, once you ve located them, don t make a habit of stopping the flow because the practice itself can contribute to incontinence. You want to contract these muscles and hold the contraction for about five seconds, then relax the muscles. Aim for at least 10 repetitions about three times daily. A nice aspect of this exercise is that you can do it anywhere and no one will know you are!
If you experience incontinence, regardless of the type, look for any factors that could contribute to it. Urinary stones or tumours, urinary tract infections, constipation, prostate problems, and even poor control of conditions like diabetes should be addressed. Some drugs can worsen incontinence (for example muscle relaxants, antihistamines, antidepressants and decongestants) and you may not even realize that your symptoms are a drug side-effect.
Some people try to solve incontinence problems by reducing their fluid intake. However, you do need a good fluid intake to ensure proper bladder functioning. A better idea is to try toilet training. That is, take routine trips to the bathroom regardless of whether you feel the need or not. Later in the day and closer to bedtime, your fluid intake can be reduced, and don t forget to avoid caffeine and alcohol, both of which are diuretics.
If you experience incontinence, don t just accept it as part of growing older. Yes, as you age your risk does increase, but with treatment of any underlying cause, changes in habits, exercise, and even medications, incontinence doesn t need to interfere with your day-to-day activities. And, don t forget that there are incontinence products that are ideal for keeping you dry when you may experience leakage.
Marie Berry is a lawyer/pharmacist interested in health care and education.
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With the aging of the Canadian population, dementia including Alzheimer s disease is becoming more common. Presently, about half a million people are living with Alzheimer s, but over the next 25 years the number is expected to double. Next month, we ll take a look at dementia in general and some new therapies.
