Decoding Incontinence

WomanListening174805193Incontinence300X200If you have ever found that some of your urine ends up on your clothes, instead of in the toilet, you are not alone. According to the Agency for Healthcare Research and Quality, more than 13 million people have urinary incontinence. Women are more than twice as likely to have it as men. One might expect that it is a disease in itself, but it is actually a symptom of several conditions, and treatments vary based on the cause and other factors. So what’s a person to do? First you should know that this is a condition that can often be fixed or improved. Here’s a quick guide for getting to the bottom of urinary incontinence.

Sure, it’s embarrassing. But the first thing to do is put your pride aside and start thinking like a scientist. Careful observations—like when and how, precisely, the urine comes out—are the best tool for determining the cause and targeting the most likely treatment to correct the problem. Discuss this with your physician or urologist. Many times this condition can be fixed or improved. You may be asked to keep a journal of fluid intake, including type and amount; bathroom usage; instances of incontinence; and a description of the instance, including what you were doing when it happened. Here are the terms associated with some of the most common observations:

• Stress incontinence happens when your bladder leaks as a result of some pressure, like coughing, sneezing, laughing, exercising, or lifting.

• Urge incontinence is the phenomenon of having a sudden, intense urge to urinate followed by an involuntary loss of urine. It can happen at any time and frequency, including through the night.

• Overflow incontinence is frequent or even constant dribbling of urine most often associated with a bladder that doesn’t empty completely.

• Functional incontinence is a result of some physical impairment, such as being in a wheelchair or having poor mobility, resulting in being unable to get to the toilet in time.

• It is possible to experience more than one at a time.

Solving Temporary Urinary Incontinence

Based on your journal, you may find that certain foods, drinks, or medications may be causing the problem. Try decreasing your intake of alcohol, caffeine, decaffeinated tea and coffee, carbonated drinks and those with artificial sweeteners or corn syrup. Do replace those beverages with a reasonable amount of water, 64 ounces per day, so as to avoid dehydration. Spicy, sugary, and acidic foods, like citrus, can have an effect, as well. Since constipation can sometimes be a cause, try adding some high fiber foods to your diet. Like many other conditions, being overweight is a risk factor. Losing some weight may help mitigate incontinence too.

Also, pay attention to your medications. Some heart and blood pressure medications, sedatives, muscle relaxants, and large doses of vitamins B and C can increase incontinence. If you find a medication may be to blame, talk with your doctor and pharmacist before making any changes.

If you have incontinence you should discuss this with your Doctor. Like we said, incontinence is a symptom and may indicate a more serious condition, like an infection or neurological disease. Also, it sometimes keeps people from being as active as they are normally and can cause fall injuries as people rush to the toilet. In severe cases, incontinence can lead to skin infections. When you do see your doctor, be prepared to discuss your careful observations about what you have been experiencing.

Based on your account of the problem, the doctor may make a referral to a urologist, a doctor who specializes in diseases of the urinary tract and the male reproductive system. The urologist will also want to review observations and symptoms in addition to a list of the medications you are taking. A review of your diet, fluid intake, and medications may is usually performed. In addition other conditions may be reviewed such as lifestyle, diet, alcohol, and narcotics use. Medical conditions such as constipation, obesity, and conditions that caused dementia such as Parkinson’s Alzheimer’s, diabetes, and multiple sclerosis may be evaluated. He may recommend some tests, including urinalysis, which checks your urine for infection, and others using catheters and even ultrasound, and x-ray, or cystoscopy or urodynamics to better evaluate your bladder function

CowderAndrewThere are a number of treatment options available depending on the specific case. Some find that changing diet or toilet habits is enough to stave off the problem. For others, doctors may recommend special exercises to strengthen the muscles that control urination. In addition to medications, other treatments include electrical stimulation, medical devices, interventional therapies that can be conducted right in the office, or surgery. Some choose protective garments or a catheter to solve the problem.

With all of the treatments available, there is very little reason to let urinary incontinence stand in your way of an active lifestyle.

Andrew Cowder, MD, is the a urologist with SVMC Urology. “Health Matters” is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care.