Bladder & Bowel Management
There are many different reasons why you, or someone close to you, may need to pay special attention to managing your bladder and/or bowels.
Bladder problems typically take the form of incontinence (leaking urine) and retention (inability to empty the bladder) and can arise from disorders such as spinal cord injury, multiple sclerosis and spina bifida. Incontinence and retention can also be age related, or result from an underlying disease, causing a dysfunction in the bladder.
Causes of bladder problems
Medical conditions causing bladder/urinary problems are usually categorised as neurogenic or non-neurogenic. Some conditions can cause retention or may completely prevent the bladder from emptying and require catheterisation. Some conditions can cause incontinence in which case a collecting device (sheath and bag) offers a comfortable solution for men, or incontinence pads for women.
Neurogenic conditions causing bladder issues
Conditions causing damage to the nervous system include:
Symptoms vary depending on where the neurological damage occurs and how severe it is.
Non-neurogenic conditions causing bladder issues
- Weakening of the pelvic floor due to childbirth
- Enlarged prostate – this can have an impact on their daily life as urinary symptoms may appear as the prostate grows. Symptoms can become severe and an intermittent catheter, medicine or an operation may be needed.
- Bladder cancer
Symptoms of bladder problems
- There are different types of incontinence, each with different symptoms and causes. The most common types are stress incontinence, urge incontinence and mixed incontinence.
- Stress incontinence occurs when the muscles in the pelvic floor, under sudden, increased pressure (stress), are too weak to hold the urethral sphincters closed. The result is an involuntary leakage of urine during everyday activities such as sneezing, coughing, laughing or exercising.
- Urge incontinence (unstable or overactive bladder) is caused by involuntary, uncontrolled contractions of the muscle in the bladder. This results in a sudden urge to go to the toilet, and involuntary leakage before reaching the toilet.
- Mixed urinary incontinence is a combination of stress and urge incontinence.
- Overflow incontinence (a frequent or constant dribble of urine) results from an inability to empty the bladder fully and occurs in people with a damaged bladder, blocked urethra or neurological damage. With overflow incontinence you may feel as if you never completely empty your bladder. When you try to urinate, you may produce only a weak stream of urine.
Retention can be caused by an obstruction in the urinary tract, a bladder muscle weakness or by a neurogenic condition e.g. multiple sclerosis, spinal cord injury or spina bifida all of which interfere with signals between the brain and the bladder, resulting in a dysfunction in the system.
Urinary tract infections
When your bladder is not emptying properly there is a risk that the residual urine in the bladder will become infected. This could cause further complications e.g. urinary tract infections if it is not removed regularly. It is important to seek help if you experience symptoms of retention.
Symptoms of a urinary tract infection vary and may be subtle. They include:
- Dark-coloured and strong-smelling urine
- Cloudy urine
- Blood in the urine
- Bladder spasms
- Increased muscle contractions in your leg
If you experience any of the symptoms listed, you should consult your healthcare professional.
Avoiding urinary tract infections
While there is no definite solution to avoiding urinary tract infections, there are a number of precautions that can help you prevent infections:
- Generous intake of fluids – at least 1.5 litres a day
- Good personal hygiene
- Healthy digestion – a good bowel routine may reduce the risk of urinary tract infections
If you have difficulty emptying your bladder, you will typically use an intermittent catheter. It is important that you follow the guidance of your healthcare professional in terms of choice, technique and how often you catheterise.
Collecting devices like sheaths and bags are used effectively by many men dealing with incontinence. Sheaths are worn over the penis like a condom and connected to a collecting bag. It is important you use the right size sheath while the right collecting bag depends on how much you leak.
Symptoms of bowel leakage
Bowel leakage is the involuntary passage of stool e.g. you cannot control when your bowel opens, often resulting in bowel accidents.
- Feeling the urge to have bowel movement but not being able to control when your bowels open, resulting in a bowel accident (urge incontinence)
- Leaking stools (passive incontinence)
- Soiling of underwear
- Being unable to control when you pass air (flatus)
Symptoms of constipation
There is no exact science to what constitutes constipation as the symptoms vary from person to person. It is often characterised by decreased bowel movements and straining at defaecation.
- Inability to have a bowel movement
- Severe stomach ache
- Spending long amounts of time trying to pass stool
Symptoms of overflow incontinence
This is a combination of bowel leakage and constipation. You can be constipated but still experience loose stool that leaks past the hard stool.
Managing bowel leakage and constipation
There are a number of treatment options available and it is most likely that you will be offered conservative treatments first, such as moderating diet and fluid intake and/or taking medication, such as bulking agents, laxatives and enemas. Other treatments are available and you should contact your healthcare professional for more advice.
Bowel irrigation helps you empty your bowels in an effective and predictable manner. Irrigating on a regular basis prevents bowel leakage and eliminates the risk of bowel accidents. By preventing the build-up of stool, it is also an effective method for reducing the risk of constipation.
If you experience bowel leakage, anal plugs can be effective in preventing the uncontrolled loss of solid stool.
Approach your GP about your bowel problems
It is never too late to get help with your bowel problems. Book an appointment with your GP, write down a list of questions that you have and they will be happy to offer you advice and their expert opinion on the next steps to take.
Rapidcare has been delivering bladder and bowel appliances to customer’s homes for over 30 years and in that time we have helped and worked with many clients. Whether you are looking for answers to your questions, more information for you or a loved we, we’d be happy to talk to you and help in any way we can.