Incontinence Symptoms and Treatment
Incontinence of Feces
Incontinence is the inability of the body to control the discharge of waste products. Incontinence of feces takes two forms:
1) those patients who are aware of passing a small amount of feces through the anus but are physically incapable of stopping it.
2) those who are not aware of passing the feces but may have been able to stop it if they had been aware.
Included in the first group patients are those with severe diarrhea (such as cholera, gastroenteritis), women after childbirth (the anal canal may be torn), and patients who have had operations on the anus. In these cases, the condition causing this type of incontinence is usually of short duration and may be treatable. While it may be a considerable inconvenience it is usually a short-term problem.
The sadder and much more difficult situation occurs with those who are not aware of their own body to know that they are soiling themselves. This includes patients who are in a coma or unconscious (due to disease or injury), cases of paralysis of the lower half of the body (paraplegics and quadriplegics), the elderly (such as advanced Alzheimer's disease), the mentally deranged and those with subnormal mentality. Most of these cases cannot be cured, and the problem is long-term.
In these cases the wearing of nappies and use of protective sheeting in beds becomes routine. Careful attention to hygiene and cleanliness by attendants is essential to avoid rashes and sores developing on the buttocks and around the anus of the patient and the spread of disease and infection to those attending to their needs.
- Immediately after childbirth exercises to strengthen the muscles of the pelvic floor should be undertaken by women. These can also be done in the early stages of incontinence to help control the bladder function as normally as possible.
- A patient can practice stopping and starting the urinary stream several times whenever they go to the toilet. A physiotherapist can teach the finer details of these exercises.
If the problem has progressed beyond control by exercise alone, the options are limited.
- In younger women, an operation to correct the abnormal bladder urethra angle is usually successful.
- Men can also have an operation, but it is not as successful as in women.
- In older women, a specially shaped rubber ring may be worn inside the vagina to put pressure on the urethra and prevent urine from escaping. These rings are fitted and checked regularly by a doctor.
- In elderly and paralyzed men, it is often more practical to use a collecting bag, as this can be easily attached to the penis.
As with most diseases, the earlier incontinence is treated, the better the results. And prevention is even better than cure.
Incontinence of Urine
Uncomfortable, distasteful, embarrassing, unpleasant, intolerable, distressing and very annoying... these are just some of the words to describe the feelings associated with urinary incontinence
It is a topic that is never discussed with friends or family. Incontinence is usually associated with the old man lying on a nursing home bed. But surprisingly, it is far more common in women, and many relatively young women in their thirties or earlier can be effected by it.
Incontinence is the loss of urine from the bladder at times when such loss is not desirable. It can vary from constant bed-wetting, to the occasional dribble when a woman jumps, coughs or laughs.
The most common cause of incontinence is the damage done during childbirth to the genitals, and this is the reason for women being the victims far more frequently than men. Other causes include urinary infections, confusion in the elderly, bladder injury, strokes, epilepsy and damage to the spinal cord in quadriplegics and paraplegics.
The urethra is the tube that exits urine from the bladder to the outside of the body. In women it is only 1 cm long. It leaves the bladder at an acute angle, and this angle causes the pressure of the urine inside the bladder to keep the urethra closed. It requires a voluntary muscular effort to open the urethra and allow the urine to escape. The stretching that occurs during childbirth can cause this critical angle to be lost and the urethra to become a straight tube leading from the bladder to the outside. Any pressure put on the bladder, or any significant volume of urine, can then cause incontinence. Unfortunately this straightened tube can also allow bacteria and infection to enter the bladder more easily and cause the pain and discomfort of cystitis.
The bladder is controlled by nerves, and damage to the nervous system by a stroke or the cutting of the spinal cord in paraplegics can also lead to incontinence.
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