Health Matters - Bladder Problems?
By Consultant Pharmacist - Nick Parmar
Urinary incontinence is a common problem, affecting women more commonly than men. Many people are embarrassed by the problem but, importantly, incontinence is often treatable through life style changes and, if necessary, medication which can be prescribed by your doctor.
So what is urinary incontinence?
If you have urinary incontinence it means that you pass urine when you do not mean to. Incontinence may cause you distress as well as being a hygiene problem. It is not clear exactly how many people are affected, but it is estimated that between three and six million people in the UK have some degree of urinary incontinence. Stress incontinence and urge incontinence are the most common types of incontinence.
stress incontinence – when the pelvic floor muscles are too weak to prevent urination, causing urine to leak when your bladder is under pressure, for example when you cough or laugh
urge incontinence – when urine leaks as you feel an intense urge to pass urine, or soon afterwards.
What causes urinary incontinence?
In urge incontinence, the urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of the bladder. The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Stress incontinence happens when the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed (the urethra is the tube through which urine passes out of your body).
How can you manage your urinary incontinence?
Urinary incontinence can usually be diagnosed after a consultation with your GP, who will ask about your symptoms and may carry out a pelvic examination.
Your GP may suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.
If your GP thinks a urinary infection might be the underlying cause, they will test a sample of your urine.
Treatments of urinary incontinence include:
lifestyle changes, such as losing weight
pelvic floor muscle training (exercising your pelvic floor muscles by squeezing them)
bladder training, so you can wait longer between needing to urinate and passing urine
If these measures are not effective, medication may be used to treat stress and urge incontinence.
Other lifestyle changes include:
Changing how much you drink. If you drink large volumes, it follows that you will pass more urine. If you suffer with incontinence, you should not restrict your fluid intake too much, as you risk having a lack of body fluid (dehydration).
Changing what you drink. Drinks containing caffeine (for example, tea, coffee, hot chocolate and cola) make urge incontinence worse.
Avoiding constipation. Try to maintain a healthy balanced diet that contains plenty of fruit, vegetables and soluble fibre. Severe long-term (chronic) constipation can stop the bladder emptying properly and cause overflow urinary incontinence.
Preventing urinary incontinence
It is not always possible to prevent urinary incontinence, but there are some steps you can take to reduce the chance of the condition developing, such as:
controlling your weight
reducing or stopping your alcohol consumption
keeping fit
If you feel that urinary incontinence is something that interferes with your daily life do not hesitate to speak to your GP about it. It is a common problem that shouldn't be ignored - don't be embarrassed to talk about it!
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