Lifestyle changes may help with incontinence

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If you have ever laughed so hard your bladder leaked, or put the key into your door and felt a sudden urge to go to the bathroom, you are not alone. These leaks are called incontinence, and affect 13 million Americans.

The condition can be triggered or worsened by some medications. Diuretics can create more urine causing urge incontinence. High blood pressure medications can relax the bladder muscles causing stress incontinence. This can be very embarrassing and discouraging.

Urge incontinence occurs when there is weakness of the sphincter muscle closure and a behavioral trigger — such as putting your key in the front door — causes unplanned squeezing of the bladder muscle. This results in a sudden leakage of large amounts of urine.

Stress incontinence occurs when there is weakness of the pelvic floor muscles. Physical activity such as laughing, lifting or jumping can cause bladder leakage.

It is not uncommon to have a mix of urge and stress incontinence.

Most people go to the bathroom five to seven times during the day and once or twice at night.

Remember when you felt the urge to go to the bathroom and the urge went away when you got distracted? Bladder signals for the need to urinate come in waves. These signals can occur when the bladder is less than half full. When these signals occur too often they can be disruptive to normal activity and the bladder can become unstable.

There are a number of steps you can take to help your bladder to become more stable and reduce incontinence.

An unstable bladder can occur due to certain foods and liquids.

Alcohol, caffeine, colas, chocolates and spicy foods can irritate the bladder and increase urine production. Not enough water can also cause an unstable bladder. You can help stabilize your bladder by avoiding irrigating foods and drinks, and by staying hydrated.

Most doctors recommend six to eight 10-ounce glasses of water daily, preferably before 7 p.m.

Having a regular bathroom schedule also helps train the bladder to be more stable. Try keeping a bladder diary, and scheduling bathroom runs every 1 1/2 to 2 hours.

Stress can further upset your bladder. Taking time out to take six to eight slow deep breaths can help calm the nervous system.

When your nervous system is out of balance your hands will be cold. Try checking your hands hourly to see if they need warming. To rebalance the nervous system, try to slow down your breathing and send warm thoughts to your hands.

This is a good technique to use when you can’t get to the bathroom on time or it is not yet time to go based on your bathroom schedule. Listening to relaxation CDs or to relaxing music also may help.

Keeping the pelvic muscle system strong is important to maintaining a healthy bladder. They help to support the urinary system in correct alignment in the pelvic bowl.

The pelvic bowl is a group of muscles looped together which create the muscle closure for the bladder and bowels.

These muscles combined with the muscles of the hips and legs create a pelvic muscle force field that is important for continence. These muscles can be strengthened through walking for 20 to 60 minutes daily.

One form of strengthening synonymous with continence are pelvic floor exercises called kegels. These exercises contract the pelvic muscles upwards as if stopping the flow of urine. The contraction is held for 10 seconds, followed by a 10 second rest before repeating the contraction.

This is done throughout the day to complete 80 repetitions. It takes six weeks to see the benefits of the exercise program. Studies have shown that there is only a 20 to 30 percent success rate.

One successful new treatment approach is a program called “Beyond Kegels.” This program was designed by a physical therapist and has five important parts: lifestyle changes, physiological quieting, Roll for Control exercises, the use of a wedge for pelvic elevation and biofeedback if needed.

This program has been used with all ages and populations. Studies have shown 80 percent improvement in continence at 3 1/2 weeks. The exercises can be taught by physical therapists who work on continence training.

Advertising agencies would like you to think that incontinence is part of growing old. They would like you to believe that you need to wear their product. However, you can strengthen muscles and learn continence behaviors. There is hope for those who experience urge and stress incontinence.

Jeannine Broome is a physical therapist who works with continence training at Providence St. Mary Medical Center Outpatient Rehabilitation.

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