Most urinary and bowel problems can be either cured or significantly improved. You don’t just have to put up with it. Bladder and bowel habits can be retrained. Pelvic floor relaxation and strength can be restored.
You could think of the bladder and bowel as storage and emptying containers. They store urine and faeces respectively. When a certain volume is reached, a signal is sent to the brain and we feel the need ‘to go’. We get to a safe place when we’re able, relax and emptying can occur.
It’s normal to be able to exercise without leakage, to ‘hold on’ and reach the toilet comfortably, without pain or fear of leakage, and to have a good night’s sleep without bedwetting or having to get up frequently.
The most common bladder problems are stress urinary incontinence and urgency with or without incontinence. The first step in dealing with any urinary incontinence is to rule out urinary tract infection. If you see your doctor they will usually do a urine test.
Stress urinary incontinence
Stress urinary incontinence is leakage that occurs with exercise or physical activity. This is helped primarily with correct pelvic floor training. There may be some modifications needed for general exercise routines, whilst the pelvic floor is improving. There are vaginal support pessaries, specifically designed for stress urinary incontinence management. They can be worn during physical activities such as sport or exercise.
Urinary urgency and urge incontinence
Urinary urgency and urge incontinence is when the bladder sends very strong signals of needing to go and sometimes you don’t make it. This overactive bladder system can be retrained successfully. A bladder diary is very helpful in determining what type of training will be most useful. Often people will restrict fluid intake and go frequently, in an attempt to control the bladder but these strategies can actually make it worse in the long run.
Constipation, bloatedness and difficulty emptying
About 20 % of the Australian population have constipation problems. Constipation is when there is a hard stool that is difficult to pass.
It is considered within normal, to empty the bowels, without difficulty, once to three times per day to once every three days. The ideal stool is formed but soft. And when you go it is not difficult to pass. Constipation can sometimes be related to slow transit, irritable bowel disease or other digestive factors, hormonal changes, stress or poor timing. Being away from the home toilet can cause people to put off going with the urge. Delaying will cause the stool to move back up into the rectal canal and then it sits there and will dry out more. Suitable diet, good toilet posture, allowing enough time to go, balanced strength and relaxation of the pelvic floor muscles, can all contribute to making emptying more comfortable and easier.
Bowel urgency and leakage
Bowel urgency and leakage is very often not talked about due to embarrassment. It can cause significant distress, limit socialising and involvement in work or leisure activities. There may be anal sphincter muscle weakness, reduced or lack of sensation as to when the bowel is actually full or completely empty, or there could be rectal prolapse problems All these bowel difficulties can be successfully treated and improved with exercises, relaxation, biofeedback tools – external or sometimes internal including rectal balloon training, toilet posture, and retraining emptying technique and bowel habits.
Bedwetting (enuresis)
Bedwetting may affect adults and children. It is more likely that a child will have bedwetting if one or both parents also had it as a child. There can also be daytime wetting and sometimes bowel problems. Bowel problems usually need to be addressed first. Occasional wetting up to age 6 or 7 is usually within normal. It can be triggered by stress, change of environment or fear of night. Ongoing and frequent bedwetting affects the whole family and can limit the social life of the child.
Bedwetting is most often helped with a retraining programme, use of a soft night light and sometimes using bedwetting alarms.
Bowel problems in children can include constipation, withholding or incontinence. Healthy diet and eating habits, allowing time and going with the natural urge (encourage sitting about 20-30 minutes after a main meal), comfortable secure toilet environment and positioning with a footstool, managing stress factors and family dynamics, may all play a part in the improvement of bowel habits.
