Frequently Asked Question
What is incontinence? What causes it?
Incontinence refers to any involuntary leakage from the bladder or bowel. A fairly common condition, incontinence can significantly affect all aspects of one’s life. According to the Canadian Continence Foundation, distressing urinary symptoms affect 10% of Canadians while bowel symptoms affect 5% of Canada’s population. Gender ratios are 1 in 4 women and 1 in 10 men who live with bothersome symptoms. The National Association for Continence notes that 200 million people worldwide report unwanted leakage.
Different types of urinary incontinence are caused by various conditions, and numerous modalities are available to treat or manage each one. Embrace Continence Solutions Ltd. advocates for conservative, non-invasive behavioral modifications as the initial approach to any incontinence. Studies show promising results when courses of treatment consistently incorporate:
- individual lifestyle changes
- bladder and bowel retraining
- pelvic floor muscle exercises.
It is important to move away from the common belief that advanced age causes urinary incontinence, and to understand that age is only one of the risk factors contributing to weak pelvic floor muscles and/or bothersome bladder or bowel symptoms. Other risk factors include:
- damage caused during pregnancy
- prostate surgery
- carrying heavy objects
- certain accidents
- history of chronic constipation
- a chronic cough
- some chronic conditions
- increased abdominal weight
- menopause and hormonal changes
- lack of overall fitness
- bladder/ bowel irritants
- some medication.
Types of incontinence
Stress: small volume leak paired with an activity that puts stress on the bladder: laughing, climbing stairs, getting up from a chair, sneezing, running, etc. Usually there is no nighttime occurrence. Causes include pelvic organ descend, pelvic trauma, hormonal changes, certain medical conditions or surgeries.
Urge: medium volume leak preceded by a strong urgency that is difficult to ignore in the daytime and often involves repeated nighttime washroom visits. Sometimes termed Overactive Bladder (OAB), this urgency can occur with or without leakage, hence ‘wet’ or ‘dry’ OAB. Among the causes are: urinary infections, some medications, chronic conditions or unhealthy habits.
Mixed: a combination of the two types above; usually one kind of incontinence dominates.
Overflow: small-medium void volume day and night, with frequency, due to retention of urine from different causes such as blocked flow of urine, chronic conditions, some medications or the bladder not emptying fully. Contrary to Urge Incontinence, the bladder squeezes weakly rather than more often.
Functional: incontinence occurs for reasons outside of the urinary tract such as decreased mobility, ability, choice of clothing or environment.
Your primary physician is an important link in reaching optimal health. Keeping communication open and discussing your symptoms in more detail are indispensible to this goal.
What is the pelvic floor and how can I strengthen it?
The pelvic floor is a group of muscles working together as a team. You can find them spanning between your your pubic bone in front and the bottom of your spine. A muscle can be exercised, has memory and when used consistently in the same way, it will remember what to do.
One of the healthy pelvic floor exercises is the Kegel exercise. It consists of a combination of contractions, relaxation and breathing techniques which you perfect during your appointments with us and continue at home, in your own time. With perseverance, support and consistency, you can experience positive results in a few weeks.
Biofeedback is a specific neuromuscular therapy which reads the electrical activity of a muscle and gives you visual or auditory information about what that muscle is doing. Applied to treating incontinence, biofeedback focuses on the pelvic floor. The process is viewed on a screen, providing immediate information and creating a baseline for desirable changes. Completely safe and painless, biofeedback treatments are most beneficial when undertaken once weekly for 2-3 months.
I stay fit by running every day and I leak almost every time. How can I stop the leakage?
Reportedly, over 30% athletes, such as runners, experience unwanted leakage at one time or another. Other physical actions such as coughing, sneezing or laughter can have the same impact. When the pelvic floor is weakened, an increase in abdominal pressure can potentially trigger some leakage. You can learn to strengthen your pelvic floor in order to stop unwanted leaks by using different techniques and conservative measures promoted by Embrace Continence Solutions. Call us today!
What is Fecal Incontinence? What causes it?
Fecal Incontinence represents any involuntary leakage of gas, solid or liquid stool. Not a condition in itself, it is a symptom of an underlying problem. According to the NAFC, approximately 6 million Americans are affected by Fecal Incontinence. Its higher prevalence in women (affects 1 in 10) is believed to be most likely related to labor and delivery. A minor problem during young adulthood can worsen in later years. For sufferers, Fecal Incontinence is a source of anxiety, depression, isolation, pain and skin breakdown. Causes of Fecal Incontinence include:
- pelvic organ prolapse (POP)
- dietary and lifestyle factors
- weakened pelvic floor muscles
- inflammatory bowel conditions
- neurological conditions
- labour and delivery.
Do behavioral modifications apply to men?
Yes, they do. Many men opt for prostate surgery to improve bothersome urinary symptoms they experience. Following this surgery and the removal of the catheter, the pelvic floor muscles and sphincters need to relearn their protective and functional actions and until then, some incontinence may occur. Men can regain continence sooner through learning how to control and strengthen their pelvic floor by using behavioral modifications, neuromuscular re-education and other practical skills.
What will my treatment involve?
Treatment varies with specific conditions and needs, but typically includes:
- gaining awareness of the muscles involved
- creating an individual progressive program for muscle coordination, strength and endurance
- retraining the bladder or bowel through careful observation of patterns
- examining current diet and lifestyle as a baseline to determine improved body requirements
- using muscles’ electrical responses to isolate, retrain, tone or relax the pelvic floor
- learning about pertinent anatomical, neurological and physiological connections.