by Roger French
Inability to control urination can be inconvenient
and mightily embarrassing. It is more common in women than in men simply
because the tube from the bladder to the exterior (the urethra) is far
shorter in women. Around 50% of young women, who have never been pregnant,
have leakage at some time when they cough, laugh, etc, but this is not
necessarily abnormal. It’s when it keeps occurring that it’s
a problem.
According to urologists, most people with urinary incontinence can overcome
it. Further, it is not a normal part of aging and is not inevitable.
Causes
The cause of incontinence can be: weakness of the muscles controlling
the bladder, weakness of pelvic floor muscles, stretched pelvic-floor
nerves, prostate trouble in men, an unstable bladder (a stress reaction),
bladder infection, diabetes or the result of a stroke or spinal injury.
In women, weakened pelvic-floor muscles are often the result of childbirth
or a surgical operation.
In both sexes, stretching of pelvic-floor nerves goes hand in hand with
the Western habit of sitting on the toilet for a bowel motion rather
than squatting the way all primitive peoples have done and some peoples
still do. When we sit to defaecate, a kink in the rectum (that prevents
bowel incontinence) remains kinked, tending to produce constipation.
Straining to overcome this resistance day after day, year after year,
stretches pelvic-floor nerves.
Some drugs affect bladder control, particularly those for high blood
pressure, so check for this possibility with a practitioner.
Stinging or burning sensations during urination indicate the likelihood
of bladder infection - cystitis.
Prevention
To prevent incontinence, first and foremost, adopt a practice that has
the potential to help this and your entire health in a big way - squatting
for bowel motions. This straightens the anal canal, allowing easy bowel
motions and avoiding straining, giving stretched pelvic-floor nerves
a chance to restore to normal. Many people have recovered from bladder
and bowel incontinence, bed wetting in childhood, constipation, haemorrhoids
and other conditions when squatting becomes their normal practice. For
an explanation and case stories, refer to New Vegetarian and Natural
Health, Spring 1998, page 56. To facilitate squatting, an In Lieu Toilet
Converter can be purchased from the head office of the Society, phone
(02) 4721 5068.
If constipation is present, also take other steps to overcome it, especially
including plenty of fibre in the diet and eating a low calorie diet
(according to Natural Health Dietary Guidelines). How to overcome constipation
was explained in Natural Health, April/May 1994. Back issues are readily
available from head office, posted price $5.
If the bladder is unstable due to stress, make a conscious effort to
keep the genital area relaxed during times of tension.
If overweight, make an effort to lose weight as obesity puts extra pressure
on the bladder. Even a small reduction can significantly reduce incontinence.
[See ‘How To Lose Weight’, page ??]
If cystitis is the cause, it will require professional guidance. Just
a few tips for cystitis are to drink a good amount of water; avoid tea,
coffee and alcohol; take vitamin C at between 500 and 1000 mg daily;
and drink no-added-sugar cranberry juice twice daily or eat the cooked
fresh fruit. Cranberries acidify the urine, preventing the growth of
bacteria.
Pelvic-floor-muscle exercises are the way to hasten the return of bladder
control. The ‘Kegel Exercises’ were developed by Dr Arnold
Kegel to overcome incontinence. Firstly, locate the relevant muscles.
Without tensing your legs, buttocks or abdomen, imagine you are trying
to hold back a bowel movement by tightening the anus. This locates the
back part of the pelvic muscles. Next, when you are urinating, try to
stop the flow and then restart it. For women, imagine trying to grip
a slipping tampon. This locates the front pelvic muscles. For the complete
exercise, work from back to front and tighten the muscles in sequence
for four seconds and then relax them. Continue for two minutes at least
three times a day. You can do it lying in bed, standing at the stove
or bus stop, or while watching television, etc.
There are homeopathic remedies that can be prescribed by a homeopath,
and herbs by a herbalist, such as arbutus, which is astringent. Soak
30 grams of the leaves in 600 ml of boiling water for 15 minutes, cool,
strain and drink freely during the day for as many days as necessary.
There are many practical tips for easing or
preventing incontinence:
Go easy on fluids. Keep tabs on how much you are drinking in case you
are overdoing fluids, but don’t drink too little and risk dehydration
which can worsen urinary problems.
Avoid alcohol and caffeine, well-known diuretics.
Avoid grapefruit juice which is also diuretic and substitute cranberry
juice instead. As soon as things improve, get back to the grapefruit
juice if possible because it is so good for health.
If you smoke, quit, because nicotine irritates the bladder.
Keep the genital area clean and dry and avoid using scented soaps, talcs
and deodorants in this area. Wear cotton underwear, not nylon, and avoid
tight clothing.
Re-train your bladder. Firstly, pass urine at regular, short intervals
and gradually increase the interval until you are accustomed to having
a full bladder without leakage. When it’s full, do empty it; holding
on too long may encourage bladder infections and an over-stretched bladder.
One suggestion is to empty the bladder before and after meals and at
bedtime and also at any other time it is full.
Try ‘double-voiding’. Stay on the loo until the bladder is
empty, then stand up and sit down again, lean forward slightly and try
again.
Anticipate and prevent accidents. If you are about to sneeze, cough,
laugh, lift or bounce on a rebounder, squeeze the sphincter in advance
to avoid an accident. Also, keep a bedpan within reach of your bed.
Don’t panic if you have a sudden urge and fear leakage. Relax,
then tighten the sphincter and, when the urge passes, walk slowly to
the nearest toilet.
Absorbent products can be worn to collect leakage. Ask a pharmacist
what is available and what might suit you.
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