Bladder Leakage Treatment

Urinary incontinence is a common condition affecting 1 in 3 women after childbirth. There are several different types of incontinence as well as several different causes behind them. Let’s look into them in a bit more depth.

 Stress Incontinence

The most common type of leakage is stress incontinence (SI). Stress incontinence is leakage of urine with effort or exertion such as coughing, sneezing, bending forward, lifting, standing up from a chair, jogging, laughing, jumping on a trampoline and/or vomiting.

SI occurs when either the pelvic floor muscles and connective tissue are too weak and stretched; there is too much load or weight on the muscles (from a congested bowel, adhesions or abdominal obesity) or when the urethra loses its closure tone due to ageing changes or trauma.

Treatment for stress incontinence often involves:

  • Weight loss
  • Toning of the deep abdominal muscles and pelvic floor
  • Decongesting the bowel and small intestine with supplementation, dietary changes and visceral manipulation
  • Addressing any abdominal adhesions and reducing their impact with visceral manipulation
  • Surgery

 Overactive bladder

Overactive bladder syndrome is a collection of symptoms, including:

  • Frequent urination (more than 6 times per day)
  • Nocturia (getting up to the toilet more than once at night)
  • Getting a desperate urge to rush to the toilet to urinate with or without leakage

Causes of an overactive bladder can include:

  • Obesity
  • Abdominal/pelvic adhesions
  • Chronic constipation
  • Pelvic floor weakness
  • Age-related changes
  • Altered microbial environment inside the bladder

Symptoms of overactive bladder syndrome can point to a more serious problem occurring in the body. It is therefore wise to have further investigations done first before proceeding with treating the bladder itself.

Investigations may include:

  • Urinalysis (urine test)
  • Pelvic ultrasound (to rule out malignancy and to check if you can empty your bladder properly)
  • Completion of a bladder diary (to check for more serious conditions like diabetes or other systemic diseases)
  • Urodynamics (a test performed by urologists or gynaecologists)
  • Cystoscopy (looking into the bladder with a camera)

If the investigations confirm overactive bladder syndrome, the treatment for it includes:

  • Alteration of bladder habits (fluid intake, caffeine and carbonated beverage reduction)
  • Bladder retraining (training the bladder to gradually increase its capacity)
  • Regulating bowel function
  • Visceral manipulation to restore mobility and movement to the bladder
  • Pelvic floor exercises
  • Antimuscarinic medication (prescribed by the GP or specialist, which calms the bladder down)

If these measures fail, a specialist referral is often necessary. Treatment options may then progress to being more invasive and can include Botox injection into the bladder, nerve stimulation at the lower spine or bladder augmentation surgery.

Overflow Incontinence

Overflow incontinence is the least common type of leakage. It occurs when the bladder cannot empty completely and due to being chronically overfull, will leak small amounts regularly throughout the day.

Symptoms of overflow incontinence often include:

  • Frequent and urgent urination
  • Regular, small volume leaks throughout the day

The cause of overflow incontinence can be:

  • Obstructed bladder outlet (narrowed urethra, stone)
  • Weak bladder muscle
  • Medications that cause retention
  • Nerve conduction problems (eg diabetes or degenerative nerve conditions)
  • Masses within the pelvis

Treatment varies according to the cause behind the issue, but can include:

  • Education regarding how to urinate most effectively
  • Using running water or a cold compress over the abdomen
  • Using vibration over the lower abdomen
  • Adjustment of medications, which may be causing the problem
  • Clean, intermittent, self-catheterization
  • Permanent catheterization

Functional Incontinence

This type is also fairly rare and is most often found in elderly or disabled people. It simply is the inability to get to the toilet in time due to poor mobility, lack of dexterity causing issues removing clothes, not reading body signals about when one needs to toilet or not recognizing the toilet.

It is caused by:

  • Dementia
  • Poor mobility
  • Lack of dexterity
  • Poor eyesight
  • Poor signage of where toilets are

It can be improved by appropriate toilet signage, better access to toilet facilities, wearing clothes that are easier to don off and on and giving reminders regarding regular toileting for those who lack the signal.

If you are experiencing problems with bladder leakage – book in today to have a consult with our continence physiotherapist!

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Fibromyalgia

Fibromyalgia (FM) is a chronic condition, which causes widespread musculoskeletal pain and fatigue. It most commonly affects young to middle-aged women and its presentation is varied, often fluctuating in its clinical course.

What causes Fibromyalgia?

The cause is unknown but several theories suggest genetics may play a role as well as environmental triggers such as infection, psychological stress or physical trauma.

Longstanding stress affects the body in many ways, and in FM, this stress winds up the central nervous system and it begins to process pain differently – pain sensitivity increases and normal sensations like light touch become painful.

In the naturopathic world, there is a bit more conjecture about the cause of FM. There is suggestion that there could be problems with the gut (specifically SIBO), nutritional deficits (ferritin, B12, folic acid, vit D), hormonal imbalance, infection (lyme disease, parasites, enteroviruses), thyroid or adrenal problems and/or toxic build up.

What are the symptoms of Fibromyalgia?

Symptoms can include:

  • sleep disturbances
  • chest pain – costochondralgia – muscle pain where the ribs meet the sternum
  • digestive issues – abdominal pain, bloating, constipation, diarrhoea
  • irritable bladder – frequency, urgency
  • generalised muscle and joint stiffness in the mornings
  • headaches or facial pain
  • jaw pain and clicking
  • upper and/or lower spine pain
  • fatigue
  • candida
  • PMS
  • thyroid and adrenal dysfunction
  • numbness and tingling of the hands and feet
  • restless legs
  • sensitivity to hot and cold temperatures
  • sensitivity to loud noises or bright lights, odours, weather patterns
  • dryness of skin, eyes and mouth
  • cognitive and memory difficulties – problems concentrating, fog, memory lapses, word mix-ups when speaking or writing, difficulty getting words out, clumsiness/dropping things
  • dizziness and balance problems – difficulties in orientation when standing, driving or reading.
  • low mood (depression) or anxiety.

 How is FM diagnosed?

There is no blood test to confirm FM. Diagnosis is made after physical examination and a thorough history taking.

Diagnostic criteria includes:

  • at least 3 months of widespread pain and tenderness,
  • pain in at least 11 out of 18 recognised `tender points’

A naturopath may order the following tests to help find out the driving factor behind the symptoms:

  • biological terrain analysis
  • adrenal stress profile (including 24 hour cortical and DHEA levels)
  • thyroid profiles – T3, rT3, antithyroid antibodies
  • heavy metal analysis
  • digestive testing eg for SIBO

 What treatment is there for Fibromyalgia?

There is no one-stop shop program to cure Fibromyalgia Syndrome (FMS) as it has complex causative factors. However, there are testimonies of some people having a partial, if not full, recovery from it with the right diagnosis and treatment.

Orthodox treatment consists of:

  • medication – often a low-dose antidepressant is prescribed to help manage sleep and pain levels
  • exercise – low impact and paced is best to help improve range of motion and flexibility in the muscles
  • relaxation – meditation, yoga, deep breathing
  • physiotherapy – myofascial release, stretching
  • dietary advice

More alternative treatment options may include:

  • acupuncture and energetic therapies
  • naturopathy
  • supplements – B vitamins, magnesium, selenium, vitamin C, fatty acids, vitamin D, zinc, iodine

Overall, the most important thing to remember is that FM often requires a rounded approach. It requires thorough investigation into potential causative factors and one sufferer’s recovery and treatment may look completely different to the next person’s.

If you suffer from fibromyalgia, myotherapy may be a helpful in relieving your pain.

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