Tuesday, April 13, 2010

Remedies for Incontinence

Substitute Cranberry Juice
Cranberry juice is key to bladder health because its acidity helps prevent urinary tract infections, a common problem to people who live with many forms of incontinence. Cranberry juice also helps deodorize the urinary tract, making accidents a little less noticeable.
It's a good idea to empty your bladder on a regular basis, Dr. Jeter says. For example, don't sit at the dinner table and hold it until dinner's over. Holding too long may lead to bladder infection and an overstretched bladder. Also, if you have a too-full bladder and a weak sphincter muscle, she says, you're likely to leak when you cough, sneeze, or laugh. Your best bet is to empty your bladder before and after meals, and at bedtime.
Slide show content includes excerpts from The Doctors Book of Home Remedies (Rodale, 2003).
Panel of Advisors
Cheryle Gartley is the founder and president of the Simon Foundation for Continence in Wilmette, Illinois.
Katherine Jeter, Ed.D., is founder of the National Association for Continence in Spartanburg, South Carolina.
Joseph Montella, M.D., is director of urogynecology and an associate professor of obstetrics and gynecology at Jefferson Medical College of Thomas Jefferson University in Philadelphia.
Abraham N. Morse, M.D., is an assistant professor of urogynecology at the University of Massachusetts Medical School in Worcester.
Neil Resnick, M.D., is a professor of medicine and chief of the division of geriatric medicine at the University of Pittsburgh Medical Center.
Robert Schlesinger, M.D., was formerly a urologist at Faulkner Hospital in Jamaica Plain, Massachusetts.

Stay Loose
Constipation can contribute to incontinence. So eat a high-fiber diet, and be sure to drink adequate amounts of fluid. One incontinence clinic's prescription is daily helpings of popcorn!

Buy Special Supplies
There are several brands of absorbent underpants, pads, and shields. The products absorb 50 to 500 times their weight in water, neutralize odor, and conceal fluid to prevent leakage. The kind you need depends on your individual anatomy and the kind and degree of incontinence you have. It's understandable if you're embarrassed to buy them. Find an understanding pharmacist and ask to have your purchase waiting for you when you arrive, or purchase them online and have them delivered to your door.

Don't Smoke
Nicotine and other chemicals in tobacco smoke can irritate the bladder, says Dr. Montella. "People who smoke may have chronic irritation that can lead to an overactive bladder," he explains.
Also, if you have stress incontinence, coughing can trigger leaking.

Go Easy on Fluids
Your bladder diary may reveal that you've been downing gallons of water a day, Dr. Jeter says. "Usually, it's because a person is on a diet that requires forcing liquids. If you drink a little less, your incontinence problem should ease up."
Take note of the timing, too. It's better to sip water throughout the day rather than pouring it down all at once. And it's especially important to stop drinking water within 3 to 4 hours of going to bed, especially if you get up several times during the night to go to the bathroom, adds Joseph Montella, M.D.
But Not Too Easy
Cutting your fluid intake to below-normal levels without your doctor's approval can lead to dehydration, worsening urinary problems and possibly causing serious illness. Doctors usually advise people to drink eight glasses of water daily to prevent dehydration.

Reduce the Tension in Your Life
"Whenever you're anxious or depressed, your body sensations are magnified in a negative way," says Dr. Morse. "If you're anxious to begin with, feeling as though you have to rush to the bathroom is one more thing that can put you over the edge."
Take a hint from your bladder and unwind. Give yourself an hour each day to do something that's just for you, like taking a long walk, watching some television, or going to a movie or museum.
Another strategy for sudden urges is to "breathe deeply, calm yourself down, and have confidence that you're not going to make a mess," says Dr. Morse. If you can calm yourself for 30 to 60 seconds, there's a good chance the urge will go away, he explains.
"The idea is to get control over your bladder, rather than having a panic situation," adds Dr. Montella. "Wait until you're calm, then go to the bathroom."

Lose Excess Weight
Foundation president Cheryle Gartley says that letters from patients seen at the Simon Foundation for Continence in Wilmette, Illinois, show people who lose even a few pounds can reduce incidents of incontinence.

Do Special Exercises
Kegel exercises were developed in the late 1940s by Arnold Kegel, M.D., to help women with stress incontinence during and after pregnancy. The experts say that these exercises reduce and may even prevent some forms of incontinence in both sexes and at all ages. Here are the guidelines from the National Association for Continence.
  1. Without tensing the muscles of your legs, buttocks, or abdomen, imagine that you're trying to hold back a bowel movement by tightening the ring of muscles (the sphincter) around the anus. This exercise identifies the back part of the pelvic muscles.
  2. When you're urinating, try to stop the flow, and then restart it. This identifies the front part of the pelvic muscles. (For women: Imagine you're trying to grip a slipping tampon.)
  3. You're now ready for the complete exercise. Working from back to front, tighten the muscles while counting to four slowly, then release. Do this for 2 minutes, at least three times a day—that's at least 100 repetitions.

Avoid Caffeine
Caffeine is another well-known diuretic. Caffeine also irritates the bladder and stimulates muscle contractions, which can aggravate the symptoms of urge incontinence, explains Abraham N. Morse, M.D.
Caffeine is found in beverages, but also in foods such as chocolate and in medications such as Excedrin. Doctors advise limiting caffeine intake to no more than 200 milligrams daily, about the amount in 12 ounces of coffee. Your diary will help you notice whether you're getting too much.
Switching to decaffeinated coffee or to tea will help, but it may not eliminate the problem, Dr. Morse adds. Other substances in coffee and tea also act as bladder irritants.

Urinary incontinence is a symptom, not a disease.
"The vast majority of people with mild to moderate symptoms do not have to rush off to see a doctor. Give yourself 3 months to see if lifestyle measures work," says Abraham N. Morse, M.D.
Other symptoms—painful urination, for example, incontinence that accompanies painful intercourse, or urine that's cloudy or tinged with blood—are signs that it's time to call a doctor right away. Urinary tract infections or even tumors can cause the bladder to go into overdrive.
You should also call a doctor if you're having large "accidents" rather than small leaks. Or if accidents are accompanied by numbness or weakness in your arms or legs, vision changes, or a change in bowel habits. These symptoms may be a sign of nerve damage or other neurological problems, such as Parkinson's disease.

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