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Title

Living Well: Incontinence

Created date

February 22nd, 2011
Matt Narrett, M.D., is chief medical officer for Erickson Living and directs the provision of medical care at all Erickson Living communities. He received his medical degree from Harvard Medical School and is board certified in internal medicine and geriatrics. He is coauthor of Old Is the New Young, a guide to successful aging (available on amazon.com). This month, I d like to discuss urinary incontinence a common condition that affects one in three older women and some men as well. It is characterized by a loss of bladder control and is often avoided in conversation by both patient and physician alike. Only 30% to 40% of women with incontinence ever discuss it with their physician, which is unfortunate since it is often highly treatable with some simple interventions. Medical studies demonstrate that successfully treating incontinence is associated with significant improvements in quality of life and satisfaction.

Causes

Most bladder control problems happen when muscles are either too weak or too active. Many causes of incontinence are treatable and reversible these include (but are not limited to) infection, constipation, diabetes, mobility impairment, caffeinated beverages, and some medications. Two types of incontinence are typical: Urge incontinence occurs when you have the urge or feeling to empty your bladder but just can t get to the bathroom in time. Stress incontinence is when you leak urine with a sneeze, cough, or exertion. Some individuals have features of both and this is characterized as mixed incontinence. You should not feel alone or embarrassed if you have continence issues. The good news is that there is much you can do to help yourself, and most people can improve with simple exercises, behavioral training, and lifestyle changes.

Interventions

I recommend that you review your symptoms with a physician or health care provider to determine the best course of action. Much can be accomplished with a simple office visit and a check of your urine. Your provider may recommend pelvic floor muscle training, exercise (such as Kegel exercises), or behavioral training for stress or urge incontinence. He or she may recommend lifestyle changes like weight reduction, avoiding caffeine or scheduling convenient times to drink fluids during the day. These interventions require dedication on your part and the help of a trained professional such as a physician, nurse, nurse practitioner, or physical therapist with an understanding of incontinence. Remarkably enough, there are medications and other treatments (like surgery) available if needed, but the behavioral approach has been shown to achieve better results than medicines alone. If you have incontinence, you have opportunities to feel better and have a better quality of life. Please talk to your health care professional, read about your options, and take action. In good health, Dr. Narrett Editor s note: Next month s Your Health will discuss incontinence in greater depth.

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