How to Care for People Who Suffer from Incontinence

 

How to Care for People Who Suffer from Incontinence
How to Care for People Who Suffer from Incontinence

It is thought that 6.5 million people in the UK act as carers, providing over 50 hours of unpaid care for a relative. They fulfil all kinds of roles from companion to cook, to nurse and chauffeur.

Most of these people look after their partner, spouse or other relative gladly and without complaint. This doesn’t make it any less hard or any easier to enjoy a quality of life beyond the four walls of the home.


And there are aspects of caring for someone that can, over time, become worse. One such problem is incontinence. In the early stages, it may mean using light absorbency incontinence pads but as age and illness march on, it can become ‘double incontinence’, making caring for someone tough.

What is incontinence?

It is an involuntary leakage of urine or faeces or sometimes both, known as double incontinence. It could be a small, occasional leak of urine, for example or as in some cases, it can be a total loss of bladder control.

For some people, their incontinence is known as urge incontinence, in which they feel the need to go to the toilet immediately and without warning. People with dementia can often suffer from this type of incontinence.

Stress incontinence is when there is a leak of urine as a result of exercise, coughing, laughing or sneezing. This tends to affect women more than men.

Faecal incontinence can range from passing a small stool when passing wind or total loss of bowel control. This is less common and affects both men and women equally.

Age and incontinence

Although not an inevitable part of aging, with some age-related illnesses and conditions, incontinence can be an issue and one that carers will may need to deal with. Carers can use, alongside incontinence pads and pants, other aids too including medication in some cases, such a measuring fluid intake and so on.




There are medical reasons why people can become incontinent in old age:

  • Urinary tract infections – known as UTIs, these infections usually respond well to medication
  • Prostate gland trouble – older men can sometimes have an enlarged prostate gland which can lead to an increasing in the frequency to urinate. This is also treatable.
  • Constipation – as well as being uncomfortable, constipation also places extra pressure on the bladder which makes ‘holding on’ more difficult. It can also be a cause of faecal incontinence too, whereby liquid faeces flows around the hard, compacted stool.
  • Side-effects of some medications – if you think this may be contributing or the cause of incontinence, the GP should be able to address this by changing the person’s medication.
  • Other conditions such as irritable bowel syndrome can also underlie incontinence issues.

Tips for carers in helping to manage incontinence

It can be distressing, embarrassing and frustrating helping someone to deal with incontinence. It can make a lot of extra work in an already busy day, as well as placing relationships under pressure.

Prevention is better than cure thus, if you are a carer for someone, trying to prevent incontinence is key, thus keeping the urinary tract, bladder and bowel healthy is important:

  • The person for whom you care should be encouraged to drink six to eight glasses of water throughout the day, increasing this slightly if the person suffers from hard stools or occasional constipation. A tumbler-sized glass is the usual ‘measurement’ given by various medical establishments and professionals. This water should be in addition to other drinks the person has. Increasing fluid intake helps to prevent constipation, urinary tract infection and confusion, a symptom of mild dehydration.
  • Drink fluids throughout the day rather than squashing it together at one time – this can be very useful in preventing night time accidents.
  • A balanced diet that contains five portions of fruit and veg also helps to regulate the bowel and bladder. Make sure that there is plenty of fibre and roughage in the diet too although with a total loss of bowel control, this will need to change.
  • Encourage the person to stay as active and mobile as possible, walking a little every day if possible. This helps with bowel movements.
  • Regular visits to the toilet along with allowing plenty of time to empty the bladder and bowel is important too. Sometimes, visiting the toilet within a few minutes of finishing a meal works and there are biological reasons why this works.

There are also many other things that a carer can do to help their spouse, partner or relative remain in control of their bladder and bowel, from using incontinence pads and pants, to making sure that the toilet is clearly identifiable.

Asking for help is important too for both you and the person you care.

 

Supplying both private customers and commercial, healthcare premises, HARTMANN Direct supply a range of high quality incontinence products, from light absorbency pads to pants. With ranges for both men and women, HARTMANN Direct understand the need for hassle-free ordering and delivery too!

Hirschsprung’s disease – what are the signs and symptoms of Aganglionosis

Hirschsprung’s disease – what are the signs and symptoms of Aganglionosis
Hirschsprung’s disease – what are the signs and symptoms of Aganglionosis

Introduction

Hirschsprung’s disease is a rare condition that causes poo to become stuck in the bowels. It mainly affects babies and young children.

Normally, the bowel continuously squeezes and relaxes to push poo along, a process controlled by your nervous system.

In Hirschsprung’s disease, the nerves that control this movement are missing from a section at the end of the bowel, which means poo can build up and form a blockage.

This can cause severe constipation, and occasionally lead to a serious bowel infection called enterocolitis if it’s not identified and treated early on.

However, the condition is usually picked up soon after birth and treated with surgery as soon as possible.

This page covers:

Symptoms of Hirschsprung’s disease

When to get medical advice

How Hirschsprung’s disease is diagnosed

What causes Hirschsprung’s disease?

Treatments for Hirschsprung’s disease

Outlook for Hirschsprung’s disease

Symptoms of Hirschsprung’s disease

Symptoms of Hirschsprung’s disease are usually noticeable from soon after a baby is born, although occasionally they’re not obvious until a child is a year or two old.

Signs of the condition in a baby include:

  • failing to pass meconium within 48 hours – the dark, tar-like poo that healthy babies pass soon after being born
  • a swollen belly
  • vomiting green fluid (bile)

Signs in older infants and children include:

  • a swollen belly and a tummy ache
  • persistent constipation that doesn’t get better with the usual treatments
  • not feeding well or gaining much weight

If your child develops a bowel infection (enterocolitis), they may also have a high temperature (fever) and watery, foul-smelling diarrhoea.

When to get medical advice

Visit your GP if your child develops the symptoms described above. Hirschsprung’s disease can be serious if left untreated, so it’s important to get help as soon as possible.




If your GP suspects the condition, they will refer you to hospital for tests to confirm the diagnosis.

How Hirschsprung’s disease is diagnosed

Your child’s tummy will usually be examined and sometimes a rectal examination may be carried out. This is where a doctor or nurse inserts a finger into the back passage (rectum) to feel for abnormalities.

If Hirschsprung’s disease is suspected, an X-ray can be done to show a blockage and bulge in the bowel.

The diagnosis can be confirmed by doing a rectal biopsy, which involves inserting a small instrument into your child’s bottom to remove a tiny sample of the affected bowel.

This is then examined under the microscope to see if the nerve cells are missing.

What causes Hirschsprung’s disease?

The muscles of the bowel are controlled by nerve cells called ganglion cells. In Hirschsprung’s disease, these ganglion cells are missing from a section at the end of bowel, extending up from the anus, the opening in the bottom that poo passes through.

For some reason, the cells didn’t develop in that area when the baby was growing in the womb. It’s not clear why this happens, but it’s not thought to be caused by anything the mother did while she was pregnant.

A number of genes are associated with Hirschsprung’s disease and it does sometimes run in families. If you’ve had a child with it before, you’re more likely to have another child with it.

The condition is occasionally part of a wider genetic condition, such as Down’s syndrome, but most cases aren’t.

Treatments for Hirschsprung’s disease

All children with Hirschsprung’s disease will need surgery.

As they wait for surgery, they may need to:

  • stop having milk feeds and instead be given fluids directly into a vein
  • have a tube passed through their nose and into their stomach to drain away any fluid and air collecting in it
  • have regular bowel washouts, where a thin tube is inserted into their bottom and warm salt water is used to soften and flush out the trapped stools
  • take antibiotics if they have enterocolitis

Your child may need to stay in hospital during this time, or you may be able to look after them at home. Your doctor will advise you about this.

Surgery

Most children will have the “pull-through” operation, where the affected section of bowel is removed and the remaining healthy sections of bowel are joined together. This will usually be done when they’re around three months old.

If your child isn’t well enough to have this procedure – for example, because they have enterocolitis or a severe blockage – they may have it in two stages.

A few days after birth, the surgeon will divert the bowel through a temporary opening (stoma) made in the tummy. This procedure is called a colostomy formation.

Stools will pass directly out of the opening into a pouch worn on your child’s body until they’re well enough to have another procedure to remove the affected section of bowel, close the opening, and join the healthy sections of bowel together. This is usually done at around three months of age.

These procedures can be done using either:

  • laparoscopic (keyhole) surgery – this involves inserting surgical instruments through tiny cuts
  • open surgery – where a larger cut is made in your child’s tummy

Speak to your surgeon about the best option for your child.

Risks of surgery

No surgery is risk-free. There’s a small chance of:

  • bleeding during or after the operation
  • the bowel becoming infected (enterocolitis)
  • bowel contents leaking into the body, which could lead to serious infection (peritonitis) if not treated quickly
  • the bowel becoming narrowed or blocked again, requiring further surgery

Recovery from surgery

Your child will probably need to stay in hospital for a few days after surgery. They’ll be given pain-relieving medicine to make them comfortable and fluids into a vein until they can manage food.

No special diet is needed once you get home, but it’s important they drink plenty of fluids as they recover.

Your child should recover well and their bowels should function normally after surgery.

At first they’ll probably have a sore bottom when they poo. It can help to leave their bottom open to the air whenever possible, and use baby oil to gently clean their bottom as well as nappy cream after each change.

Call your doctor immediately if your child develops problems such as a swollen belly, fever, or foul-smelling diarrhoea.

Outlook for Hirschsprung’s disease

Most children are able to pass stools normally and have a normal functioning bowel after surgery, although they may take a bit longer to toilet train.

Some may experience persistent constipation and need to follow a high-fibre diet and take laxatives. Your doctor will advise about this treatment.

A small number of children have problems controlling their bowels (bowel incontinence), which can last until they’re a teenager and be very distressing.

Speak to your GP if this is a problem. You can also read advice about soiling in children.

Autism and Anxiety : “An Investigation of Anxiety in Children and Adolescents with Autism Spectrum Disorder” – The results of recent research from The Irish Centre for Autism and Neurodevelopmental Research h


Irish Centre for Autism and Neurodevelopmental Research
Irish Centre for Autism and Neurodevelopmental Research
You may remember that a few months ago (May 2014) we invited you to take part in a survey about autism and anxiety from The Irish Centre for Autism and Neurodevelopmental Research.

Today we are delighted to present the top line findings.

If you have any comments or questions please feel free to use the comment boxes at the bottom of this blog.

This study looked at the prevalence of symptoms.

• 10% of participants were found to have borderline clinical anxiety levels, while 75% of participants obtained scores which placed them in the clinical range for anxiety. This finding is particularly interesting as a diagnosis of an anxiety disorder was reported for only 25% of the sample.
• Gastrointestinal (GI) symptoms (i.e. nausea, bloating, diarrhoea, constipation, abdominal pain) were experienced by 80% of the sample within the last three months.
• Sleep problems were reported by 92% of the sample.
• At least one form of challenging behaviour (self-injurious behaviour, aggressive/destructive behaviour, stereotypic behaviour) was reported for 90% of the sample.


This study investigated the relationships between anxiety and other symptoms.

• Anxiety was found to be related to overall GI symptoms, indicating that higher levels of anxiety are associated with higher levels of GI issues. Specifically, nausea and constipation were found to be correlated with anxiety in this sample.
• Anxiety was found to be related to sleep problems, indicating that higher levels of anxiety are associated with higher levels of sleep problems in children and adolescents with ASD. Specifically, sleep onset delay, sleep duration, sleep anxiety, parasomnias, and daytime sleepiness were found to be correlated with anxiety levels in this sample.
• This study did not find an association between anxiety and challenging behaviour.

This study was also interested in looking at the factors which predicted anxiety.

• Sleep problems were found to positively predict anxiety in the current study. This means that high levels of sleep problems predict that an individual will also experience high levels of anxiety.
• Age was found to be a significant positive predictor of anxiety. This suggests that young people with ASD experience an increase in anxiety levels as they grow older.

World Continence Week 2014 – Some facts and figures!


World Continence Week
World Continence Week
As you can probably guess today marks the start of World Continence Week. The aim of the week is to promote knowledge of continence related issues including the medical conditions which cause them and the various therapies which can help treat incontinence.

Indeed as the International Continence Society who support the event say while incontinence cannot always be cured it almost always be managed, in some fashion, to make life bearable again. Right now 400 million people across the glove suffer from some kind of incontinence.

Causes can really vary. Travelling to another country means you can come up against different bacteria in food and water which may causes diarrhea or constipation. Indeed a friend of mine from university lost 40lb ( around 20kg) travelling in India for just over three months. Other causes could be stress or medications. Incontinence can also be caused by medical conditions such as multiple sclerosis or Parkinson’s disease. Interestingly women are more affected than men. It seems 25% of women over the age of 35 have continence issues while it only impacts 10% of men across the board.

As you may know incontinence comes in two main types which are urinary incontinence where there is involuntary leakage. Faecal Incontinence , on the other hand, is involuntary loss of stools or liquid through the anus.

That being said there are loads of useful tips for dealing with continence issues. Do you have any you would like to share with our readers. If so please feel free to add you suggestions to our comments boxes below.

Many thanks in advance.


Diverticulitis – what it is, why it happens and how to treat it!

Diverticulitis
Diverticulitis

Many years ago I shared an office with a guy who suffered from Diverticulitis.  Most of the time he was fine but during a flare up he would often, in mid conversation, leave our office and make a run for the bathroom.  He could be there for, literally, hours.

He mentioned after the first episode that he had Diverticulitis and it being England no one enquired further.

It was only later when I started working in the healthcare branch of the market research industry that I found out more and realised how difficult life must have been for Edward.

So what actually is Diverticulitis?

Well actually it is a bit of a long story.    As you may know there are bulges which may appear in the colon (large intestine) which are called Diverticula.  These are very common and are normally related to the body’s aging process.   Indeed they are also associated with the passing of hard stools.  When you have Diverticula and no other symptoms it is called diverticulosis.

Diverticulitis is when symptoms do occur – which happens in around 25% of cases of people with Diverticula.  These can include:-

  • Constipation or diarrhoea.  Or indeed both in succession.
  • A bloated feeling
  • Bleeding from the back passage or bottom.
  • Stomach pain.
  • In some cases Diverticulitis can be associated with a fever.

Obviously if you have any concerns about Diverticulitis we would strongly suggest you contact a healthcare professional as soon as possible.  In fact the sooner Diverticulitis is treated then the lower the risk of any complications developing.

Treatments are pretty much as you might expect.  A high fibre diet is recommended.  This would include plenty of fruit and vegetables as well as whole grains and pulses such as lentils and beans.  But go easy to start with on such a diet as you run an increased risk of flatulence.  If you do develop flatulence (or high levels of gas in the bowels) then this blog on prevention may be of interest and value – http://patienttalk.org/flatulence-three-natural-ways-of-fighting-flatulence/.

Diverticulitis
Diverticulitis

Antibiotics are valuable as a way of eliminating infection from Diverticulitis.  In some very rare occasions surgery may be employed if symptoms are serious enough.

As regular readers of this blog will know, one of the aims of these kinds of posts is to get our readers to share their experiences of different medical conditions. So we were wondering if people who have had or still have Diverticulitis would be interested in sharing their stories with our readers.  It would be great if you would use the comments box below to do so.

It would be useful, but not essential, if you could think in terms of the following questions:-

1)   What were your first symptoms of Diverticulitis?

2)   What impact did it have on your lifestyle?

3)   How was the Diverticulitis treated and how successful were the treatments?

4)   What one piece of advice would you give to somebody who has just been diagnosed with Diverticulitis?

We really look forward to reading your comments.  Many thanks in advance.