diabetes

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Bowel incontinence – warning signs and treatments

Bowel incontinence

Bowel incontinence

Bowel incontinence is an inability to control bowel movements, resulting in involuntary soiling. It’s also sometimes known as faecal incontinence.

The experience of bowel incontinence can vary from person to person. Some people feel a sudden need to go to the toilet but are unable to reach a toilet in time. This is known as urge bowel incontinence.

Other people experience no sensation before soiling themselves, known as passive incontinence or passive soiling, or there might be slight soiling when passing wind.

Some people experience incontinence on a daily basis, whereas for others it only happens from time to time.

It’s thought one in 10 people will be affected by it at some point in their life. It can affect people of any age, although it’s more common in elderly people. It’s also more common in women than men.

Why bowel incontinence happens

Bowel incontinence is a symptom of an underlying problem or medical condition.

Many cases are caused by diarrhoea, constipation, or weakening of the muscle that controls the opening of the anus.

It can also be caused by long-term conditions such as diabetes, multiple sclerosis and dementia.

Read more about the causes of bowel incontinence.

Seeking advice and treatment

Bowel incontinence can be upsetting and hard to cope with, but treatment is effective and a cure is often possible, so make sure you see your GP.

It's important to remember that:

Bowel incontinence isn't something to be ashamed of - it's simply a medical problem that's no different from diabetes or asthma.

It can be treated - there's a wide range of successful treatments.

Bowel incontinence isn't a normal part of ageing.

It won't usually go away on its own - most people need treatment for the condition.

If you don't want to see your GP, you can usually make an appointment at your local NHS continence service without a referral. These clinics are staffed by specialist nurses who can offer useful advice about incontinence.

Read more about diagnosing bowel incontinence.

How bowel incontinence is treated

In many cases, with the right treatment, a person can maintain normal bowel function throughout their life.

Treatment will often depend on the cause and how severe it is, but possible options include:

lifestyle and dietary changes to relieve constipation or diarrhoea

exercise programmes to strengthen the muscles that control the bowel

medication to control diarrhoea and constipation

surgery, of which there are a number of different options

Incontinence products, such as anal plugs and disposable pads, can be used until your symptoms are better controlled.

Even if it isn't possible to cure your bowel incontinence, symptoms should improve significantly.

Read more about treating bowel incontinence.

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What is autoimmune disease?

Barbara Grubbs - what is an autoimmune disease?

Barbara Grubbs – what is an autoimmune disease?

Barbara Grubbs shares her brilliant explanation of what actually is an autoimmune condition.

Some of the conditions (there are over 100) that are defined as autoimmune include

alopecia areata
autoimmune hemolytic anemia
autoimmune hepatitis
dermatomyositis
diabetes (type 1)
glomerulonephritis
Graves’ disease
Guillain-Barré syndrome
idiopathic thrombocytopenic purpura
myasthenia gravis
some forms of myocarditis
multiple sclerosis
pemphigus/pemphigoid
pernicious anemia
polyarteritis nodosa
polymyositis
primary biliary cirrhosis
psoriasis
rheumatoid arthritis
scleroderma/systemic sclerosis
Sjögren’s syndrome
systemic lupus erythematosus
vitiligo
granulomatosis with polyangiitis (Wegener’s)

Some also include fibromyalgia in the list!

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Bladder weakness – The Silent Epidemic

Dr Ruth Maher

Dr Ruth Maher

Research has found that 1 in 3 women over 30 suffer from bladder weakness/leaks every day, making it more common amongst UK women than hay fever.
Dr Ruth Maher, a specialist in innovotherapy, calls out pad companies and incontinence management products for deliberately misleading consumers into believing that they can only manage the symptoms of incontinence rather than tackle the cause.

It’s a dignity issue and a silent epidemic; this is the last taboo. Women do not like to talk about all the things that happen in their pelvis – society has a role to play in enforcing this embarrassment and taboo. Women are remaining silent and being encouraged to use pads to manage their symptoms.

7% rely on drugs/medication and 6% use manual rehabilitation with a physiotherapist to manage symptoms. Over half of women with bladder weakness (52%) use sanitary pads or incontinence pads/slips to manage their symptoms, spending an average of £420 a year.*

Nearly a quarter (24%) admit that pads make them feel uncomfortable, 33% feel unsexy or unattractive and 28% feel self-conscious.

We spoke to Dr Maher to find out more!

Maher : Hi. My name is Dr Ruth Maher. I am a professor at Creighton University in the USA.

Patient Talk: And what are the signs and symptoms of bladder weakness?

Maher: Well, actually there’s no such thing as bladder weakness. Bladder weakness has been put out there by pad companies to sell their products and it’s led to women to believing that that is the only solution. What we’re really talking about is a condition called stress incontinence; urinary incontinence which is manifested by weak pelvic floor muscles which many women experience after pregnancy and menopause.

Patient Talk: What are the causes?

Maher: The causes are tears in the muscle after pregnancy, hormonal deficiencies, congenital problems can cause it and age. The other thing that can cause it is a lot of fat tissue around the abdomen area; we’re all eating a lot more these days and not exercising so we all carry a bit more around the middle section and the sheer cause of it is when you cough or sneeze, you increase the pressure in your abdomen area and that pushes down on the pelvic floor muscles that are weak so women are losing urine.

Patient Talk: What are the main treatments and how do they work?

Maher: The main treatments are what’s called pelvic floor exercises or kegels. Unfortunately women don’t know how to contract the muscles because the muscles don’t move adjoined like the bicep that would move your arm. You can use electrical stimulation; the conventional methods are uncomfortable because the use a probe, like a little tampon and that can cause all sorts of things like infections and bleeding. But there’s a new device called inova (???) therapy. That’s shown great promise in the research and it’s a device that’s worn like a pair of shorts in the comfort of the woman’s home. She can treat herself thirty minutes a day for five days and we’re seeing curates of up to ninety per cent in some ladies.
Patient Talk: What are the effects on lifestyle for a person with bladder weakness?

Maher: It’s a huge quality of life issue. Women modify their life, their entire life based around visits to the bathroom. They will put pads in their handbags, they will plan their shopping trips based on where the loos are, they will not engage in exercise or social events, they’ll change the clothes they wear and the sheer cost of it, isn’t the pads which are about £400 a year. It’s the cost across their lifespan of putting on weight, dealing with the conditions that are associated with weight loss (??? I think she means weight gain) such as diabetes, heart disease, it really is a silent epidemic. It affects their sex life, they’re terrified of leaking urine during sex so they avoid it and it ruins relationships.

Patient Talk: What one piece of advice would you give to somebody who has just discovered they have incontinence?

Maher: I would advise them to talk. Talk to other women, talk to their GP, go to their local physio. Physios are great with dealing with muscle issues and this is a muscle issue. If they remain silent, things are only going to get worse so education is key and conversation.
Patient Talk: Where can people go for more information?

Maher: They can go to restorethefloor.com; a website that has lots of good information about this condition.

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A Layperson’s Guide To Blood Sugar Levels

A Layman's Guide To Blood Sugar Levels

A Layman’s Guide To Blood Sugar Levels

What do you know about blood sugar levels? Depending on your experience, you may associate them with kids who have had way too much candy and are frantically running around the house. Or, if you suffer from diabetes, you probably think of regularly jabbing yourself with a needle to make sure you don’t need to immediately consume a candy bar.

It can be a confusing topic if you don’t know the terms or what normal levels look like. That’s where we come in. In this article, we’re going to give you the what and why of blood sugar. We’re going to dive into what causes blood sugar levels to get high or low, and what what a normal blood sugar level should look like.

Consider this a layman’s guide. It won’t give you every detail (you really should talk to your doctor), but it will guide you through the major points and help you understand what to keep an eye on.

Let’s get started.

What’s The Difference Between Sugar and Glucose?

What comes to mind when you think of sugar? Probably the white granular stuff that you would secretly eat when you were a kid, right? But it’s actually more complicated than that. Sugar is the general name given to sweet carbohydrates that dissolve in water.

There are a number of different types of sugars. Your body most frequently uses glucose. Fructose is found in fruit and lactose is found in milk. When you guzzle a big glass of milk or eat an apple, your body takes the lactose or fructose and converts it to glucose. Once everything is converted to glucose, your body can use it for energy.

Starches, like those found in white bread, are sugars stuck together and are converted by your body into glucose.

So far so good, right?

Now, this is important. When people say “blood sugar”, they mean “blood glucose”. The terms can be used interchangeably.

If you really want to be annoying, you can correct them every time they say, “Blood sugar,” and then proceed to give them the above explanation. You probably won’t have many friends after that.

How Is Blood Sugar Measured?

Now we need to discuss how blood sugar is actually measured. In the United States, blood sugar is measured in terms of milligrams of glucose per deciliter of blood (mg/dl). Why couldn’t they put it on a simple 1 to 10 scale or something like that? Because scientists wouldn’t be able to feel important.

But that’s beside the point.

A milligram is a tiny, miniscule amount, around 0.00018 of a teaspoon. A deciliter is only 3 ⅓ ounces.

In Canada and the United Kingdom, they measure things on a different scale. Of course they do. In the United States they do everything differently.

Canada and the UK measure blood sugar in terms of millimoles per liter (mmol/L). If you happen to be reading a comment or study from those countries, you can multiply the numbers by 18 to get the American numbers.

So, to recap: 

  • In the United States, blood sugar is measured in terms of milligrams per deciliter (mg/dl).
  • In the UK and Canada, blood sugar is measured in millimoles per liter (mmol/L).

Still with me?

What Are Normal Blood Sugar Levels?

Now let’s talk about normal blood sugar/glucose levels.

First, the levels will vary throughout the day. If you’ve been fasting or just woke up, your levels should be under 100 mg/dl.

Before a meal, your levels should be somewhere between 70-99 mg/dl. Two hours after meals, your levels should be less than 140 mg/dl.

To state the obvious, eating increases blood sugar levels. After you eat, your blood sugar levels will be higher than before you ate. Failing to eat causes the levels to fall.

How Does Diabetes Affect Blood Sugar Levels?

To break down sugars and turn them into glucose, your body uses insulin, which is produced by the pancreas. In a person with diabetes, the pancreas either produces too little insulin or none at all. Or, the body is unable to use insulin effectively.

When this happens, blood sugar levels rise and the body is deprived of the energy it normally would receive from glucose.

If you have diabetes, the American Diabetes Association recommends that you keep your blood sugar levels between 80-130 mg/dl before meals and under 180 mg/dl 1-2 hours after meals.

Ideally, you should try to keep your blood sugar levels close to those of a person without diabetes because it will protect your body against the complications often caused by the disease.

But (and this is crucial), you have to carefully measure and monitor your diet to accomplish this. This is possible but it probably means gorging yourself at the local Chinese buffet is out.

What Happens When Blood Sugar Levels Get Too High Or Low?

Is it really a big deal if glucose levels get too high or too low?

Yes. It really is.

If your glucose levels get too high, you’ll start to get inflammation in your blood vessels and nerves. The longer this inflammation goes unchecked, the more damage it causes to the body and the more complications it creates.

Those without diabetes are able to keep their glucose levels in check automatically through the production of insulin. If you have diabetes, however, your pancreas isn’t producing insulin properly, which means glucose levels can quickly get too high or low.

If your blood sugars fall too low, a condition called hypoglycemia sets in. This can result in dizziness, confusion, and fainting.

The moral of the story? If you have diabetes, you really MUST regularly monitor your blood sugar levels. If they get out of control, it can cause serious damage to your body, or even death.

How Can You Monitor Your Blood Sugar Levels?

Okay, this is where things get a bit annoying for those who have to monitor blood sugar levels.

One option is to regularly use a fingerstick blood test, which involves pricking yourself with a tiny needle and then using a little strip and a glucose meter to test your blood sugar levels.

If the thought of needles sends you into a sweaty panic, you have the option of a continuous glucose monitor (CGM). A little sensor is inserted under the skin and constantly monitors your blood sugar levels to ensure everything is where it should be.

Neither of those options are particularly fun, but they’re better than the alternative, which is having wildly varying blood sugar levels.

The frequency of testing depends on your circumstances. If you take a fast acting insulin, you’ll want to test regularly. If you take the wrong amount of insulin, your blood sugar can drop too low, which can cause you to get dizzy, confused, or faint.

You don’t want to faint. Especially when driving a car and/or skydiving.

If you have Type 2 diabetes and aren’t taking insulin, it’s up to your doctor on how frequently you will need to test. If you’re trying to keep your blood sugar levels within a tight window, you’ll want to test in a variety of circumstances to see how they affect your body.

For example, test after eating a big meal, after exercising, and after sleeping. Keep records so you can compare these different situations.

If you make any big changes, such as taking a new medicine or beginning a new diet, pay close attention and always tell your doctor.

How Can Diabetes Be Managed?

 

Thankfully, diabetes isn’t the end of the world. Yes, it may mean you can’t eat an entire box of Milk Duds at the movie theater, but if you follow a few specific guidelines along with the instructions from your doctor, you’ll be okay.

  • Pay attention to what you eat. Eat well-balanced meals and pay careful attention to how many carbohydrates you consume. Avoid sweetened beverages (sorry soda lovers) and be sure to carefully coordinate your meals and when you take any medications. Natural foods such as Aloe Vera may lower blood sugar.
  • Ketogenic Diet – Many at risk individuals see great results when doing the ketogenic diet for a few months. (and here are a few ketogenic breakfast recipes for you)
  • Exercise regularly. Consistent physical activity causes your body use insulin more effectively and causes your muscles to use glucose. Talk to your doctor about an exercise plan.
  • Take medication with the help of your doctor. If you can’t manage your levels through diet and exercise, you can take insulin and other medications. Work closely with your doctor to ensure you’re getting the right medicine.
  • Avoid stress when possible. Stress can cause a rise in blood sugar levels and can also make it tougher to stick to your carefully planned diet and exercise routine. If you regularly encounter stress, be sure to learn effective coping techniques.
  • Be careful with alcohol. When your liver is metabolizing alcohol, it can’t counteract falling blood sugar levels. Talk to your doctor to make sure it’s okay for you to drink.

Conclusion

See, that wasn’t so bad, was it? Now you understand blood sugar levels, how to manage them, the consequences of not managing them, and how to manage diabetes.

Yes, it can be a pain to carefully monitor your levels, but it’s important for those with diabetes. Failing to do can create significant long term effects that can seriously damage your body.

Now, go eat that candy bar you’ve been craving. Or don’t. Measure your levels first and do what is best for your body.

This article originally appeared at https://www.vitamonk.com/blogs/news/guide-to-blood-sugar-levels and has been reused with permission.

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What’s an Ideal Blood Sugar Level?

Continuous glucose monitoring

Continuous glucose monitoring

You want your blood sugar level to be as close as possible to that of someone who does not have diabetes or any other condition that affects blood sugar levels. Your doctor should tell you what your target blood sugar level is, and what you should do if your blood sugar falls outside a given range.

As a guide, someone with Type 2 diabetes should have a blood glucose level of 4-7mmol/l before meals, and less than 8.5mmol/l two hours after a meal. Pregnant women should have a fasting blood glucose level below 5.3mmol/l. The measurement mmol/l stands for millimoles per litre, which measures the concentration of a substance in a liquid.

How to Check Your Blood Sugar Level

Blood sugar levels are checked by measuring a small sample of blood. There are two ways to test your blood sugar levels: continuous glucose monitoring (CGM) or using a blood glucose meter.

Continuous glucose monitoring uses a small device worn under the skin. It measures blood sugar every few minutes and transmits the data to a display. You may be able to see your results in real time, or you may have to download them to see your historical numbers. A real-time CGM will alert you of a precipitous spike or decline in your blood sugar level.

CGM allows you to continuously track your blood sugar levels, even during the night. You can see when your level is starting to go up, so you can take action sooner and possibly prevent a spike. CGM will alert you to a spike even at a time when you don’t typically test. If you use insulin, you may be able to tailor your dosing to keep your sugar more level over the course of the day.

Using a blood glucose meter is a more traditional way to test your blood sugar, and some people prefer it to CGM. There are many different meters on the market, so consult with your doctor about which meter is right for you. Be sure you understand how to operate the meter correctly, as incorrect operation can provide incorrect results.

Understanding what blood sugar levels are, what your target level is, and how to read your level is critical to managing your diabetes or hypoglycemia.