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Incontinence Is Now Reason To Die Of Embarrassment


Incontinence Is Now Reason To Die Of Embarrassment

When people lose control of the ways their bodies can eliminate food wastes they join a large percentage of the population with continence problems.

At least one in three adult New Zealanders have some degree of incontinence, although experts say it is widely under-reported and studies suggest that under-reporting may be as high as 60%.

This week (26 Nov – 1 Dec) 1500 delegates from 50 countries representing healthcare disciplines such as urology, obstetrics and gynaecology, geriatrics, neurology, nursing, research sciences and physics have been discussing these basic issues at the International Continence Society’s 36th annual meeting in Christchurch.

Christine Norton, Professor of Gastro-intestinal nursing at St Mark’s Hospital in London, gave a keynote speech about managing faecal incontinence in adults. She was the first continence nurse specialist in the UK and founder member for the Association for Continence Advice.

She said that it’s not surprising there is such a high incidence of faecal incontinence when our diets are based largely on refined processed foods. It is a common problem, but inadequately understood condition, with a lack of accepted standardised terminology, no good random control tests to support treatments and little published evidence for good practical management.

The causes are often a complex interaction of many things – constipating drugs, poor diet, not enough water intake, metabolic disorders, poor dental care, confusion, dementia, depression, and bowel cancer.

“It’s a common condition in the frail elderly and in rest homes where more than half the residents suffer from it to some degree. Maintaining good bowel function is the cause of much anxiety in older people, and taking up residence in such an establishment has been shown to increase the rate of faecal incontinence by 20% in patients after 10 months of arrival.”

Prof Norton said one UK study found a huge range, from 95% of patients in one establishment to as low as 20% in another. “The level of care is important including the choice of diet, mobility and being toileted frequently.”

Prof Norton said people often felt uncomfortable discussing symptoms. A recent UK campaign was based on the slogan “Don’t die of embarrassment”. She said a major message is to ask about any bleeding, and not to assume bleeding is caused by piles.

‘It’s possible to have too much fibre in the diet as well as too little. And there’s no need to drink large amounts of water because the kidneys regulate the fluid balance and just excrete more as a response to increased water intake. There is a lot of nonsense talked about water intake. It doesn’t cause a patient to open their bowels any more often; it just makes them urinate more. Caffeine and alcohol act as bowel stimulants.”

Bowel malignancies are the second most common cancer in most western populations and increase with age.


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