Embarrassing Toilet Trips – An Age Old Problem?
by Alexander Lamb, Healthcare Development Manager.
Date: 03 December 2011
For many, getting a little older can mean more frequent trips to the loo, either during the day or at night – but in reality this shouldn’t be the case. Indeed, continence problems can start at any time of life. But fear not, there is much that can be done to help sufferers of this often-embarrassing condition.
Continence problems can take many different forms and occur at any age in both men and women. Perhaps the most common types in females are urinary incontinence that can be characterised by two main sets of symptoms.
The first is often referred to as an Overactive Bladder, or OAB. The symptoms of OAB are driven by what specialists refer to as ‘urgency’ – a sudden and compelling desire to pass water that is very difficult, sometimes impossible, to hold off. Other symptoms of OAB include increased frequency, or toilet trips; and nocturia whereby sufferers wake through the night to pay a visit to the loo.
Sufferers do not always have ‘accidents’ however, so often they do not see this as a continence problem. The second form of urinary incontinence is referred to as stress incontinence. Here, small amounts of urine often leak when coughing, laughing or stretching.
This is particularly common in ladies following childbirth. All of these symptoms are troublesome and impact on quality of life. Some patients often have both stress and urge or OAB symptoms.
Having an Overactive Bladder is very common, though perhaps due to embarrassment or fear - or simply feelings of “getting older” - many people do not seek help.
Guidelines To Doctors
The government body NICE (the National Institute for Health and Clinical Excellence) published guidelines to doctors in 2006 that look at the management of urinary incontinence in women.
These guidelines suggest that between 25 and 45% of the population suffer from an overactive bladder (NICE Clinical Guideline 40: The management of urinary incontinence in women). The website www.bladderproblem.co.uk states that there are over 5 million sufferers in the UK, with 1 in 5 adults over the age of 40 having symptoms.
A study published in 2001 in the British Journal of Urology by Milsom(1) estimated that as many as 4 in 10 people do not seek help – sufferers may not be aware that often simple steps can be taken that can help alleviate their symptoms easily and effectively. The prevalence of OAB increases with age, but OAB should not be accepted as a normal part of ageing. With the right help, it may be easier than you imagine to regain control.
Impact of Incontinence
The impact of incontinence and these symptoms on a sufferer’s quality of life cannot be underestimated. Experts consider the following to be true:
* OAB can be a major cause of embarrassment for sufferers amongst friends, family or colleagues
* Sufferers tend to adopt coping strategies such as ‘toilet mapping’ in public areas, for example an OAB sufferer will know exactly where all of the toilets are when visiting the local shops!
* There tends to be a reduction in social and physical activities such as trips and holidays – family visits to see the grandchildren may even suffer!
* Sufferers are often fearful of odours if they have accidents and can often buy pads to attempt to contain leakages
* Sufferers can often loose their self esteem and even develop a fear of venturing out of the home.
Prostate Problems
Men too suffer from many continence problems such as OAB and stress incontinence. Incontinence in males is also often related to prostate problems, as the prostate naturally increases in size from the age of about 40 onwards.
This increase in size can often restrict the flow of water from the bladder to the outside due to the fact that the prostate sits at the base of the bladder, surrounding the urethra – the tube through which water flows – which causes the bladder to become ‘irritated’ as it needs to work harder to pass urine.
The symptoms associated with prostate problems are often a weak stream of urine; sometimes having to push or strain to start; stopping and starting mid-flow; a sudden need to pass water; increased trips to the loo, especially at night; and occasionally pain or discomfort.
In most cases, this prostate enlargement is a perfectly normal part of getting older and is called benign prostatic hyperplasia, or BPH.
In some cases however, these symptoms can be a sign of a more serious problem with the prostate, such as cancer, and the advice is to always seek help from your GP.
If left unchecked, BPH can lead to more complicated problems later such as ‘retention’ in which you may not be able to pass water at all. This is painful and requires a trip to hospital to rectify!
Talk To An Expert
So what can be done? The most obvious solution to the problem is to talk to an expert. This can be embarrassing for some, and some people wait many months or years before taking the plunge.
Advice can be found in many different areas such as from your local GP or practice nurse to on-line resources such as bladderproblem.co.uk. There are also often specialist continence advisors in the area that accept self-referrals.
These can be found by searching local health directories or by talking to a chemist, practice nurse or GP. You can call the Bladder and Bowel Foundation helpline on 0800 011 4786 or learn more about Overactive Bladder, get further advice, and hear others people’s experiences by visiting amatterofurgency.co.uk.
Help Is Available
Whichever option you choose, help is available. It could be that small lifestyle changes can be made that will help with your bladder problem very quickly. Other options include medications that your doctor can prescribe and there are many of these available if you do not find that the first works for you.
The key to success with your bladder problem is to talk to someone – don’t suffer in silence, help could be closer than you think!
(1) Milsom et al, How widespread are the symptoms of an overactive bladder and how are they managed? A population prevalence study. BJU International 2001;87:760-766
