Weekend Check-up, Winfield Daily Courier, October 24, 2009

By Shona Woods

   Shona is a Registered Physical Therapist at William Newton Hospital with special training in women's health issues.

   Do you notice a sudden urge to get to a restroom while searching for the key to your front door? Do you sometimes have trouble making it to the toilet on time? Do you leak when you cough, laugh or sneeze? If so, you are not alone-one in four women will experience incontinence during their lives.
   In addition to urgency, symptoms commonly associated with urinary incontinence include
   pelvic or back pain, constipation or diarrhea, difficulty withholding gas, pain during intercourse and pressure in the pelvic floor area. These physical annoyances are often accompanied by behavioral triggers, such as the key in the door example above. Women struggling with incontinence may also experience low self-esteem.
   Childbirth increases a woman's risk of incontinence significantly, often surfacing after menopause. Forty percent of women leak during exercise, even elite athletes. Although incontinence is common, it is not normal or an inevitable part of aging.
   The cause of urinary incontinence in women is often a weak pelvic floor. Healthcare providers may suggest performing specific exercises, such as Kegels, to strengthen these muscles.
   Unfortunately, many women perform Kegel exercises incorrectly. To improve stamina of the pelvic floor muscles, perform 10 repetitions and work up to 10-second contractions two or three times a day. It is vital to allow the muscles to recover after each contraction - rest time should equal contraction time.
   Women who are unable to stop flow while voiding most likely have a very weak pelvic floor. They should perform Kegel exercises while lying down until strength can overcome the added effect of gravity.
   A weak pelvic floor is only one piece of the incontinence puzzle. If the bladder is irritated, a premature signal may be sent to the brain relaxing the pelvic floor muscles and resulting in leakage. Some of the more common bladder irritants include citrus fruits and drinks, alcohol, milk, vinegar, tomatoes, caffeine, carbonated beverages and sweeteners. A change of diet may be necessary.
   Another possible factor in incontinence is dehydration. Many women restrict fluids in hopes of reducing incontinence episodes. Concentrated urine is also an irritant to the bladder and water keeps the urine diluted. Drinking small quantities of water throughout the day may actually reduce incontinence symptoms.
   Research is underway on a possible connection between incontinence and nerve root irritation of the lumbar/sacral spine. It is common for a person being treated for back pain to report improvement in incontinence symptoms.
   There are more treatment options for incontinence than ever before. These include lifestyle changes, bladder retraining, pelvic floor exercises, biofeedback, medications and surgery. Your healthcare provider may recommend one or more to help you achieve your goals.
   The first step to regaining your freedom is to speak with your healthcare provider. Unfortunately, the average woman waits seven years before letting her doctor know she has an incontinence problem. You don't have to suffer from incontinence!