Incontinence: involuntary urination, or urination without knowing you have lost urine. The key to successful treatment of urinary incontinence rests in proper evaluation of the underlying condition.
Possible causes and factors
If the incontinence is associated with cloudy urine or pain, burning or urgency in urination, the incontinence may be the result of infection.
If foods are involved in causing the incontinence, or in causing inflammation of the bladder called cystitis, this may be the source of the incontinence. Infection is most frequently associated with food sensitivity, the irritation from the food weakening the lining of the bladder which then allows a germ to infect the bladder.
If the incontinence is brought on by coughing, sneezing, laughing, exercise or strong emotions such as intense grief, the diagnosis is stress incontinence.
“Cold foot cystitis:”
If the incontinence occurs mainly during cold weather, it may be caused by chilled feet.
If the incontinence occurs mainly when you are reaching for the bathroom door or removing your clothing, it may be due to weak control of the voluntary muscles, and a strong detrusor muscle in the bladder (involuntary) which squeezes the bladder while the voluntary muscle control is not at its peak.
If the condition began following surgery or radiation, there may have been nerve or muscle damage which may be more or less permanent.
It can be helpful to keep a voiding diary recording the times of voiding, the volume voided, any incontinence episodes, the severity of the leakage, and whether it occurs at night or on a regular daily schedule at a certain period during the day. Keep the diary for one week. If your incontinence comes on only after drinking large quantities of water, some degree of fluid restriction may be helpful. If the urine volume is 2000 to 3000 cc. per day (two to three quarts), the diagnosis may be overhydration.
Urinalysis and blood tests should be performed to determine if there are systemic problems such as diabetes, and nephritis. If the laboratory test results show abnormalities in some of the chemistries, this can be the cause of incontinence. Sugar in the urine or too much calcium can both aggravate incontinence. When elevated calcium causes mental confusion, this condition can result in interference with urination.
Hypothyroidism has been associated with irritability and instability of the bladder.
If the person becomes chronically dehydrated and has very concentrated urine, the waste chemicals in the urine can irritate the bladder and cause incontinence.
Nervousness with residual urine:
If the urinary bladder is not completely emptied with each urination and there is significant “residual urine,” this can lead to incontinence. Nervousness or being in too big a hurry to finish urination can cause residual urine.
Some drugs change urethral pressure preventing effective bladder emptying, urinary retention, or challenge the bladder with excessive fluid load—antihypertensives, antidepressants, antipsychotics, sleeping pills, caffeine, muscle relaxants, antihistamines, diuretics, hormones (progesterone, thyroid hormones). In one study over 70 per cent of nursing home residents with incontinence took drugs. In another study it was 90 per cent.
Invalidism or urge incontinence:
Patients who cannot move about very well may not have time to get to the restroom to prevent an accident.
An examination of the pelvis, or abdomen, may detect masses, suprapubic fullness, or tenderness.
Irritation of perineum:
A pelvic exam should be performed to evaluate the perineal skin for rashes, and the vagina and urethra for evidence of estrogen deficiency leading to irritation of the urethra or bladder. Some women respond to treatment with herbs and diet for low estrogen (about 50 per cent of symptoms are relieved).
The urethral diverticulum often gives tenderness in the vaginal wall. Prolapsed uterus can cause pressure on the bladder resulting in a small capacity for urine.
Muscle function should be tested in the urethra, as well as the perineal muscles. Check the anus and note the quality of the pressure on the examining finger which can easily reveal the strength of all perineal muscles including urethral muscle strength.
The neurologic function should be assessed by perineal sensations, whether pinpricks appear sharp or blunt. This checks the nerves S2, S3, S4 and evaluates the strength of the lower limbs by simple actions requiring strength. Gentle stroking of the perianal region with a pencil eraser will produce the “wink” reflex from reflex contraction of the perineal muscles.
Our recommendation is to have a proper evaluation of the underlying condition with your professional provider and then the proper treatment.
“Healthy Lifestyle Matters in Prevention of Diseases”
For more information contact:
Amazing Natural Medicine
Phone: 44- 756 24 25 749
Silvia Rojas Reyes, N.D., Health & Life Couch
(Specialist in Lifestyle Medicine, Harvard)