Contents:
Gastrointestinal
Disorders - Part Two
Irritable
Bowel Syndrome
-
Diagnosis
-
Treatment
Urinary Incontinence
- Causes
-
Types
-
Treatment
-
Prevention
Newsletter
Sources
University
News
Gastrointestinal Disorders - Part Two
This newsletter is the second
in our series on gastrointestinal disorders. Last month’s issue discussed
heartburn, gastroesophageal reflux disease, and colon cancer. This
issue will discuss irritable bowel syndrome and urinary
incontinence.
Irritable bowel syndrome (IBS)
is a chronic intestinal disorder that affects up to 22% of the population.
This condition has been called many other names in the past. Some
of these include: colitis, mucous colitis, spastic colon, spastic bowel,
and functional bowel disease. The exact cause of IBS is still unknown,
and a cure has yet to be found.
Irritable bowel syndrome can
present in several different ways. Most patients will experience
fluctuating symptoms over long periods of time. Some symptoms patients
often experience include: gas, bloating, dyspepsia, constipation, diarrhea,
flatus, alternating diarrhea and constipation, abdominal pain and cramps,
or mucous in the stools.
Diagnosis of Irritable Bowel Syndrome
Until recently, IBS was known
as a diagnosis of exclusion, meaning that it was diagnosed after other
medical conditions were eliminated. Now researchers have developed a set
of criteria to be used as guidelines for diagnosing IBS. These guidelines
are called the Rome Criteria. These include:
1. Continuous or recurrent symptoms of abdominal
pain that:
A. May
be relieved by defecation
B. May
be associated with a change in frequency, or
C. May
be associated with a change in the consistency of stools.
2. Two or more of the following are present at
least 25% of the time:
A. Altered
stool frequency
B. Altered
stool form
C. Mucous
in stools
D. Bloating
Some other factors that physicians
consider include the presence of pain at night, any signs of GI bleeding,
fevers, chills, excessive sweating, or weight loss. These criteria
and symptoms help physicians diagnosis and plan treatment for patients
with IBS.
Treatment of Irritable Bowel Syndrome
Since there is no cure for IBS,
treatment focuses on controlling the symptoms. If the main symptom
is constipation, patients are usually told to increase their intake of
fiber. For patients who complain of diarrhea, several types of medications
can be used. Antidiarrheal medications such as Loperamide or Diphenoxylate
may be prescribed. Tricyclic antidepressants have been used to improve
diarrhea and abdominal cramping. Calcium channel blockers are also
given as a second line of treatment. Other IBS patients use antispasmodic
medications to decrease complaints of gas and abdominal pain.
There are many ongoing research
studies on Irritable bowel syndrome. As the results of these studies
are published, physicians and patients will learn more about this condition
and the best possible treatments.
Urinary incontinence is defined
as a full or partial loss of bladder control. This is a common problem
that affects over 13 million Americans. Urinary incontinence can
be a symptom for many more serious disorders, and it is important to see
a physician if you experience the symptoms. Many people who suffer
from incontinence do not seek treatment because they feel nothing can be
done. However, this problem can be effectively treated in several
ways.
Urinary incontinence can affect
people of any age, but it is most common in women and older adults.
Women may experience incontinence more often due to pregnancy, childbirth,
hormonal changes from menopause, and differences in the structure of the
female urinary tract.
Back to top
Causes
of Urinary Incontinence
Urinary incontinence is usually
a symptom of another medical condition that needs treatment. There are
two categories of urinary incontinence: temporary and chronic.
The most common causes of temporary incontinence include:
1) Urinary tract infection
2) Pregnancy (because the pelvic floor muscles are stretched)
3) Severe constipation
4) Side effects of medications
5) Too much caffeine in the diet
6) Bladder-irritating foods or drinks such as carbonated
drinks, milk, coffee, tea, highly spiced foods, or artificial sweetener.
Chronic urinary incontinence
is often caused by more serious conditions. Chronic incontinence
is commonly caused by:
1) Weakness of the muscles that support the bladder
2) Weakness of the bladder
3) Overactive bladder muscles
4) Blocked urethra ( this can result from an enlarged
prostate in men)
5) Hormonal imbalances in women
6) Neurological disorders
7) Stroke
8) Cognitive impairments
9) Multiple sclerosis
There are several different types
of incontinence. It is possible to experience more than one type
of incontinence, which is often called mixed incontinence.
Urge incontinence is when a person starts to leak urine as soon as they
realize the need to urinate. A patient with urge incontinence may
feel the need to urinate frequently, as much as every two hours during
the day or night. Stress incontinence is when a person begins to
lose urine during an activity such as exercise. They may also leak
urine when sneezing, coughing, or laughing.
Overflow incontinence is when
the bladder never feels completely empty, even after urination. Patients
with this type of incontinence may often feel the need to empty their bladder,
but they cannot urinate. Functional incontinence occurs when a patient
has a problem with thinking, moving, or communicating about the need to
urinate. One example of this is a patient with Alzheimer’s disease.
Reflex incontinence is
when a person loses urine when they did not feel a need to urinate.
This may be caused by a leak in the bladder or an abnormal opening near
the bladder. The last type of urinary incontinence is called surgery-induced
incontinence. Some surgeries such as rectal surgery, hysterectomies,
or cesarean sections may lead to incontinence.
Urinary incontinence is not a normal
part of aging. There is an underlying cause for the problem, and
it is important to consult a physician about the problem. There are
many different types of treatments available for urinary incontinence.
Some of these include:
1) Timed Voiding - This treatment may be effective in
urge or overflow incontinence. It involves charting urination and
leaking patterns to determine the times during the day when you need to
empty your bladder.
2) Kegel exercises - These exercises are designed to
strengthen the pelvic floor muscles. For more information, check out http://www.kegel-exercises.com/.
3) Changing fluid intake - Some patients benefit from
increasing or reducing their fluid intake.
4) Electrical stimulation - Brief doses of electricity
are given to stimulate contraction of the lower pelvic muscles to strengthen
them.
5) Medication - Your physician may prescribe a drug to
treat your particular type of incontinence.
6) Surgery - This treatment is usually done only as a
last resort.
The Simon Foundation for Continence
recommends the following four tips to prevent incontinence:
1) Make sure to drink six-eight cups of fluid each day.
2) Do not strain to empty your bladder.
3) Try to maintain regular bowel movements.
4) Quickly seek medical attention if you experience leaking,
pain during urination, or see blood in your urine.
** Sources for this newsletter include:
http://www.gastromd.com
http://www.iffgd.org
** Free blood pressure screenings will be done Friday,
Feb. 15th for all faculty and staff. The screening will be from 11-1
in the lobby of the library and the Choctaw A room in the Reng Center.
Please contact case_hinton@hotmail.com
for more information.
** A group of ASU employees is starting a Weight Watchers
program here on campus. If you are interested, please contact Linda
Cole at ext. 2542.
** The Wilson Student Health Center will be hosting a
health fair on March 5 at the Armory. Please contact Marcia Morgan
at ext. 2054 for more information.
** A Brown Bag Luncheon will be held Feb. 19th in the
Osage Room. The event will begin at noon and will include discussions
with Marcia Morgan, BSN, RN, on various health concerns of African Americans.
Please bring your own lunch. For more information, please contact
Parice Tyler-Porter at ptyler@astate.edu.
** Casey Hinton of the Employee Wellness Program will
be leading a circuit training class open to all faculty and staff.
The class will be Tuesday, Wednesday, and Thursday from 12-1 in the weight
room in the HPESS building. For more information, contact case_hinton@hotmail.com
.
The Arkansas State University
Employee Wellness Newsletter is published monthly during the academic year
by the College of Nursing and Health
Professions. Health questions can be addressed to Dean Susan
Hanrahan, Ph. D., ext. 3112 or hanrahan@astate.edu.
Produced by Kim McGaughey, graduate student in the College
of Nursing and Health Professions, Physical Therapy Program.