Darren Fletcher and Lewis Moody experiencing Ulcerative Colitis
Darren Fletcher
The announcement by Manchester United, the Scottish Midfield Dynamo is suffering from Ulcerative Colitis is sad news for both himself and also the team but it does help increase awareness of this disabilitating condition amongst the general public.
Talking to the Guardian Newspaper, Dr. Ian Arnott, a leading specialist in ulcerative colitis and consultant gastroenterologist at the Western General hospital in Edinburgh said:
“Ulcerative colitis can be a very disabling condition and leaves people weak, tired, frustrated and lacking energy. It can change people’s lives completely. They can’t be very far from the toilet so aren’t able to go out very much. Patients tell me that when they go to a nearby town or city, they know exactly where every toilet is, because they often get very little warning about needing to go to the toilet. It can mean that people have accidents with their bowel motions. It’s an embarrassing condition – it’s a difficult subject to talk to people about.”
Ulcerative colitis is inflammation of the large intestine (both the colon and rectum) accompanied by development of ulcers in this area which can have a tendency to bleed. These are what can cause the common symptoms of the condition, diarrhoea and passing blood and mucus, often accompanied by stomach pains.
The cause is not known and the condition can affect anyone, though some believe it to be genetically linked as it is often common amongst relatives. One common belief is that some factor such as food, atmospheric pollution or stress may trigger the immune system to cause inflammation in the large intestine in people who are genetically prone to developing the disease.
People who live with the condition will have good periods of remission when they feel normal, this can last up to a month or even a few years – and bad periods when they feel dreadful and can be forced to go to the toilet six, eight or even 10 times a day, including nightime.
About 2 in 1,000 people in the UK develop Ulcearative Colitis and it can develop at any age but most commonly first develops between the ages of 10 and 40 years old. Statistically non-smokers are more likely to get Ulecerative Colitis than smokers though smoking obviously brings other dangers to health which far outweigh this benefit.
Crohn’s disease also has similar symptoms, and the two conditions are referred to together as inflammatory bowel disease (IBD). One in 200 people in the UK develop IBD, so around 300,000 have that overall.
To diagnose Ulcerative Colitis the normal test is for a doctor to look inside the large intestine by passing a special telescope into the rectum and colon. A stool sample is also commonly done during each flare-up and sent to test for bacteria and other infecting germs.
When Ulcerative Colitis is first developed it is usual to take medication until symptoms clear. After that a course of medication is then usually taken each time symptoms flare up. The drug selected depends on both the severity of the symptoms and the location of the inflammation, other drugs may be advised to take daily to prevent further flare-ups which reduce by up to 50% the likelihood of experiencing a flare-up.
About 25% of people with the condition need surgery at some stage, the most common procedure is the removal of the large intestine.
Although not related to incontinence the condition shares many similarities in that view people talk about the condition, former England Rugby Captain, Lewis Moody has also now come forward and talked about his own experiences of the condition, including how he tried to hide it. “There was no way I was going to let my secret out to a bunch of rugby players who would then mock me mercilessly. I ended up hiding it from them for three years and I slumped into a state of depression.”
However sharing your experiences can help and Moody admitted that hiding it hadn’t been helpful. “Eventually, I decided to tell my best friend at Leicester, Geordan Murphy. He had guessed something was up. He was sympathetic, of course, but he didn’t overdo it. Geordan made me realise that perhaps it had not been the best course to keep everything to myself. Slowly, events made it inevitable that others would know. The England management were more than understanding, as were the Leicester coaching team when I finally mustered the courage to tell them. Ironically, I became less stressed about my condition when people knew about it. Being stubborn about it and keeping it a secret had simply made life harder for myself.”
The need to know the location of toilets wherever you travel is also shared, and regular toilet use is important as well, as well as the use of absorbent incontinence products when necessary to give confidence.
Combination therapy more effective for incontinence
Issue Codes Incontinence Accessories and Hygiene
A new trial suggests that combination therapy for anal incontinence is more effective at dealing with the condition than current treatments.
Publishing their findings in Deutsches Arzteblatt International, researchers conducted a randomised trial designed to compare the effectiveness of different treatments for fecal incontinence, Science Daily reports.
Incontinence pads can help people with the condition to cope with the symptoms; however the research suggested that new methods of treatment could be effective.
Approximately one to two per cent of the population in Germany – where the research was conducted – suffer from anal incontinence, with weakness of pelvic floor muscles accounting for a large proportion of cases. Currently, treatments involve trying to restore control to the muscles responsible for controlling the bowels through targeted training with electrical stimulation.
However, the research suggested that such physical stimulation is not enough to effectively train all of the muscles required for continence. Furthermore, the standard treatment – low-level electric stimulation – can be painful for patients.
Instead, the news provider reports that the authors of the review suggested combination therapy, also known as triple-target treatment. This involves treating the different muscle groups with different levels of stimulation, which is less painful than the low-frequency solution and has also been shown to restore continence in 50 per cent of patients receiving treatment.
Meanwhile, the Association for Continence Advice (ACA) has published new guidance designed to educate teenagers about the importance of exercising their pelvic floors before the symptoms of incontinence appear.
Maintaining a strong pelvic floor not only helps combat faecal incontinence, it can also help people with bladder control as well.
The pelvic floor tends to weaken as people get older, so the ACA hopes that its new advice will encourage more people to start pelvic floor exercises at an earlier age.
Open to all healthcare professionals, the ACA seeks to promote continence and the better management of incontinence.
Bulking agent may reduce need for incontinence products
New research suggests that an injectable bulking agent may help to improve symptoms of faecal incontinence and reduce the need for incontinence products. Swedish scientists carried out a clinical trial of the new treatment, which involves injections of a product called dextranomer and hyaluronic acid.
A total of 206 patients, aged 18 to 75, took part in the study and the researchers found that after six months, more than half of the participants had a 50 per cent or greater reduction in the number of episodes of incontinence. In contrast, just 31 per cent of patients who received a sham treatment reported a similar improvement. Dr Wilhelm Graf, from Akademiska Sjukhuset in Uppsala, Sweden, told Pulse magazine: “This treatment is easy to apply and safe and might be used as a treatment before more invasive techniques or as an additional or adjuvant treatment if other treatments do not give adequate symptomatic relief.” News of the trial is likely to be welcomed by many people, as about one per cent of adults in England are thought to need faecal incontinence products on a regular basis.
Incontinence caused by Childbirth
Childbirth is the most wonderful experience a woman can have in her entire life but for a small minority this experience can leave lasting injuries that will degrade their lifestyle.
One of these injuries is called obstetric fistula – a fissure, or hole, between her rectal and vaginal passages that can damage nerves cutting brain communication with the bladder leading to a severe case or urinary incontinence.
Such problem is not very common here in the UK but a recent article on The Guardian caught our attention and we decided to share it with our readers.
The article “Torn Apart by Childbirth” tells the story of Mel who had a problematic delivery that caused her change ever since. Sex is difficult and painful; she rarely goes out socially, and she has only been able to return to work in the last two months.
Despite Mel’s case being a rare one, birth injuries that lead to long term or permanent damage are more common that many people think. One study found that between 25 and 40% of patients will have a birth injury of some kind if you actually look for it. It’s much more widespread than anyone believes.
Many women suffer in silence and here is where the problem needs to be tackled. We’ve heard from women in their 50′s that gave birth in their 30′s and have lived with faecal incontinence all this time and done nothing because they thought they were freaks.
Maureen Treadwell at the Birth Trauma Association agrees: each week, she says, her organisation hears from women who haven’t known where to turn for advice before. “It’s a totally hidden problem, and it affects women’s lives in devastating ways,” she says. “Many of the women who contact us have rectal as well as urinary incontinence, and they can’t have sex . . . for some, their relationship totally breaks down as a result of it all. Women tell us it makes them feel dirty; it wrecks their work, their home and their social life. And it’s a total taboo.”
Every day we hear from people that are ashamed of their condition and don’t seek help because they simply don’t have the confidence to do so. For years now here at All About Incontinence we have been stressing out the fact that Incontinence is nothing to be ashamed off and it is TREATABLE.
Our aim here is to help you feel more confident through giving you the best incontinence products for reliable protection and the right information to help you understand and manage your condition.
Do not hesitate to contact us or ask our nurse specialist Shona with your doubts. All emails and calls are dealt with total discretion.
More information on Faecal Incontinence
Whilst the taboo around discussing urinary incontinence and bladder weakness is slowly being overcome, faecal incontinence remains one of those topics that people avoid talking about still. However, many people have to live with it, and there’s a lot that you can do about it, here is some additional information to help you understand and manage the condition better.
Muscle Damage
Two ring-like muscles – the external and internal sphincter – help keep faeces inside your rectum. Most of the time, they perform their jobs well and there is never a problem. However certain situations can cause damage to those sphincters, making them weak and susceptible to leaking feces. In most cases, haemorrhoid surgery and childbirth are responsible for sphincter muscle damage.
Constipation
Most people experience constipation – an inability to produce bowl movements – from time to time. Constipation is a major cause of fecal incontinence, which seems counterintuitive. However, the hard faeces that are unable to be expelled can become lodged in the rectum; looser stools can then slide out past the blockage, causing incontinence. Also, these hard faeces can sometimes cause damage to the sphincter muscles, making it more difficult for a person to make it to the bathroom in a timely manner.
Nerve Damage
When the nerves that sense stool in the rectum – or the nerves that control the external and internal sphincters – become damaged, faecal incontinence can occur. In the first case, your body is unable to warn you when faeces need to be expelled; many times, you only find out when it leaks out. In the second case, the nerves that are in charge of those sphincters don’t work properly, and incontinence occurs. Nerve damage in these areas can be caused by strokes, childbirth, a habit of straining exceptionally hard to pass stools, multiple sclerosis, diabetes and other conditions that affect nerves in the body.
Diarrohea
Since diarrhea is loose and watery, it is more likely to leak out unexpectedly. Most of the time though, this is only a short-term condition.
Reduced Capacity
Inflammatory bowel disease, rectal surgery or radiation treatment can scar the inside of the rectum, making it less elastic. The reduced capacity then makes faecal incontinence much more likely to occur, since the rectum is unable to stretch to accommodate faeces.
No matter what the cause, it’s important to consult your health professional should you experience ongoing faecal incontinence to receive the correct diagnosis and support for your own condition. Use of Disposable Incontinence products such as Tena Pants Plus or Tena Pants Super can assist in managing the condition and reducing the effect of leaks. However as no product has yet been produced specifically for the absorption of solid matter then it is always advisable to change any product as soon as soiling has occurred to maintain freshness and skin condition.
Childhood constipation often lingers into adulthood
Stubborn cases of chronic constipation in childhood may become an adulthood problem for a significant percentage of kids, a new study suggests.
Dutch researchers found that among 401 children and teens treated for chronic constipation at their center, one-quarter were still having symptoms 11 years later, as young adults.
The odds of long-lasting constipation were greater when the problem arose later in childhood or when years passed between a child’s first bouts of constipation and his or her referral for specialized treatment.
The findings, reported in the journal Pediatrics, are based on a group of children and teens with symptoms serious enough that they were referred to a specialist clinic.
So they may not be representative of kids treated for less-serious constipation by their primary care doctors, note the researchers, led by Dr. Marc A. Benninga of Emma Children’s Hospital in Amsterdam.
Experts generally recommend that children see their doctor if they have constipation problems that last more than two weeks. Typically, treatment involves diet changes – such as eating more fiber-rich grains, fruits and vegetables – and, with a doctor’s approval, stool softeners or laxatives.
The new findings suggest that children whose symptoms do not improve with initial treatment might benefit from earlier referral to a specialist, according to Benninga and his colleagues.
It’s estimated that functional constipation – constipation not caused by an underlying health condition or medication side effects – accounts for about 3 percent of all visits to the pediatrician. But there has been little research into how often those problems persist into adulthood.
The current study included 401 children and teenagers who were treated for chronic constipation at the researchers’ center in the 1990s. All had at least two symptoms of chronic constipation – such as having fewer than three bowel movements a week and two or more bouts of fecal incontinence per week – and had not improved after using laxatives for at least two months.
After six to eight weeks of “intensive” treatment that included medication and behavioral therapy, the children were followed, through yearly surveys, to track their long-term progress.
After 11 years, the researchers found, three-quarters of the study participants were showing a “good” outcome – defined as having had at least three bowel movements per week in the past month, and fewer than two bouts of incontinence.
That left one-quarter who were still suffering symptoms. For comparison, that rate is much higher than studies have found among adults in the general population; in the U.S., for example, it is estimated that between 4 and 5 million Americans have frequent constipation – with older adults accounting for a large portion, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Benninga’s team also found that certain factors – including constipation problems starting later in childhood, and longer gaps between a child’s first symptoms and treatment referral – seemed to increase the likelihood of persistent constipation.
For example, they say, a boy whose symptoms began at age 3, and included only two bowel movements and multiple bouts of incontinence each week, would have a 7 percent chance of adulthood constipation if there were a one-year gap between the onset of his symptoms and his referral for specialist treatment.
Those odds increased to 31 percent with a 9-year delay before referral.
The findings, according to Benninga’s team, suggest that referring kids for specialist care earlier on might cut the risk of long-lasting problems.
“Referral to a specialized clinic should be considered at an early stage for children who are unresponsive to first-line treatment,” they conclude.
Urinary and Faecal Incontinence Basics
Although it might not be a subject you want to think about, if you are dealing with incontinence, the one thing you should not do is ignore it. Many have the incorrect assumption that nothing can be done to improve the condition but that is far from accurate.
Incontinence is the involuntary loss of bladder or bowel control, i.e. the loss of the ability to determine when and where urination and/or bowel movements may occur. Although rarely discussed it is actually a very common disorder experienced by as many as 6 million men and women of all ages.
Many find it difficult to manage, leading to frustration and even isolation and depression in the worse cases. Yet, incontinence is not a disease, but rather a symptom of underlying conditions that affect men and women of all ages and backgrounds.
The many causes of incontinence include pregnancy, surgery, infections or even just being overweight. It also can be triggered by a variety of other diseases, such as multiple sclerosis, muscular dystrophy and even diabetes.
There are also different types of incontinence:
• Stress incontinence: A small amount of urine is released by such everyday physical activities even ones as basic as, coughing, sneezing or laughing. This is generally due to weakened pelvic floor muscles and in many cases can be easily treated by activities such as pelvic floor exercises.
• Urge incontinence: The urge to urinate comes on so suddenly that it is impossible to reach a toilet in time. This generally results in larger losses than stress incontinence. Bladder re-training may help improve this condition.
• Overflow incontinence: The bladder is constantly filled, causing it to release small amounts of urine frequently.
• Reflex incontinence: The absence of bladder control is due to impaired nerve function. This is often linked to other diseases.
• Faecal Incontinence: Impaired rectal sensation or muscle control results in the loss of faeces (stools) or the staining of underclothes.
We always advocate discussing the symptoms with your own health professional as they are best placed to diagnose your own symptoms and condition and recommend appropriate treatments.
Medtronic reports positive trial data for faecal incontinence therapy
Medtronic has published data from a clinical study which demonstrates the efficacy of its new treatment for faecal incontinence.
The company’s InterStim Therapy was tested among 120 sufferers of the condition who had previously failed to respond to other treatment options, with the Medtronic implant helping to achieve a reduction in incontinence episodes.
This device functions by applying mild electrical stimulation to the sacral nerves controlling the bladder, sphincter and pelvic floor muscles, with the aim of delivering perfect continence.
Medtronic senior vice-president and neuromodulation president Tom Tefft stated that the studies show the product’s efficacy in meeting a pressing clinical need.
He said: “InterStim Therapy has a significant impact on quality of life when few other treatment options exist.”
Earlier this month, the company was granted a recommendation from the Food and Drug Administration’s circulatory system devices panel for a new pacemaker optimised for safe use with MRI scanners.
Source: http://www.zenopa.com/news/19698987/Medtronic_reports_positive_trial_data_for_incontinence_therapy
New Faecal Incontinence Pads released in America
Faecal incontinence is probably the most embarrassing and frustrating type of incontinence there is and nearly all incontinence products available are bulky and uncomfortable to use.
A new product developed and recently introduced in the American market promises to deal with mild faecal incontinence in a discreet and hygienic way. With a unique butterfly shape this incontinence product fit into place without the need of tape, pins or other fastening devices.
This innovative incontinence product is described as an anal leak pad, highly absorbent (up to 10 ml leakage per pad) of mild faecal leakage and perspiration, it is a soft, smooth and latex free.
These pads act as breathable moisture that helps contain leakage, keeping sensitive skin drier and at the same time reducing irritation. With its compact size of 3-1/2 x 5 inches open (fold to use) these pads are easy to carry and use when needed.
Designed for active lifestyle these faecal incontinence pads are disposable, biodegradable and flushable making it easy to change and dispose it in the privacy of a restroom, making it a simple and easy to use solution for people living with Faecal Incontinence.
Product Profile
Name: B-SURE® Anal Leakage Pads
Manufacturer: B-Sure
Available in Boxes of 24
Expect to see these new pads in the UK any time soon and stay tuned for more information about other incontinence products here at All About Incontinence.
More Women are Having C-Sections Because of the Risk of Incontinence
More and more women are having C-sections, which could be partly due to concerns about the dangers of vaginal delivery, Dr. C. E. Turner of the Royal Prince Alfred Hospital in Sydney reports.
Australian researchers have sought to put a number on how much risk pregnant women would be willing to accept before opting for a C-section. They looked at 17 potential complications, including various degrees of vaginal tearing, faecal incontinence or urinary incontinence.
For each of the complications, the participants gave a percentage for the risk they would be willing to accept before deciding on a C-section.
Pregnant women were least willing to accept the risk of severe anal incontinence; on average, they said that if the risk of having this complication was any greater than 32% they would want a C-section.
Emergency C-section, moderate anal incontinence, severe urinary incontinence, and severe tears were less acceptable to pregnant women than pain, less severe tears, and prolonged labour.
Severe or moderate anal incontinence and urinary incontinence were among the top 5 least acceptable risks for the pregnant women.
‘When the women were informed of these rates at the end of the interview, they felt generally relieved.’
The researchers are currently involved in a study looking at whether women’s views changed after giving birth.
Allanda can provide all the products and advice for all your incontinence needs.