It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

Gallstones can be the cause behind quite some pain and discomfort if not treated by an Ayurvedic medical expert. This helps you get over the ailment before it can inflict any more pain. Before learning about the treatments for the condition, it is important to learn what exactly is a gallstone? A gallstone as the name suggests is a peculiar stone-like formation found in the gall bladder. The stones vary in size and number from person to person and are mainly constituted from bile components that settle inside gallbladder. Gallstones as mentioned above are only stone-like formations and not really stones. They are formed from the cholesterol, bilirubin and salt contained in the bile.

How are gallstones diagnosed?
In the majority of cases, it becomes impossible to detect whether a person has gallstones or not. It is only when the stones close or block a specific duct and become the cause for inflicting some pain, does the chance of the presence of a gallstone crosses the mind. In case one is undergoing similar pain in the stomach, it is advised that you make your way immediately to an Ayurvedic medical expert, who will help you to recover from the condition with 100% natural medicines and treatments, with no side effects whatsoever.

Different types of Gallstones:
Another thing to be noted, before you start treatment for gallstones, is their type. There are distinctly two different types of gall stones. These are-

Pigment Stones: Pigments stones are smaller in size compared to the cholesterol stones and are usually larger in number and darker in colour. The main building component of these pigment stones is bilirubin. The bilirubin, in turn, comes from the bile, which is an enzyme secreted by the liver and carried into the gallbladder to be stored there.
Cholesterol Stones: The Cholesterol stones, on the other hand, are the most common kind of gallstone there is. 80% of the times, patients are detected to have cholesterol stones. These stones are characterised with a yellowish green colour.
Causes leading to Gallstone:
Only when gallstones reach a particular size or an overwhelming number that they start blocking ducts, which in turn cause the pain. But what results in the formation of these gallstones? There are a number of things that can lead to the formation of these stone like formations in your gallbladder. Some of these reasons include-

Increase in weight
A non-efficiently functioning gallbladder
Following a wrong diet
Over consumption of cholesterol rich food
Genes, and most commonly
Bile
While these are the common causes for bile stones, the most common causes of pigment stones are certain kinds of medical conditions, such as- sickle cell anaemia or other blood diseases and cirrhosis of the liver.

Ayurvedic cures for Gallstones:
According to Ayurveda, there are three doshas, namely the Kapha, pitta, and Vata, which lead to the formation of gallstones. Opting for Ayurvedic treatment helps you eliminate the requirement of harsh allopathic medication or for that matter surgery. The three major point covered by Ayurvedic treatment for gallstones include- modification in diet, herbal and all natural Ayurvedic medication and detoxification.

Ayurvedic gallstone treatment includes detoxification, herbal medications and diet modifications. A common therapy is a liver flush, which can include olive oil, lemon juice and spices. Citrus fruits, vitamin C, tumeric and ginger may assist with reducing cholesterol in the gallbladder to prevent its buildup. You can also place a castor oil pack over the gallbladder area to purportedly alleviate pain and inflammation, improve circulation and promote healing of damaged tissues.

Naturopathic Treatment for Gallstones:
Gallstone treatment requires altering carbohyderate and lipid metabolism of the entire body, especially of the liver. This will mostly involve changing the foods you eat, as well as adding specific supplements to encourage particular biochemical paths in the body. The details of this process consist of three major categories of actions.

Normalize bile composition leaving the liver
Dissolve existing gallstones in the gallbladder
Prevent the reabsorption of bile and cholesterol in the small intestine
Naturopathic treatment will start with a high-quality nutrition program made to reduce your body's tendency to produce excess cholesterol. It will also use a variety of nutritional supplements to break up fat deposits in the liver. Still other agents, both herbs and supplements, can dissolve existing gallstones. The exact details will vary from one individual to another depending on your medical history. As always in Naturopathic Medicine, the treatment program is customized to you and your individual situation. 

Gallstones - Know The Different Types!

This surgery involves the removal of Gallbladder, which is a pear-shaped organ that lies right beneath the right side of the liver. The main function of the gallbladder is to collect and concentrate bile, which is a digestive juice produced by liver after eating, aiding digestion. The most common disorder of the digestive system is presence of Gallstones, which are the stones made up of a mixture consisting of cholesterol, bile pigment and calcium salts.

These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.
Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

    The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
    A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
    Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
    Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
    In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.

Complications after gallbladder surgery:
This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:
There are three main types of gallstones. They are
1. Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
2. Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
3. Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.

Medical factors to consider before cholecystectomy:
The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:
Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week. 

Gallstone Surgery - Things You Should Know About It 

Following are some common Gall Bladder and Biliary Disorders. Read on to know in brief about them. 

1. Gall stones: Gall stones also known as cholelitiasis is a condition in which gall bladder contains stones or calculi. Usually, these stones are asymptomatic and do not cause any trouble to the patients. Few patients experience recurrent right upper abdominal pain. This condition is known as biliary colic and if it persists, the patiet is adviced gall bladder removal surgery. Sometimes the patient presents with severe right upper abdominal pain with fever and deranged Liver function tests. This condition is known as acute cholecystitis. The surgery is minimally invasive and is called Laproscopic cholecystectomy. If there are dense adhesions, the surgeon may plan to convert the surgery to open cholecystectomy. The patient is usually discharged by day 3 of surgery.

2. Common bile duct stone or choledocholithiasis: Occasionally stone from the gall bladder slips into the common bile duct (CBD stone).This causes obstruction of the bile duct causing Fever, abdominal pain and Jaundice. This is called Cholangitis and is a medical emergency. The patient requires urgent hospitalisation and decompression of the bile duct by inserting a plastic stent in the CBD with the help of ERCP. Severe untreated cholangitis can be life threatenig.CBD Stones which are detected because of dull aching abdominal pain, deranged liver function tests or by ultrasonography also need removal. The CBD stone is removed by an endoscopic modality called ERCP, which is minimally invasive and needs no surgery.

3. Bile duct cancer or cholangiocarcinoma: Cancer of bile duct usually occurs in the elderly patients who present with gradually progressive jaundice. Because of the obstruction to the flow of bile, produced in the liver, the patient develops jaundice. Gastroenterologists examine the patient and CT scan abdomen with MRCP is required to fully evaluate the stage and extent of the tumour. The treatment is multimodality and requires the expertise of Radiologists, Surgeons, Oncologists and gastroenterologists. The Gastroenterologists can help in decreasing Jaundice by inserting plastic or a metal stent (SEMS self-expanding metal stent ) in the common bile duct. These are very aggressive tumours and very few patients are fit for surgery. Survival is very low for these tumours.

4. Gall bladder cancer: Gall bladder cancers are very aggressive and lethal cancers. The patients present with obstructive Jaundice and Itching all over the body. Definitive treatment is surgery but very patients present in the early stage. Advanced stage cancers are treated with palliative intent by metal stenting (SEMS for cancer of gall bladder) to reduce jaundice.

Learn More About Gall Bladder And Biliary Disorders!

These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to the removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.

Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.
Complications after gallbladder surgery:

This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:

There are three main types of gallstones. They are

Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.
Medical factors to consider before cholecystectomy:

The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:

Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week.

Know Everything About Gallstone Surgery!

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