Urinary Incontinence is the sudden urine loss that occurs involuntarily in women. Some of the factors which cause urinary incontinence are pregnancy, menopause and childbirth. It should be noted that urinary incontinence by itself is not a disease, but is a symptom of other underlying disorders such as diabetes, infections and other conditions.

Causes of temporary cases of urinary incontinence include:
1. Constipation
2. Urinary tract infections
3. Excess consumption of alcohol and caffeine
4. Consuming carbonated drinks
5. Use of artificial sweeteners
6. High doses of vitamin B and vitamin C
7. Being on sedatives, muscle relaxants, blood pressure and heart medications
8. Eatables which are too spicy, acidic or sugary

However, persistence of incontinence might be due to a more serious condition. Some of the causes are stated below:

Age: The bladder muscles tend to weaken with age. This affects the bladder s urine holding capacity.
Pregnancy: Hormonal changes and increase in weight during pregnancy can cause incontinence.
Menopause: Oestrogen is responsible for the healthy maintenance of the lining of the urethra and bladder. The onset of menopause causes the oestrogen hormone levels to drop. The gradual damage of the bladder tissues causes incontinence.
Childbirth: The bladder control muscles are weakened during normal vaginal delivery, thus leading to incontinence.
Obstruction: Occurrence of tumours in the urinary tract can block the normal flow of urine which can cause incontinence.
Hysterectomy: The same ligaments and muscles support both the bladder as well as the urethra. With removal of the uterus by hysterectomy, the pelvic floor muscles are deteriorated. This leads to urinary incontinence.
Neurological disorders: Conditions such as multiple sclerosis (autoimmune disorder in which the immune system destroys the protective sheath of the nerves), Parkinson s disease (disorder affecting motor functioning of the body), brain tumours, spinal injury or strokes are capable of causing incontinence.

Different forms of urinary incontinence are classified on the basis of their symptoms:

Urge incontinence: Urge or urgency incontinence occurs when there is a leak before the person reaches the toilet.
Stress incontinence: Small amounts of urine leak out during normal physical movements such as sneezing, coughing and exercising. This happens because of the minimum stress exerted on the body, and hence, the name.
Functional incontinence: Sudden leakage of urine occurs due to external deterrents or physical disabilities such as not being able to find a toilet.
Overactive Bladder: This is characterized by frequent and urgent urination.
Overflow incontinence: A full bladder, at times, leads to unexpected leakage.
Transient incontinence: If urine leakage occurs due to temporary situations such as infections, or new medications.

Did You Know - Constipation Can Also be a Sign of Urinary Incontinence

Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.

These are called Hunner s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner s ulcers are seen only in people with intestinal cystitis, it s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.

Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the  loo  as much as 40, 50, or 60 times a day.

Diagnosis
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner s ulcers are both a diagnosis of exclusion. This means that they re diagnosed only after a number of other conditions have been ruled out.

Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.

Treatment
There's no cure for IC, but Hunner s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.

Pain medicines are the first line of treatment to manage Hunner s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner s ulcers.

Hunner's Ulcer In Urinary Bladder - How They Can Be Treated?

Blood circulation is one of the most important functions in our body because blood is the medium that carries oxygen and all the significant nutrients to the different organs. When blood circulation takes place, a certain pressure is exerted on the arteries of the heart and the blood vessels. However, when this pressure increases, a condition called high blood pressure develops whereby the systolic and the diastolic pressure escalate above the normal levels. High blood pressure not only leads to the damage of the heart, the brain and the eyes, it also leads to the impairment of the kidneys.

To combat a fast-paced life in an urban setting, we adapt certain lifestyle measures which serve some of the core purposes, like satiating our hunger, quickly. One of these measures includes the intake of canned products. With canned foods, cooking becomes faster and easier. But, one of the major downsides of canned foods is that too much of it can lead to the development of high blood pressure.

The link between BPA and canned foods
BPA or Bisphenol A is an industrial chemical that is present in high concentrations in canned foods and beverages. According to researchers, our body contains the reproductive hormone, estrogen in a particular amount. However, BPA mimics the properties of estrogen and tampers with the cells of the heart and our blood vessels that are otherwise sensitive to estrogen, thereby increasing the chances of high blood pressure. Because of that, same reason BPA can also lead to the development of cardiovascular disorders.

BPA is also the primary chemical used to prepare the food containers or the cans. That is why when people drink or eat from these cans, the body accumulates the chemical as well.

According to medical experts, the systolic pressure rises by 5 mm of Hg after consuming two bottles of canned beverages. To detect this effect better, a medical team conducted a study using 60 men and women, among whom some were asked to drink soy milk from canned bottles and the remaining drank the same product from glass bottles. After this, these 60 men and women underwent a urine test. The test results showed that those who drank from canned bottles had a significant amount of BPA in the urine, which concluded the fact that canned foods are not such a healthy option after all.

What can you do?
So instead of opting for canned foods, another option is basing your diet around fruits and salads. But not the canned variety, but the homemade ones. If you are strapped for time, then you can look for salad bars and cafes. Else simply look for easy to prepare recipes online, prepare the food and store them in your freezer.

How Can Canned Food Products Affect Your Kidneys?

The ideal diet after a kidney transplant

A kidney transplant is a surgical procedure where your kidneys are cleansed and rebuild using the kidneys of a deceased person, in order to flush out the excessive waste fluids from the kidneys. It is of paramount importance and your dietary patterns and lifestyle should be altered after you go through a kidney transplant. Your dietician will help you out by preparing your diet chart to clearly list out the foods that you should consume and those which you should avoid after the surgery. The diet chart that would be prepared for you would be highly subjective and it would totally depend  on your lifestyle, medical history, family health records, genetically transmitted conditions and such others. Apart from improving the condition of your kidney and assisting your transplant, the diet chart will also help you to lose weight, boost your metabolism and enhance your immune system. Some of the most common recommendations that your dietician may give you are as follows:

-Eating at least 5 full servings of fresh fruits and vegetables each day as both are an important part of a healthy diet for a person who has just undergone a kidney transplant. The vegetables should mostly be eaten after cooking/boiling as per the suggestions of your dietician.
-Having enough of fiber rich foods in your daily diet is essential as it speeds up the process of digestion and prevents constipation by promoting frequent and easy bowel movements.
-If you are a non-vegetarian, then you should be going for lean meat alternatives which are low on fat and high on nutritional value. -Examples of such meat are fishes and poultry. Additionally, you should also avoid all kinds of red meat as it is high on fat.
-Consume low-fat milk and dairy products as they help to prevent the fat accumulation inside the body and also maintain an acceptable level of calcium and phosphorus inside your body.
-Maintain a low level of iodized salt in your meals, as it helps to keep your blood pressure under control.
Over the counter health supplements like vitamins and proteins can also be taken, if recommended by your dietician.

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The Ideal Diet after a Kidney Transplant

A kidney transplantation is a surgical procedure where a diseased kidney is replaced with a healthy one.

Once the surgery is over and you are recuperating, it is very important that you make certain alterations to your diet to facilitate faster recovery. You need to maintain your weight and exercise on a regular basis.

What Does a Balanced Diet Include?

After the surgery, eat meals or food items that are low in sodium. A properly balanced diet should include ample amounts of fresh fruits, lean meats, fresh vegetables, dairy products that are low in fat. Drink sufficient amount of water (2-3 litres) to keep yourself hydrated.

Why Do You Need to Supervise Your Diet?

Post a kidney transplantation surgery the patient will need to take anti-rejection drugs which are also known as immunosuppressive drugs. These medications lower the risk of the new kidney being rejected by the body. On the flip side, these drugs suppress the immune system making you vulnerable to infections. A healthy diet will ensure that you don t fall ill.

What Food Items Should You Avoid?

  Consuming undercooked or raw meat, poultry and seafood such as squid, crabs or prawns.
  Consuming dairy products that have been made from unpasteurized milk such as yoghurt and cheese.
  Undercooked or uncooked eggs or any food items that might contain such eggs
  Fruits such as pomegranates or grapefruits
  Unwashed salads, sprouts and vegetables.

Restrain Caution when Consuming Carbohydrates:

When you are taking drugs, it is difficult for the body to utilize all the extra carbohydrates that you consume. This can lead to high blood sugar levels. Carbohydrate-laden food items come from starches and sugars and provide fuel for the body.

In short right after a kidney transplantation surgery, you need to make sure that you are following a diet that is high in proteins but low in sugar. In order to avoid developing diabetes or any associated disease during this phase consult with your healthcare provider and chalk out a proper dietary plan.

Nutrition After Kidney Transplant!

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!

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