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

The condition of enlarged prostate occurs due to the enlargement of a man s prostate gland, with the passage in time. Also known as benign prostatic hyperplasia (BPH), it is more common in men over the age of 60. Some cases might have symptoms and others may be symptomless. Although the causes are relatively unknown, it is evident that BPH is not a form of cancer, neither does it cause cancer. The prostate is located below the bladder and is responsible for producing the fluid needed by semen. The growth of the prostate tissue that is associated with benign prostatic hyperplasia begins near the inner prostate which is a tissue ring around the urethra. Its growth is generally inward.

Causes
It is of common knowledge that in males, the urine originates from the bladder and flows through the urethra. BPH is a condition where the prostate experiences a benign i.e. non cancerous enlargement which leads to blockage of urine flow through the urethra (the urinary duct). The resultant enlargement, caused due to the gradual multiplication of cells, subjects the urethra to extra pressure. Further narrowing of the urethra causes more contraction of the bladder, resulting in the urine being forcefully pushed out of the body.

With time, the condition leads to the bladder muscles gradually becoming thicker, stronger and oversensitive. Contraction occurs even due to the presence of small amounts of urine, giving rise to frequent needs of urination. At one point, the bladder muscle is unable to overcome the effects of the narrowed urethra. Due to this, urine does not pass properly and the urethra is not emptied.

Some of the common symptoms of enlarged prostate include:
1. Frequent urination
2. Urgency to urinate
3. Difficulty during urination
4. A slow or weak urinary stream
5. Requirement of extra effort to urinate
6. Interrupted sleep due to need of urination

Further risks
Sometimes, when the bladder is not emptied completely, a risk of urinary tract infections develops. Some other serious problems which can be a result of enlarged prostate include blood in urine, bladder stones as well as acute urinary retention (inability to urinate). In some rare cases, kidney and/or bladder damage might also result from such a condition.

Frequent Urination - Can it be a Sign Enlarged Prostate

Kidney stones are caused when certain minerals of your urine are retained and are not fully released, causing them to amalgamate and form a stone. Passing a kidney stone is one of the most painful experiences you may face physically. Its magnanimity is often compared to childbirth, and those who are suffering from kidney stones dread having this experience. If you are not yet affected by kidney stones and do not want to, read further to know what type of diet you need to follow in order to prevent it.

1. Drink lots of water: On an average, a person must be drinking at least 3 liters of water every day. If you live in a more hot and humid climate, your water intake must be even more than that, so that on an average, 2.5 liters of urine is passed throughout the day, which decreases the chance of unnecessary retention of minerals from the urine and release them more easily from the body.

2. Continue eating foods rich in calcium: It is a common misconception that calcium accelerates the formation of kidney stones. Calcium is digested by the intestine, only excess calcium cannot be digested by the intestine and is sent to the kidney. Continue consuming calcium rich foods unless your doctor prescribes you against it. Make sure your diet includes enough dairy products such as milk, cheeses, etc., or other calcium rich foods, such as oats and broccoli.

3. Limit intake of oxalic acid: Oxalic acid is mostly found in foods obtained from plants. It restricts the absorption of calcium in the intestines and as a result, more calcium is passed into the kidneys; thus, forming calcium oxalate, or oxalate stones. Try to avoid foods, such as rhubarb, Swiss chard, nuts, tea, sweet potatoes, etc.;mainly leguminous plant products.

4. Decrease the ingestion of sodium salts, sugar and meat protein: Salts and sugars, mainly found in packaged foods are used to prevent them from expiring. They increase the release of calcium and oxalates into the blood, which thus increases the chance to develop kidney stones. Meat contains fibers which affect certain nutrients in the kidney, thus aggravating the formation of stones.

5. Increase the consumption of insoluble fibers: Insoluble fibers are those rough fibers which are not soluble in water during the process of digestion. They are found in rice, wheat, barley, etc., and are found to decrease calcium absorption in the kidney. They attach themselves to the calcium and oxalates, which enable them to be released as stool instead of urine.

Kidney Stones and Your Diet

The prostate is a vital organ that located between the penis and the bladder. The prostate is involved in the release of the prostate fluid that keeps the sperm properly nourished. Prostate cancer, as the term indicates, is characterized by the abnormal and uncontrolled growth of cancerous cells in the prostate. Though the incidences of prostate cancer are low in India, necessary precautions and diagnostic steps should be carried out to prevent the condition from jeopardizing our lives.

Prostate screening includes two tests known as the Digital Rectal Exam (DRE) and Prostate-Specific Antigen test (PSA). PSA combined with DRE helps to identify prostate cancer at a very early stage. If any of the tests show an abnormality, a doctor might prescribe an ultrasound such as MRI Fusion or Prostate Biopsy to confirm the diagnosis.

Immediate treatment may not be necessary
For low-risk prostate cancer, doctors often recommend active surveillance that includes periodic blood tests, rectal exam, and biopsies.
Active surveillance helps a doctor to continuously track the growth of cancer cells and the possibility of their spread to other areas of the body.
Surveillance is fit for those who are already suffering from a serious condition or for those patients who are above the age of 60.
A surgical procedure to remove prostate cancer
Surgery is considered when the cancer has metastasized to surrounding tissue and the lymph nodes. There are two kinds of surgeries that a patient can go through- a Robot-Assisted surgery and a Retropubic surgery.
Radical Prostatectomy might have risks involved. It is, therefore, wise to discuss the pros and cons of the surgery with the doctor well in advance.
Understanding the treatment options

Radiation therapy: Radiation therapy involves the use of high-powered and high-frequency energy beams to kill cancer cells. Radiation therapy is often used to shrink the size of the cancer cells. There could be two types of radiation therapy-Brachytherapy and External beam radiation. Radiation therapy too can have its side effects. Doctors prescribe several medicines during therapy.
Hormone therapy: Hormone therapy helps to stop the production of a male hormone known as testosterone. This treatment option includes medication that completely stops the production of testosterone, the medications may also block the flow of testosterone on the cancer cells, and surgery to remove the testicles. Hormone therapy is used in advanced cancer stages.
Chemotherapy: Chemotherapy is a drug that goes into the body and kills rapidly growing and metastasizing cancer cells. It is administered through IV (intravenous), or orally as pill or both. This treatment option is employed when cancer spreads to a remote body location and does not respond to hormone therapy.
Biological therapy: Biological therapy involves the usage of the body s immune system to fight cancer. A type of biological therapy known as the sipuleucel-t is used to treat patients with advanced cancer stage and recurring cancer as well.

Prostate Cancer - How Biological Therapy Will Help?

Problems of the large intestine are very common and patients should usually consult gastroenterologists for the proper diagnosis and treatment

1. Bleeding per rectum: Bleeding through the anal canal or rectum is usually the most common problem of the patients. It can be due to following reasons: 

A. Piles also known as Hemorrhoids: Hemorrhoids are dilated venous channels of the anal canal. They occur due to long term constipation or chronic cough or due to less fibre intake in the diet. Sigmoidoscopy or proctoscopy is required for diagnosis. Treatment options include medicines and high fibre intake, Injection therapy(Sclerotherapy) for stopping bleeding from piles and Stapler hemorrhoidectomy if the piles are large.

B.  Polyps: Polyps are soft tissue growths seen in the large intestine. They are usually silent but can present with bleeding or anaemia. Polyps usually grow slowly in size and large polyps can turn into cancer of large intestine also known as colorectal carcinoma. Colonoscopy is required for the diagnosis. The gastroenterologists can diagnose the presence of polyps by colonoscopy. Smaller polyps can be removed by polypectomy by gastroenterologists without the need for open surgery. However large polyps or those polyps with suspicion of cancer require surgery.

C. Large intestine Ulcer: They can occur due to early cancer, SRUS, Infections or drugs. They require colonoscopy for the diagnosis. The gastroenterologists usually take Biopsy from the ulcer to know the cause of the ulcer. The mere taking of biopsy does not mean cancer and biopsy samples are seen in the microscope for better diagnosis.

D. Ulcerative Colitis and Crohn s disease: Ulcerative colitis is one form of Inflammatory bowel disease (IBD). The other IBD is known as Crohn s disease. Whereas ulcerative colitis involves only large intestine, Crohn s disease can involve any part of the gastrointestinal tract including small intestine. Ulcerative colitis and Crohn s disease present with Loose stools(diarrhea), bleeding , abdominal pain, weight loss, Anemia and Perianal fissures and  fistula. The diagnosis of IBD is challenging and involves blood tests, CT Scan abdomen, Colonoscopy with biopsy and clinical history. Management includes Medicines which control the inflammation such as Pentasa, Rowasa, Mesacol etc. Severe disease requires additional drugs such as Azathioprine and Anti TNF sich as Infliximab and Adalimumab. Occasional cases require surgery such as those with tight stricture of the intestine, severe dilatation of Large intestine (also known as Toxic megacolon), excessive bleeding, the disease not responding to medical management, or presence of cancer with IBD.

E. Anal fissures: Cut in the anal skin (fissure) causes severe pain in the anal area during passing motions. It is usually due to constipation or straining. It is usually treated by Gastroenterologists initially by medicines and ointments. If the pain continues Surgery is required named as Lateral internal sphincterotomy (LIS).

2. Loose motions or Diarrhea: Excessive passing of liquid motions is known as diarrhea or commonly lose motions. It is usually due to Infections caused by contaminated food and water. It is usually self-limiting. Severe cases with dehydration require admission for IV fluids and antibiotics for the infection. Loose motions for more than 6 to 8 weeks is known as chronic diarrhea. It is evaluated by blood tests and colonoscopy. Usual causes include tuberculosis, celiac disease, ulcerative colitis, microscopic colitis, Malabsorption such as chronic pancreatitis and small bowel bacterial overgrowth.

3. Irritable bowel syndrome (IBS): IBS is very common and at least 20 to 30 percent of Indian patients suffer from it. Symptoms include altered bowel habits such as diarrhoea or constipation, abdominal pain which is usually relieved or increased by defecation. Weight loss or bleeding is not the feature of IBS. Few simple blood tests are required and good medicines are now available for IBS. Few cases may require colonoscopy to rule out alternative causes of the symptoms.

Understanding colonoscopy: Colonoscope is a flexible tube with a camera at its tip to see the inside of the large and small intestine. Bowel preparation is required at least 8 hours before the procedure so that the inside of the large intestine can be seen clearly without the interference of stools.colonoscopy is an OPD based procedure where the patients are discharged the same day. A colonoscopy helps in evaluation symptoms of the large intestine such as loose stools, bleeding and abdominal pain.

In Detail About Colorectal Disorders!

Urinary Tract Infections are a group of diseases that affect one s urinary system such as the urethra, bladder, ureters or kidneys. Women are more prone to contracting UTIs than men. They may be accompanied by symptoms such as a constant urge to urinate frequently along with a burning sensation in the concerned parts and pelvic pain. The urine may have traces of blood in it. These infections are usually treated with antibiotics.

Causes behind Urinary Tract Infection:

Urinary Tract infection generally occurs when the bacteria enter the urinary tract via the urethra and begin to proliferate in the bladder. Although the urinary system is structured to ward off such invaders, at times, the defense mechanism fails. In that case, the bacteria may evolve into a full-blown infection in the urinary tract.

Few risk factors are:

Female anatomy: A woman s urethra is shorter as compared to a man s, thus lessening the distance the bacteria need to travel to the bladder. This increases the chances of UTIs in women.

Using diaphragms and spermicidal agents for birth controls

A dip in the levels of estrogen post menopause

Abnormalities in the urinary tract that hinder the discharge of urine or cause the urine to travel back into the urethra.

Enlarged prostate or kidney stones that cause the urine to be trapped in the bladder.

An impaired immune system because of diabetes and other ailments

Using catheters (tube) to urinate is one of the common risk factors because of the chances of infections.

Urinary Tract Infection - Reasons behind It

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