The words bowel and bladder dysfunction refer to any type of problem affecting the passing of urine or the elimination of stool. More specifically, bowel dysfunction involves the retention of feces within the bowel—commonly known as constipation, or the involuntary leakage of stool while passing gas and, in severe cases, at any time. Similarly, bladder dysfunction implies either the inability to pass urine or the need to urinate all too often. The ability to control these needs has many different levels, and may if left untreated, lead to incontinence, that is to say, a complete loss of control over bladder and bowel functions, involving the involuntary passing of urine or stool.
In recent years, studies have indicated a frequency of bowel or bladder dysfunctions that reaches very high percentages in certain groups of patients: 40%-70% of multiple sclerosis patients, 70%-80% of people having sustained spinal cord injuries, and 32%-70% of Parkinson’s patients experience problems regarding the regulation of stool and urine. Another interesting fact that applies to a greater majority of individuals is that almost 1 out of 3 women who have given birth without a C-section experience some kind of incontinence. The most common type of incontinence is bladder incontinence among these women.
It is safe to say that bowel and bladder dysfunctions are generally problems that do not affect young people. However, this always depends on the cause of the dysfunction: Parkinson’s disease most of the time affects the senior generation. Therefore, the incontinence issues accompanying the disease will also affect a population of those over 65 years old. On the other hand, spinal cord injuries may cause bladder and bowel issues in younger individuals.
Both the issues of bladder and bowel dysfunctions are considered by many individuals “taboo subjects”—people refuse to talk about these kinds of conditions and as a result, postpone their meeting with a physician.
Due to the embarrassing nature of these issues, patients experiencing symptoms such as the ones described are socially and emotionally debilitated and they refrain from social activities for fear of leaking stool or urine in public. They also experience a decline in their sexual life, as intercourse is an activity that causes them to stress out at the prospect of a leak. Isolation, depression, low self-esteem, and anxiety in the workplace are indicative of the low quality of an individual’s life when experiencing such issues.
When assessing the problem of constipation, one must always keep in mind that toilet habits are extremely individualized. While many people may be used to going to the bathroom once a day, others may do so three to four times a week, which is also considered normal. By strict definition, a person is medically considered constipated when they start passing stool less frequently than they used to, or the quantity of feces is diminished each time they do.
There are great varieties of reasons for why a person may be experiencing the symptoms of constipation:
The partial or complete loss of control over one’s bowel functions is a problem that is treatable. Even though it is considered by many people a reason for embarrassment, and many times medical attention is not sought, the involuntary passing of stool is a debilitating state that can be reversed.
Whether the problem is constipation or the involuntary passing of stool, treatment is available. It involves changing one’s dietary habits, special exercises for the strengthening of the pelvic region, surgery, or medication. Treatment is always administered depending on the cause and a physician’s opinion should be sought once the symptoms appear.
An average person passes urine which, on a daily basis, amounts to 800 ml to 2 liters. A person is considered to be having the symptom of oliguria (a diminished quantity of urine) when they relieve themselves of 400 ml of urine daily or less.
There are two distinct reasons why this might be happening. One involves an abnormally small volume of urine produced by the kidneys (renal failure), and the other one, the inability to pass urine that has already reached the bladder.
Neurological conditions: Even if a person feels the need to urinate, in order for the process to take place, regional nerves have to pick up the stimulus and send it over to the brain. Conditions like multiple sclerosis, diabetes, inflammation of the spine or brain, or heavy metal poisoning result in the message failing to reach the brain. Therefore, a person may feel the need to urinate but fail to do so.
Benign prostatic hyperplasia: The enlargement of the prostatic gland causes pressure on the urethra, through which urine is passed from the body. This results in the urethra becoming gradually smaller and weakened, finally losing its ability to pass urine.
Urethra pathologies: Kidney stones have the ability to move around in the urinary tract. When they end up located in the urethra, they obstruct the natural movement of urine and do not allow it to leave the body. A similar cause is urethral stenosis (narrowing of the urethra).
Urinary tract infection: One of the most common symptoms of a lower urinary tract infection is the need to urinate while producing only a small amount of urine each time.
Bladder incontinence is the inability to control one’s need to urinate, therefore resulting in the involuntary passing of urine. It is divided into the following types:
Mild or severe bladder incontinence can be a debilitating symptom, causing patients to refrain from social activities or feel embarrassed and stressed in public. Sexual life can also be affected because urine leakage many times happens during intercourse.
Treatments vary from medication to surgery, and there are tests like a urodynamic study, which help determine the type of incontinence with great efficacy.