Introduction
Loss of bladder control (urinary incontinence) is a common and mostly embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that is quick and strong that a person does not get time to reach a toilet before starting peeing. This often occurs in old females, especially those who had many children or complicated delivery. Clinical presentation of urinary incontinence is always an involuntary voiding of urine against the will to hold it. This may happen either with cough or sneezing in the beginning stages but over time, it can happen without any such activities causing a heavy abdominal pressure. The quantity of urine and the frequency of the involuntary expulsion of urine increase by time. Though the symptom is mostly the same, the disease is classified into many types. They are:
- Stress incontinence – this is the condition where leakage of urine happens when the bladder suffers a pressure on it while a person does activities like cough, sneeze, lift heavy weights or heavy work outs. All these activities cause an abdominal pressure downwards that causing the incontinence.
- Urge incontinence – This is when the person feels a sudden urge to urinate, followed by a course of involuntary passing of urine. In this condition, the frequency of the urge or feeling to urinate is usually very high. Usually, it is more during the night, disturbing the sleep. This kind of clinical presentation may present in acute and comparatively less severe conditions like a urinary tract infection or a serious neurological disorder.
- Overflow incontinence – this happens when a person suffers mostly frequent or continuous dribbling of urine. It develops due to incomplete voiding of urine from the bladder due to various reasons.
- Functional incontinence – this the condition where timely and proper voiding of urine is not happening due to any physical or mental disorder. Examples can be later stages of arthritis, or a fractured leg where the patient can not go and position himself to pee on time.
- Mixed incontinence – this is when more than a single type of the above conditions co-exists in a single patient. Mostly stress and urge incontinence conditions tend to exist together.
Causes of loss of bladder control
Causes of urinary incontinence can be broadly classified as two, based on the time period of pathogenesis.
A short term, acute or temporary incontinence may develop due to factors like:
Substance abuse like alcohol
Excess caffeine intake
Carbonated drinks
Artificial sweeteners
Chocolates
Types of pepper
Spicy and acidic foods
Citrus fruits
Some type of medications, especially that used in cardiac conditions or sedatives
High doses of vitamin C
Urinary tract infections
Severe constipation
Chronic or Persistent urinary incontinence can be developed due to factors like:
Pregnancy mostly in third trimester
Childbirth
Senile changes in the body
Menopause
An enlarged prostate
Any type of obstruction in the tract
Neurological disorders like MS
Treatment of loss of bladder control
The management of urinary incontinence or loss of bladder control depends upon the causative factor(s). Acute conditions like tract infections can be managed with medications like antibiotics. But in most cases where the muscle tone and functioning are impaired and the sphincters are not working properly, physical training and techniques are found beneficial. They include behavioural techniques, bladder training, double voiding of urine, scheduled toilet visits, and Kegel’s exercise. Diet especially fluids should be modified and monitored well.
Some other medications like alpha blockers, anticholinergics and topical application of oestrogen are also been used successfully.
Complications of loss of bladder control
Continued contact of urine with the skin and mucous membranes inside and around the vulval area may cause irritation of the skin there and skin rashes. Many people complain about itchy or painful skin rashes that are recurring or not healing at all. Likewise urinary tract infections are most common and frequent in people with urinary incontinence. Apart from such physical issues, there are emotional and social problems one may suffer due to the ….. that is caused by this condition in the society. Such mental status may lead to depression anxiety or other mental disorders.
Preventive measures of loss of bladder control
Prevention is always better than cure. Urinary incontinence can be prevented in many cases by retaining the tones and strength of muscles and preventing chances of infections. Such preventive measures include:
Maintaining a healthy weight
Keeping the private parts clean and dry as possible
Doing pelvic floor exercises
Avoiding excess caffeine, alcohol and acidic diet
Eating a healthy diet rich in fibre, to avoid constipation
Quitting the habit of smoking
Ayurvedic Concept of loss of bladder control
Urination is considered as one the adharaneeya vegas (urges that should not be held or forcibly expelled) The word Vega itself denotes that Ayurveda considers it as a frequent and normal urge or feeling to pass urine. The process is controlled by Vaata dosha as all the other movements in the body. In a healthy person, the Vaata does this function to remove fluid toxins and waste materials from the body through urine. Vaata dosha helps to hold the urinary sphincters tight unless there is a voluntary push to void urine. But in some conditions, this balance is lost and Vaata is unable to hold the sphincter tight. In such people, urine is passed without their will or interest. This condition of loss of urinary bladder control is understood in the light of Ayurvedic principle as either a local problem or the manifestation of a condition that affects the whole body.
Ayurvedic Nidana of loss of bladder control
Any condition that provokes the aggression or imbalance of Vata dosha can lead to this disease. Some of them include:
Vardhakya or Old age
Prameha
Rajayakshma
Krimi
Mootratisaara
Ayurvedic treatment for loss of bladder control
Ayurveda does not always treat for the symptoms but it cuts the root cause and pathogenesis of the disease. Likewise, the treatment approach is customised, as an old age person should not be given the same treatment as a youth with the same complaint. Generally, loss of bladder functions is considered as a condition due to Vaata kopa, and brumhana is advised as a way of management. It can be internal and external where medicated oils and ghee preparations are used for drinking and abhyanga. Sesame oil and cow’s ghee processed with herbs that are good for urinary tract system and locomotor system are used internally and externally. Avagaha or sitbaths after applying medicated oils on the hip area is very useful in loss of bladder control due to loss of muscle tone or degeneration. In some cases, such as Krimi, snehana is not done in the initial stages, instead Virechana kashaya s and Rookshana procedures are done.
Herbal Preparations for loss of bladder control
Dhanwantaram tailam
Balaa tailam
Ksheerabala tailam
Laghupanchamoolam choornam
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Dr. Rajesh Nair, Ayurveda Medicine, India
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Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
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