Pelvic Radiation Therapy and Incontinence

Radiation therapy aims to kill or damage cancer cells in the area being treated. Cancer cells begin to die days or weeks after treatment starts and continue to die for weeks or months after it finishes. Although the radiation can also damage healthy cells, most of them tend to receive a lower dose and can usually repair themselves.  Pelvic radiation therapy can often irritate the bladder and bowels.

When Pelvic Radiation Therapy Might Be Used

Radiation therapy to the pelvis is one of the treatment options used when bladder cancer has been diagnosed. Bladder cancer starts when cells that make up the urinary bladder start to grow out of control. As more cancer cells develop, they can form a tumor and, with time, spread to other parts of the body. Radiation therapy uses high-energy radiation to kill cancer cells. Radiation therapy can be used as part of or the primary treatment for early-stage or advanced bladder cancers.

Possible Side Effects of Pelvic Radiation Therapy

Side effects of pelvic radiation therapy depend on the dose given and the area being treated. They tend to be worse when chemotherapy is given along with radiation. Side effects from pelvic radiation therapy can include:

  • Redness, blistering, and peeling of the skin in areas treated with radiation therapy
  • Feeling a burning sensation when urinating
  • Feeling the need to urinate often
  • Blood in stool or urine
  • Diarrhea
  • Fatigue from low blood counts
  • Nausea and vomiting
  • Bruising easily

After pelvic radiation therapy treatment, these side effects usually go away over time. However, some people can have longer-term problems such as:

  • Urinary incontinence and bowel incontinence
  • Damage to the lining of the bladder, called radiation cystitis, causing long-term problems such as blood in the urine or painful urination
  • Erection problems in men due to damage of nearby nerves and blood vessels

Urinary Incontinence After Pelvic Radiation Therapy

Sometimes pelvic radiation therapy can cause long-term changes to the way the bladder works. Urinary incontinence can happen when radiation therapy weakens the pelvic floor muscles and the valve that keeps the bladder closed. Involuntary urinary leakage can then occur and may not resolve over time. Urinary incontinence may develop during, immediately after, or many months later after radiation therapy treatment is over.

Bowel Incontinence After Pelvic Radiation Therapy

Sometimes pelvic radiation therapy can cause long-term changes to the way the bowel works as well. Controlling when and how often the bowels are emptied might be more difficult after pelvic radiation therapy. Talking to your doctor about your symptoms of bowel incontinence is essential for them to provide a treatment plan that may help. You might keep track of the foods you eat and the time and duration of any symptoms you may feel afterward. This information can help your doctor come up with a plan that may alleviate or lessen your symptoms.

Ways to Manage Incontinence After Pelvic Radiation Therapy

There are various steps you can take to help manage bladder and bowel incontinence after pelvic radiation therapy.

Diet

Your doctor or nurse may suggest changing your diet and making sure to drink plenty of water. Making these changes can be an important way of improving bowel and bladder control.

Anti-diarrheal drugs

sunmark anti-diarrhealIf you have urgency, loose stools, diarrhea, or bowel incontinence, anti-diarrhea drugs may help. Anti-diarrheal medicines containing loperamide as the active ingredient help slow down the bowel, making stools less frequent and more solid. Your doctor may prescribe other types of anti-diarrheal treatment or advise you about the medicines that may be best for you. It is crucial to speak to a doctor before taking any medication.

Stop smoking or vaping

If you are experiencing problems with urgency, loose stools, or bowel incontinence, smoking or vaping could worsen the situation. Nicotine stimulates the bowels, so find a way to cut back or quit may be in your best interest. Make sure to speak to your doctor before going ‘cold turkey.’

Strengthening the pelvic floor muscles

woman in exercise outfit on all fours doing kegel exercisesPelvic floor exercises can help strengthen the muscles used to control the bladder and bowels. These exercises may help with difficulty emptying the bladder or bowels, gas, and urgency.

Bowel and bladder retraining

Bowel and bladder retraining can help you get your bowel and bladder habits back into a regular pattern. Setting a routine time to empty your bowels and bladder can build up a resistance pattern. You will learn to hold on when the urge to go to the bathroom strikes. Eventually, there will be an increased amount of time between the urge and emptying your bladder or bowels, building your confidence and self-control.

Medicines that can make bowel symptoms worse

man pouring a prescription capsule from a bottle into his handSome medicines can make bowel symptoms worse or increase bloating, wind, urgency, or loose stools. If you are taking any of the drugs listed below and feel that they may worsen your symptoms, speak to your doctor. They may be able to prescribe alternate medications that may lessen your symptoms.

Some of the medicines that may be contributing to bowel symptoms include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac
  • Beta-blocker tablets to treat high blood pressure and some heart problems
  • Antibiotics
  • Diabetic treatment medicines containing metformin
  • Anti-depressants such as venlafaxine and citalopram
  • Magnesium in heartburn antacids
  • Proton pump inhibitors such as omeprazole

At Personally Delivered, we carry various products that can help with bladder and bowel incontinence. For help finding any medicines or products your doctor recommends, our Product Experts are just a phone call away and ready to assist. If you do not see the products you are looking for, chances are we can get them or something comparable for you. We are here to help make life a little easier so you can enjoy life to its fullest.

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Vitamin D and Bladder Health

Did you know that being deficient in vitamin D may impact our bladder health? Having a sufficient level of vitamin D in the body has been shown to alleviate bladder leaks. Vitamin D is an essential vitamin that has powerful effects throughout the body. This vitamin helps us in so many ways since every cell in the body has a receptor for it.

Many people don’t know much about vitamin D, why we need it, how a low level can affect us, or how it is related to our bladder health. Here, we will break it all down for you and explain what vitamin D is and why it is essential in our overall health.

Why We Need Vitamin D

father and mother assisting their daughter umping outside in the sunVitamin D is essential for everyone; however, it is especially critical for women. As women age, estrogen levels begin to drop off. Estrogen is the hormone that protects a woman’s bones. This decrease in estrogen contributes to loss of bone density and muscle strength.

Without this essential vitamin, bone health suffers, leading to osteoporosis, increasing the chances of breaking a bone. Vitamin D also optimizes our muscle strength for stability, balance, and flexibility. When we don’t have even one of those, the risk of falls, injury, and other problems increases.

Vitamin D plays many essential roles within our bodies. Some of the ways it helps us are:

  • Facilitates calcium absorption
  • Impacts our heart health
  • Keeps our bones strong
  • Contributes to a healthy immune system
  • Stabilizes our mood
  • Controls healthy blood sugar levels
  • Keeps our bladder healthy

When we take in vitamin D from food, supplements, or the sun, it gets stored in our fat cells. From there, vitamin D remains inactive until it is needed. When the body needs vitamin D, it is released into the liver and then the kidneys, where it goes through a process to activate the vitamin D in our bodies.

Vitamin D, Pelvic Floor Health, & Bladder Control

Not only does Vitamin D benefit our bones, but it may also help with muscle strength, including the muscles in the pelvic floor and bladder control. With age, childbirth, or trauma, the pelvic floor muscles can become weak. Pressure from the organs above the bladder can then cause occasional urinary leaks. Since vitamin D optimizes our muscle strength, a lack of it will impair our muscle strength, mass, and bladder health.

The pelvic floor is a sling of muscles, like a hammock that supports our uterus, colon, and bladder. A vitamin D deficiency can contribute to a weak pelvic floor, potentially causing any of the following:

  • Stress incontinence– Experiencing leaks and drips after physical movement such as laughing, coughing, sneezing, or lifting.
  • Overactive bladder– The bladder muscles sporadically contract, giving a sense of urgency to urinate and leading to involuntary leakage.
  • Bladder Prolapse – Also known as a cystocele, a herniated, or fallen bladder, bladder prolapse is when the muscles between the bladder and the vagina weaken, causing the bladder to droop into the vagina.

One clinical study found was that women with lower levels of Vitamin D were much more likely to experience pelvic floor dysfunctions and disorders than those with healthier levels. Speaking to your doctor to get your vitamin D levels checked might be a good idea if you are experiencing any signs and symptoms we will discuss now.

Signs of Low Vitamin D Levels

woman sitting in a chair holding her stomach in painLack of vitamin D is not quite as apparent in adults as it is in children. Some of the signs and symptoms of a vitamin D deficiency might include:

  • Getting sick often – Vitamin D keeps the immune system strong to fight viruses and bacteria.
  • Fatigue – Talk to your doctor. Fatigue is often an overlooked symptom and can usually be controlled by taking a vitamin D supplement.
  • Bone and back pain – Again, talk to your doctor. A vitamin D supplement may be able to alleviate some of this pain.
  • Hair loss – If you are nutrient deficient, hair loss could be related to low vitamin D levels in the body. Most commonly, this is caused by an autoimmune disease called rickets. This disease causes soft bones due to a vitamin D deficiency.
  • Muscle weakness, aches, or cramps – Muscle pain can be pretty difficult to pinpoint. Chronic muscle pain has been linked to low levels of vitamin D.
  • Mood changes or depression – Vitamin D deficiency has been linked to depression, especially in older adults. A supplement of vitamin D may improve this symptom.
  • Urinary and fecal incontinence – Studies have shown that low vitamin D levels are linked to pelvic floor disorders such as urinary and fecal incontinence. Since vitamin D is related to bone and muscle strength, a deficiency could lead to bladder leakage.

Vitamin D deficiency is quite common, and most people are unaware of it. Symptoms often come on slowly, so it can be difficult to pinpoint whether they are caused by a lack of vitamin D or something else. Always speak to your doctor about any symptoms you are having so they can measure your blood levels. Usually, a vitamin D deficiency is easily fixed by taking a supplement, increasing your sun exposure, or eating more vitamin D-rich foods such as dairy products or fatty fish.

How Can You Increase Your Vitamin D Levels?

There are a variety of ways that you can boost your Vitamin D levels. Here are a few suggestions:

Get outside and soak up some sun… safely!

Referred to as the “sunshine vitamin,” vitamin D is made in the body by using the sun’s UV-B rays. When the cholesterol in the skin is exposed to these rays, it becomes vitamin D. Many other factors contribute to the amount of vitamin D the body makes, such as skin tone, age, geographic location, and sunscreen. The older you are, the darker your skin, the further away from the equator you live in, and the higher USP-rated sunscreen you wear all contribute to how much sun exposure you need to produce vitamin D.

Vitamin D supplements

There are two types of vitamin D supplements; vitamin D2 and vitamin D3. Vitamin D2 is found in plant-based foods, and vitamin D3 is found in animal products and fatty fish. One of the best supplements for increasing your vitamin D3 is cod liver oil or fish oil. Vitamin D2 supplements help the body keep the right amount of calcium for healthy bones and teeth. Both vitamin D2 and D3 supplements are available over-the-counter. However, getting your blood levels checked can help your doctor determine the correct dose of vitamin D supplements to take.

Add vitamin D to your diet

You can try to incorporate many foods into your daily diet to help increase your vitamin D levels. Some of those foods are:

  • Mushrooms – Like humans, mushrooms produce vitamin D when exposed to the sun’s UV light.
  • Egg yolks – Chickens raised in a free-range pasture are exposed to the sun and produce more vitamin D-rich eggs.
  • Foods fortified with vitamin D – Many goods like cereals, orange juice, almond milk, yogurt, and tofu have vitamin D added to them to increase the intake of this vitamin.

The Bottom Line About Vitamin D and Bladder Health

Vitamin D is an essential vitamin that keeps the body and bladder healthy. It builds strong bones and muscles, including the bladder muscles that support your pelvic floor and help it work efficiently. It may be helpful to keep a bladder diary if you are starting to notice bladder leaks. You can share that information with your doctor so they can better understand your symptoms. You might be surprised how getting a little more sun or slightly changing your diet could help your vitamin D levels and bladder health.

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Neurogenic Bladder Explained: Causes and Management

The central nervous system consists of the brain, the spinal cord, and many nerves in between. It is responsible for many of the functions within our bodies. When the brain and the nervous system are not properly communicating, or there is damage to these nerves, messages that are supposed to be sent to and from the brain are disrupted. In neurogenic bladder, the nerves do not work the way that they should. Find out more about this condition, including symptoms, risk factors, and potential treatment options.

What is neurogenic bladder?

Neurogenic Bladder (NGB) happens when conditions related to the brain, spinal cord, or central nervous system affect the bladder. Under normal conditions, the bladder communicates with the brain to hold or release urine. When the nerves that control this communication are disrupted, the bladder becomes either overactive or underactive, depending on the nature of the damage. This condition occurs when neurological issues interrupt these critical messages, causing the bladder to malfunction.

The two different types of neurogenic bladder are:

Overactive bladder

Overactive bladder (OAB) causes you to have little or no control over your urination. It can also cause you to feel a sudden urge or frequent need to urinate.

Underactive bladder

Underactive bladder (UAB) occurs when your bladder muscles are unable to hold urine. The brain fails to send the proper nerve signals, and the ability to sense when your bladder is full or when to empty it is lost, leading to urine leakage.

What are the symptoms of neurogenic bladder?

woman holding her hands on her stomach in painThe symptoms of neurogenic bladder depend on what is causing the condition. The most common symptom of NGB is the inability to control urination. You can either lose control over your ability to urinate (overactive bladder or OAB) or are unable to empty the bladder fully, or have slow bladder emptying (underactive bladder or UAB).

Other symptoms of NGB may include:

Urinary Tract Infection

A urinary tract infection (UTI) is often one of the first signs. Those with overactive and underactive bladder often experience repeated urinary tract infections. UTIs are caused by harmful bacteria, viruses, or yeast growing in the urinary tract.

Urine Leakage

Urinary incontinence happens when the bladder muscles may be overactive and squeeze more often than regular, leading to urine leaks. You may leak just a few drops of urine, or you may expel a large amount of urine. This urine leakage can happen at any time of the day or night.

Urine Dribbles

With underactive bladder symptoms, you may only dribble a little bit of urine. You may not be able to empty your bladder fully or may not be able to empty your bladder at all. Urine dribbles are most common in those with diabetes, MS, or who have had major pelvic or bladder surgery. The sphincter muscles around the urethra may not work correctly, or they may stay constricted when trying to empty your bladder.

Frequent Urination

Feeling the sudden urge to pass urine often may happen to those with overactive bladder. Frequent urination is passing urine more than eight times in 24 hours. After feeling the sudden urge to urinate, some experience urine leaks, which can be a few drops or a more significant amount.

It is critical to contact your doctor if you have these symptoms or others that are related to urinating. More harm to the urinary system may happen by leaving signs and symptoms to progress without proper medical treatment.

Who is at risk for neurogenic bladder?

Neurogenic bladder can be from a congenital disability or caused by a brain disorder or bladder nerve damage. Whatever the cause may be, the nerves that communicate between the brain and the bladder are not working correctly.

Congenital disabilities that can cause neurogenic bladder include:

Spina bifida

When a fetus’ spine does not fully develop during the first month of pregnancy, Spina bifida occurs. After birth, babies often have weakness or paralysis that affects the bladder and how it works.

Sacral agenesis

Sacral agenesis is a congenital condition in which parts or all of the sacrum and lower spine are missing.

Cerebral palsy

Cerebral palsy is a group of chronic disorders that affect a person’s ability to control body movement and posture. These disorders result from injury to the motor areas of the brain. Cerebral refers to the brain, and palsy refers to weakened muscles. Cerebral palsy may occur in the womb or after birth and is not always diagnosed in the first year of life.

Various other medical conditions and brain disorders that can cause neurogenic bladder include the following:

  • Stroke
  • Parkinson’s disease
  • Alzheimer’s disease
  • Multiple sclerosis
  • Spinal cord injuries
  • Erectile dysfunction
  • Trauma/accidents
  • Central nervous system tumors
  • Heavy metal poisoning

If your doctor thinks you might have a neurogenic bladder, they will perform or order nervous system and bladder muscles tests. By treating the underlying condition, symptoms can often be reduced.

How is Neurogenic Bladder Diagnosed?

Various tests can help determine the health of the central nervous system and the bladder for a doctor to determine if neurogenic bladder is the diagnosis.

Some of the typical testing a doctor may perform or order includes:

Medical history

Your health care provider may ask you several questions to understand your medical history. These questions may include:

  • Symptoms you are having, how long you have had them, and how they are changing your life
  • Information about your past and current health problems
  • A list of the over-the-counter and prescription drugs you are taking
  • How your diet is and about how many liquids you drink during an average day

Physical exam

A physical exam may help your doctor better understand what might be causing your symptoms. The physical exam will likely include your abdomen, pelvis or prostate, and rectum.

Urine culture

A sample of your urine is tested for blood or infection when asked for a urine culture.

Bladder scan

A bladder scan is an ultrasound that shows the amount of urine remaining in the bladder after using the restroom.

Bladder Diary Page 1Bladder diary

You may be asked to keep a bladder diary to track how often you are using the restroom or leaking each day. By keeping a bladder diary for a couple of weeks, your doctor and you can sit down to discuss and learn more about your daily symptoms.

You can download and print your bladder diary here: Bladder Diary

Cystoscopy

A catheter with a tiny camera is inserted into the urethra during a cystoscopy to look into the bladder. This procedure can help the doctor diagnose urinary problems and determine what treatment is necessary. The test can tell how much the bladder can hold, how elastic it is, and when you feel the need to release urine. Bladder cancer, an enlarged prostate, and UTIs can all be found during a cystoscopy.

Other imaging

Your doctor may need to do additional imaging tests such as x-rays and CT scans to help diagnose your condition. Your doctor may also refer you to a specialist for imaging of the spine and brain.

How is Neurogenic Bladder Treated?

Treatment for neurogenic bladder is dependent on what is causing your symptoms and how serious they are. Manufacturers in the medical industry continue to release new inventions to help improve bladder control. The most popular surgery for both men and women is bladder sling surgery. Your doctor may consider these procedures when helping you determine what may work best for you. The goal of the treatment chosen by you and your doctor is to control the symptoms and prevent damage to the kidneys.

Currently, there is no cure for neurogenic bladder, but these are some options your doctor may recommend as treatments to help manage your symptoms:

Portrait of happy young Caucasian woman wearing sportswear doing pelvic muscle exercise lying on mat and smiling in gymBladder training

Kegel exercises can help strengthen your pelvic floor muscles. Since these muscles support your bowel and bladder, practicing these exercises can help prevent urinary leakage. To learn more about Kegel exercises for pelvic floor health, visit our blog post, Take Control of Your Pelvic Floor Disorder.

Delay urination

By waiting a few minutes after you feel the urge to urinate, you are practicing delayed voiding. The goal of delaying urination is to extend this time to a few hours in another attempt to train your bladder.

Urinate on a schedule

By urinating at certain times throughout the day, you might avoid, which can help prevent your bladder from becoming too full. Your doctor may also ask you to keep a bladder diary or journal to record any leakage incidents. A bladder diary can help you determine the best intervals for urinating.

Incontinence products

Incontinence products such as protective underwear, pads, panty shields, panty liners, and adult diapers can help prevent wetness and odors while protecting skin and clothing. The use of underpads, bed pads, chux, and mattress protectors can protect mattresses.

Intermittent catheterization

Your doctor may recommend intermittent catheterization to ensure complete bladder emptying. You may need to self-catheterize a few times a day; however, the catheter may need to stay in long-term in some instances. A variety of intermittent catheters are available to ensure the experience is as smooth and comfortable as possible.

Medication

Your doctor can prescribe medications to help improve bladder function. Specific medicines for neurogenic bladder depend on if your bladder is overactive, underactive, or both.

collage of coffee mug, brownies, tomatoes, and alcoholic beveragesChange of lifestyle and diet

Making a few lifestyle changes might be a good first step for those with minor nerve damage. Maintaining a healthy weight can reduce pressure on the bladder and help relieve symptoms of overactive bladder. Avoiding foods and beverages such as the following can also help reduce or prevent irritating your system:

  • Caffeine
  • Alcohol
  • Spicy foods
  • Dairy
  • Chocolate
  • Artificial sweeteners
  • Citrus fruits
  • Fruit juices

Electrical stimulation

Another treatment option is electrical stimulation therapy. This therapy involves placing small electrodes on the bladder. When stimulated, the electrodes can send impulses to the brain, telling it you need to urinate.

Botox for OAB

Botox works by stopping the nerve signals to the bladder muscles that trigger OAB. The entire procedure is outpatient and typically done in a doctor’s office. Your doctor will fill your bladder with a numbing agent. Once the bladder is numb, a cystoscope is inserted through the urethra, and Botox is injected into multiple strategic points of the bladder muscle. Your doctor will discuss Botox as a treatment for neurogenic bladder if you are intolerant to all other medications and treatment options.

Surgery

If other treatments fail, you could require a procedure or device to help you urinate. Your doctor can insert an artificial sphincter into your body that compresses the urethra to prevent urinary leakage, which can be manually released to allow emptying of the bladder. Other surgical options include bladder reconstruction surgery which may help with bladder control, or undergoing urostomy surgery. With a urostomy, the ureters are attached to a small portion of the ilium that is then used to create a stoma. A urostomy pouch is then be used to collect and discard urine from the body.

At Personally Delivered, we carry a wide range of incontinence products, catheters, ostomy supplies, and more to manage various symptoms from medical conditions. For help choosing the products, you need for your unique situation, give us a call. One of our compassionate, knowledgeable, and friendly Product Experts is ready to assist.

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Disclaimer: Important Notice Regarding Medical Advice

The information provided in this blog is intended for general informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment.

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Traveling with Infants and Toddlers During Diaper Years

Traveling with infants and toddlers can come with its challenges. But preparing for the number of diaper changes that will happen while on the road or on a plane can feel almost impossible. By packing a sufficient amount of essentials, you can hopefully take a little stress out of the equation and enjoy your trip to its fullest. Keep reading for some tips and checklists that might help make your travels easier with babies, toddlers, or young children.

Traveling with Infants and Toddlers by Air

Flying with young children can have many challenges, especially in the summer months when more people travel for vacations and holidays. Not only do parents have to deal with airport traffic, long TSA lines, flight delays, and COVID protocols, they are doing so with small children. Flying with an infant or toddler can be more manageable by planning ahead.

Per FAA rules, airlines do not require an infant or toddler under the age of two to be seated in their separate seat. Babies or toddlers under the age of two are allowed to sit on the parent’s lap for the duration of their flight; however, the FAA strongly encourages securing your child in a child restraint system (CSR) in their own seat. If your toddler is two years or older, a separate seat must be purchased. It would be helpful to check with the airline to see if they offer a discounted child fare to save some money.

For a full list of airline fees, restrictions, and allowances for traveling with infants and toddlers, visit Skyscanner.

For a complete list of special procedures for traveling with infants and toddlers, visit TSA.gov.

Balmex Diaper Rash OintmentTips for traveling with infants or toddlers by air include:

  • Decide whether your infant needs their own seat and ask if there is a reduced fee.
  • Choose an aisle seat.
  • Double your carry-on bag as a diaper bag.
  • Pack extra supplies

Most airlines allow a stroller to be kept at the front of the plane. However, if your stroller is collapsible, it may fit into the overhead bins. Another important reminder is about the changing air pressure in the cabin as the flight ascends and descends. Feeding your child at these times may help to avoid or reduce any uncomfortable pressure in the ears.

Traveling with Infants and Toddlers by Car

Road trips remain a popular way to travel, especially for families with young children. They offer the benefit of cost savings, schedule flexibility, and convenience.

If you find yourself in a bind and need to change your baby or toddler’s diaper immediately, the following best practices for safety are recommended:

  • Pull your car off onto the shoulder of the road. Ideally, it would be best to pull off on an exit ramp or rest stop, but sometimes that is not an option.
  • Turn the car’s ignition off, and then turn on the hazard lights.
  • Prepare your diaper changing space in your vehicle.
  • Remove your baby or toddler from their car seat to change their diaper.

A baby car kit is a helpful tool to help you stay organized with the essential items needed for a baby’s car changing station. Turn your vehicle into a prepared and ready-to-change diapering area by starting with an efficient container.

Baby getting their diaper changed by their mother on a changing padInfant and Toddler Car Kit Checklist:

NOTE: It is against the law to remove a baby, toddler, or young child from a car seat while the car is in motion. Never attempt to change a diaper while traveling with infants and toddlers while in a moving vehicle. Each state in the U.S. sets car seat and booster seat laws and imposes fines accordingly. For more information, visit Safe Ride 4 Kids for car seat laws by state.

If you’re planning on traveling with infants and toddlers, save yourself time by scheduling time for diaper breaks and equipping your car or carry-on diaper bag with the essential items your child needs. A successful trip will help create an even better vacation with wonderful family memories!

For any questions about the baby diapers, toddler diapers & briefs, or any other products and supplies we carry at Personally Delivered that can help complete your preparation kits for travel, give us a call. One of our friendly, knowledgeable, and compassionate Product Advisors will gladly assist you in building the perfect car travel kit or diaper bag essentials kit for traveling with infants and toddlers. We want to help take some of the stressors away and make sure you have the most enjoyable and memorable trip.

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Ulcerative Colitis: Symptoms, Causes, and Treatment

Ulcerative colitis is classified as an inflammatory bowel disease (IBD) that primarily affects the digestive tract and can also affect other parts of the body. Ulcerative colitis can cause symptoms of abdominal pain, blood in loose stool, and fecal incontinence. Diagnosis and treatment of ulcerative colitis can be complicated since the symptoms differ for everyone. However, some common symptoms are shared and seem to be the most prevalent.

Common Symptoms of Ulcerative Colitis

emotionally distressed man on edge of bedUlcerative colitis is usually a progressive disease and starts with ulceration in the last part of the intestine and then spreads up through the rest of the colon, causing inflammation along the way. Depending on the form of ulcerative colitis, some of the symptoms may vary. However, the most common symptoms of ulcerative colitis include:

Forms of Ulcerative Colitis

  • Ulcerative proctitis: The mildest form of ulcerative colitis causes inflammation in the rectum due to fine ulcerations in the colon lining. The inflammation of ulcerative proctitis can cause diarrhea, bloody stool, rectal pain, and fecal incontinence.
  • Proctosigmoiditis: This form of ulcerative colitis affects the last section of the colon that attaches to the rectum. Inflammation in this area can cause bloody diarrhea, fecal incontinence, and pain on the left side of the abdomen.
  • Distal colitis: Inflammation with distal colitis starts in the rectum and extends up the left colon, causing bloody stools, weight loss, loss of appetite, and sometimes severe pain on the left side.
  • Pancolitis: The most severe form of ulcerative colitis is pancolitis when the entire colon is inflamed. This inflammation throughout the whole colon causes diarrhea, cramps, significant weight loss, and severe abdominal pain.

What Causes Ulcerative Colitis?

Although there is no exact confirmed cause for ulcerative colitis, some factors contribute to it, such as a complex interaction of genetics, immune response, and environmental triggers. Some early research pointed at stress, mental illness, and diet as being potential triggers. However, it is now known that ulcerative colitis is not caused by stress or eating the wrong food.

Let’s take a look at how these factors may contribute to ulcerative colitis.

Genetics

We have many genes in our bodies, and many of those genes get passed down to children. Therefore, a person is more likely to develop ulcerative colitis if there is a family history of the disease. However, that does not mean that a person will develop ulcerative colitis just because they have the genes associated with the disease. There are a variety of other factors that can contribute to ulcerative colitis beyond just genetics.

Autoimmune Reaction

Since ulcerative colitis is an autoimmune disease, the immune system isn’t working properly to fight against bacteria and viruses. Instead, the immune system attacks healthy cells throughout the body, and in the case of ulcerative colitis, it attacks the large intestine. In addition, medications used to treat ulcerative colitis suppress the immune system, causing fewer flare-ups.

Environmental Factors

woman holding a large amount of pills in hand with a glass of water in the other handOther factors to consider in developing ulcerative colitis beyond genetics and the immune system response may be related to a person’s environment. Some of these environmental factors that could trigger a flare-up are:

Non-steroidal Anti-Inflammatory Drugs (NSAIDs)

This type of pain medication is often used as a treatment in people with ulcerative colitis because it has been shown to decrease flare-ups of the disease. However, the continuous, long-term use of NSAIDs can cause irritation and bleeding in the digestive tract.

Antibiotics

Antibiotics have been shown to trigger flare-ups of ulcerative colitis for some people. In addition, when antibiotics are taken for an extended period or used in young people, it can be associated with a higher risk of developing a form of ulcerative colitis.

Geographic Location & Ethnicity

Ulcerative colitis tends to occur in people who live in cities within Northern Europe and North America and closely linked to a westernized environment and lifestyle. Ulcerative colitis also has a higher incidence in Jewish populations compared to any other ethnicity.

Complications of Ulcerative Colitis

Ulcerative colitis can cause complications both within the digestive system and outside of it. Inside the digestive system, these problems are referred to as intestinal, and outside the digestive system, they are called extra-intestinal.

Intestinal complications from ulcerative colitis can include:

  • Fissure: A fissure is a tear in the lining of the anal canal that can cause severe pain and bleeding during bowel movements. Anal fissures can be acute or chronic and are usually treatable at home without medical intervention.
  • Bowel perforation: Intestinal perforation can happen when the colon’s wall becomes so weak due to chronic inflammation and ulceration of the intestine resulting in a hole. This perforation is life-threatening and needs immediate attention. Bacteria can spill into the abdomen, causing infection and toxicity.
  • Toxic megacolon: Considered the most severe intestinal complication of ulcerative colitis, toxic megacolon needs emergency treatment. With toxic megacolon, the colon dilates, resulting in painful and uncomfortable abdominal distention. In addition, the colon loses its ability to contract and move gas along, and if not treated immediately, the colon could rupture.
  • Colon cancer: The risk of developing colon cancer from Ulcerative colitis increases with the duration and severity of the disease. It is essential to schedule routine colon cancer screenings with a gastroenterologist.

Extra-intestinal complications from ulcerative colitis can include:

  • Arthritis: Different forms of arthritis can occur in people with ulcerative colitis. The most common include:
    • Peripheral arthritis: Inflammation in the large joints such as knees, elbows, ankles, and wrists.
    • Rheumatoid arthritis: An autoimmune disease where the immune system attacks healthy cells, causing inflammation in many joints at once.
    • Axial arthritis: Inflammation in the lower spine, hips, pelvis, and buttocks.
    • Ankylosing spondylitis: Inflammation affecting the neck and back can cause the vertebrae to fuse, affecting the spine’s ability to flex.
  • Delayed bone growth in teens: Many older medications for ulcerative colitis patients contain steroids. Unfortunately, steroids can stunt bone growth, causing teens with ulcerative colitis to have delayed bone growth.
  • Mouth ulcers: With an ulcerative colitis flare-up, it is common to get mouth sores or canker sores. These mouth ulcers are small lesions at the base of the gums and can make eating and drinking painful.
  • Skin problems: Ulcerative colitis can also cause painful skin rashes and irritations due to the inflammation within the body or from the medications used for treatment. Some of the skin conditions include:
    • Psoriasis: An immune disorder where skin cells build up and form red patches or silver scales on the skin.
    • Vitiligo: White patches of skin develop due to this autoimmune disorder where the cells that produce the skin pigment are destroyed.
    • Hives: These red, itchy rashes can occur anywhere on the body and are often caused by the medication used to treat ulcerative colitis.
    • Erythema nodosum: The most common skin problem for those with ulcerative colitis is erythema nodosum, where red nodules form on the legs and arms, appearing like bruises.
    • Pyoderma gangrenosum: This second most common skin issue is when small blisters form and spread to create a deep and painful ulcer. This skin problem is usually around the shin and ankles but can also form on the arms.
  • Eye diseases: Several eye conditions such as glaucoma, uveitis (inflammation in the middle layer of the eye causing redness and blurred vision), episcleritis (redness on the whites of the eye), and dry eye are associated with ulcerative colitis or the treatments for the disease.

Treatment Options for Ulcerative Colitis

A gastroenterologist will discuss a treatment plan based on the form of ulcerative colitis and how long a person has been experiencing symptoms. Over-the-counter and prescription medications may be considered as well as lifestyle modifications. Probiotics may also be recommended to help restore healthy gut bacteria. In addition, surgical procedures may be discussed in more severe cases to remove diseased parts of the colon and help reduce the risk of developing colon cancer.

Over-the-Counter Medication (OTC)

OTC medications may be used to relieve some symptoms of ulcerative colitis. However, they are used in conjunction with prescription drugs because they do not address the underlying causes of the disease.

Enemeez Mini EnemaSome of the most common OTC medications are:

  • Antidiarrheal medications: Imodium (loperamide) can help with diarrhea but should be used with caution, as they can increase the risk of toxic megacolon.
  • Pain relievers: For mild pain, Tylenol (acetaminophen) can be used. Advil or Motrin (ibuprofen), Aleve (naproxen sodium), and Voltaren (diclofenac sodium) should be avoided as these OTC medications can worsen symptoms.
  • Enemas and suppositories: Those containing butyrate may effectively treat ulcerative colitis in the very last sections of the colon. Butyrate has been shown to be beneficial to the cells in the intestinal tract by combating inflammation, preventing cells from becoming cancerous, and reducing the effects of oxidative stress
  • Iron supplements: In chronic intestinal bleeding, a person is at risk for developing iron deficiency anemia. The inflammation from ulcerative colitis disrupts the body’s ability to use stored iron or absorb it through food. Iron supplements may be able to help.

Prescription Medications

A gastroenterologist may use one or more combinations of prescription medications to treat the symptoms of ulcerative colitis. Some may be taken regularly, while other fast-acting drugs are given on a short-term basis to treat an active flare-up.

Anti-Inflammatories

As a first step in treating ulcerative colitis, gastroenterologists turn to anti-inflammatory medications, which can include:

  • 5-aminosalicylates: Depending on which part of your colon is affected, these are taken orally or as an enema or suppository. Some examples include Azulfidine (sulfasalazine), Asacol HD (mesalamine), Colazal (balsalazide), and Dipentum (olsalazine).
  • Corticosteroids: Prednisone and hydrocortisone are two types of corticosteroids used to treat ulcerative colitis and are reserved for moderate to severe ulcerative colitis. These medications’ potential unwanted side effects are weight gain, fluid retention, high blood pressure, mood changes, and osteoporosis.

Immune System Suppressors

Immune system suppressor medications control inflammation in the body by suppressing the immune system response. These medications are typically used in people who haven’t responded to or cannot tolerate other treatments and include:

  • Azasan and Imuran (azathioprine); Purinethol and Purixan (mercaptopurine): These medications suppress the immune system by interfering with the body’s production of DNA molecules. The doctor will monitor their patient closely and take regular bloodwork, as side effects can affect the liver and pancreas.
  • Gengraf, Neoral, and Sandimmune (cyclosporine): These immunosuppressants are generally reserved for people who haven’t responded well to other medications. Cyclosporine is believed to work by suppressing lymphocytes, a type of white blood cell. However, because cyclosporine has the potential for serious side effects, it is not intended for long-term use.
  • Entyvio (vedolizumab): This medication works by blocking inflammatory cells from getting to the site of inflammation.
  • Remicade (infliximab), Humira (adalimumab), and Simponi (golimumab): These drugs, called biologics or tumor necrosis factor (TNF) inhibitors, control the abnormal immune response.
  • Xeljanz (tofacitinib): This is an oral medication that can regulate immune cell function, and it is used to treat moderate to severe ulcerative colitis.

Antibiotics

If an infection in the colon is suspected, the gastroenterologist may prescribe antibiotics to treat ulcerative colitis. However, it is essential to note that antibiotics can cause diarrhea and lead to uncomfortable and painful flare-ups.

Surgical Procedures

If prescription medication side effects are too severe and other alternative treatment options have failed, the gastroenterologist will discuss surgical procedures to relieve the symptoms. There are two types of surgeries that involve removing the large intestine that are the most common in treating ulcerative colitis; “J-Pouch” and total proctocolectomy surgeries.

"J-Pouch" Surgery

A proctocolectomy with ileal pouch-anal anastomosis (IPAA), or “J-Pouch” surgery, involves removing the large intestine and most of the rectum. The end of the small intestine is then used to form an internal pouch shaped like a J, hence “J-Pouch.” A temporary ileostomy is created by diverting the small intestine out of the abdomen to form a stoma. An ileostomy pouch is used to collect stool as the “J-Pouch” heals. After approximately 12 weeks, a second surgery is performed to reconnect the small intestine and allow regular bowel movements since the muscles of the anus remain intact.

“J-Pouch” surgery is not a cure for ulcerative colitis and does not entirely put a person in the clear for developing colon cancer.

Total Proctocolectomy

This surgery involves complete removal of the large intestine, rectum, and anus and is a permanent cure for ulcerative colitis. A total proctocolectomy also eliminates the risk of colon cancer. However, because the rectum and anus are removed, the ileostomy is permanent, and ostomy supplies will be required for the rest of life.

collage of ostomy supplies

Complementary Medicine (CAM)

Some patients with ulcerative colitis have responded well to complementary medicines. Although each person’s symptoms are different, the risk of using supplements, herbs, and other homeopathic remedies is low but should always be discussed with a gastroenterologist.

A few CAMs to consider discussing with a doctor may be:

probiotic yogurt bowl with pineappleProbiotics & Prebiotics

Probiotics act as a barrier by lining the bowels, so harmful bacteria cannot reach the intestinal wall. As a result, these microorganisms help “good” bacteria grow and are often able to reduce inflammation and improve the protective mucus lining of the gut.

Prebiotics are found in fibrous foods such as bananas, garlic, onions, asparagus, artichoke, and oats. These foods aid in the “good” bacteria in the colon. The undigestable prebiotic fibers from these foods help build up the gut lining, protecting it from harmful bacteria.

Boswellia

Boswellia is a medicinal herb derived from a tree native to India that has anti-inflammatory properties. The active ingredient is found in the resin of the bark. It has been used to treat inflammatory conditions such as rheumatoid arthritis without causing stomach irritation that some OTCs or prescription medications can cause.

Aloe Vera Gel

Aloe vera gel in its pure form is from inside the leaf of the aloe plant. This complimentary medicine has been found to have an anti-inflammatory effect in people with ulcerative colitis. It is critical to note that most stores carry aloe vera juice which is not the same as pure aloe vera gel. Aloe vera juice has a laxative effect and can cause diarrhea. For those with ulcerative colitis, aloe vera juice should be avoided.

Lifestyle & Diet Adjustments

Making a few changes to your lifestyle and diet may significantly impact relieving ulcerative colitis symptoms and prolong the time between flare-ups. Here are some examples to consider:

  • Try eating small meals: Five or six small meals a day rather than two or three larger ones may help you digest more easily and efficiently.
  • Limit fiber: High-fiber foods, such as fresh fruits and raw vegetables, and whole grains, may worsen ulcerative colitis symptoms for some. Grilling, sauteeing, or roasting raw foods may be an option to try.
  • Limit dairy: Diarrhea, abdominal pain, and gas may improve by limiting or dairy from your diet. In addition, if you are lactose intolerant, your body is unable to digest the milk sugar (lactose) in dairy foods. There are many products in stores that cater to those with lactose intolerance, such as Lactaid, Almond Breeze, and various dairy-free cheeses and yogurts.
  • Incorporate fatty fish: Omega-3 fatty acids found in salmon, mackerel, trout, Pollock, and swordfish may keep inflammation at bay. These healthy fats have been known to ease ulcerative colitis symptoms. Think of them as lubing up your intestines and joints.
  • Avoid spicy foods, alcohol, and caffeine: These choices may increase your symptoms, lead to dehydration, diarrhea, or worsen a flare-up.

When to See a Doctor

Doctor Discussing Medication with his patient as they sit next to one anotherWith the symptoms associated with a flare-up from ulcerative colitis, it can be challenging to know which are an emergency and which can wait. However, symptoms that should prompt contacting a gastroenterologist right away include:

  • Severe abdominal pain
  • Bloody diarrhea
  • Light-headedness
  • Painful cramps in the legs
  • Decreased urination

Calling the gastroenterologist before heading to a hospital might help in deciding what level of care is needed. For example, it may be necessary to change treatments or adjust the current treatment plan to get any inflammation under control quickly.

However, if a severe condition such as a bowel perforation or toxic megacolon is suspected, it may be necessary to call 911 because these are medical emergencies.

Ulcerative colitis symptoms and treatment will vary from person to person. If you are confused about the disease and all of the medications and therapies available, have a discussion with your gastroenterologist. They will discuss the benefits and risks and help you make informed decisions together about your care.

If you or a loved one have ulcerative colitis and have questions about the home delivery medical supplies we carry that might be helpful to manage the symptoms, our Product Experts are just a phone call away and ready to help.

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Disclaimer: Important Notice Regarding Medical Advice

The information provided in this blog is intended for general informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment.

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Botox Treatment for Overactive Bladder

Are you experiencing a sudden urge to urinate more often than usual? Do you find yourself unable to make it to the restroom in time? Or are you experiencing side effects from certain medications that impact your bladder? If so, you might be wondering if Botox treatment for Overactive Bladder may be the right solution for you.

What is Overactive Bladder?

An Overactive Bladder (OAB) can happen to anyone, regardless of age, sex, or race. It is a chronic incontinence condition that affects the communication between nerve signals and bladder muscles. The bladder muscles contract uncontrollably, resulting in the involuntary leakage of urine. These uncontrollable spasms of the bladder create a strong and sudden urge to urinate and are often accompanied by frequent urination throughout the day and night.

What is Botox?

Botox, formally termed onabotulinumtoxinA, is a drug that is classified as a neurotoxin. Neurotoxins disrupt the nervous system and how it functions. These types of drugs specifically are toxins that destroy nerve tissue. Since the nerves cannot transmit signals to the muscles when Botox is injected, the muscles become extremely relaxed or paralyzed.

How Can Botox Treat Overactive Bladder?

Have you experienced severe side effects from OAB medications or did not find relief using those medications? Before discussing Botox as a treatment for your OAB, start thinking about how OAB may be affecting your life.

  • Is OAB limiting your daily activities because you frequently need to find and use restrooms?
  • Are you limiting your intake of fluids?
  • Do you feel embarrassed that others are noticing your symptoms?
  • Are you experiencing frustration because OAB impacts your daily decisions like what you wear, where you go and affects your self-confidence?

If OAB is compromising your overall quality of life, Botox for Overactive Bladder may help.

In your body, certain chemicals travel from nerve cells to bladder muscle cells so they can contract and you can urinate. With OAB, these muscles uncontrollably contract and cause a sudden urge to go to the bathroom, causing involuntary leakage or the need to urinate many times throughout the day.

Botox can help patients with OAB reduce their leakage episodes by 50%-75%. It works by stopping the nerve signals to the bladder muscles that trigger OAB. The entire procedure is outpatient and typically done in a physician’s office. Your doctor will fill your bladder with a numbing agent. Once the bladder is numb, a cystoscope is inserted through the urethra, and Botox is injected into multiple strategic points of the bladder muscle. The entire prep, procedure, and monitoring should take approximately one hour.

What are the Possible Side Effects of Botox Treatments for Overactive Bladder?

Coloplast SpeediCath Compact Catheter Set for WomenAfter the Botox treatment for Overactive Bladder is complete, you may have a few side effects such as:

  • It may sting or burn when you urinate the first few times after treatment.
  • You may notice a small amount of blood in your urine.
  • You might experience an inability to empty your bladder fully.
  • You might get a urinary tract infection (UTI).

If any of these symptoms persist longer than a week, you should contact your doctor. If you continue to have trouble fully emptying your bladder, your doctor may prescribe the temporary use of an intermittent catheter such as the Infyna Chic Hydrophilic Female Catheter or the SpeediCath Compact Sets for Women or Men. Since Botox treatment for Overactive Bladder has had much success, using a catheter has been a rare side effect.

How Long Does Botox Treatment for Overactive Bladder Last?

Each person will respond differently to Botox treatment for Overactive Bladder. The Botox injections can help manage OAB with as few as two treatments per calendar year. After the first treatment, you should experience fewer and fewer leakage episodes as the weeks move on. In clinical trials, Botox relieved OAB symptoms for up to six months.

It may be helpful to keep a bladder diary to track your urination pattern and how you felt before and after Botox treatment for Overactive Bladder. When you meet with your doctor to discuss the results of your treatment, bring this bladder diary with you. Your doctor will use this as a tool to determine if you may need an additional Botox treatment sooner than every six months.

Download our useful Bladder Diary now.

Is Botox as a Treatment for OAB Covered by Medicare?

The good news is Botox treatment for Overactive Bladder is covered by most insurance companies, including Medicare. You may have no out-of-pocket expense; however, the cost of Botox is different for everyone depending on your specific insurance company.

To see if you are eligible and to find out how much Botox treatment for Overactive Bladder will cost you, visit this handy calculator now.

For any questions related to incontinence products that we offer to help manage Overactive Bladder symptoms, please Contact Us or give us a call at (800)777-1111. Our compassionate and experienced team is here to help make life a little easier for you so you can get back to enjoying life.

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Disclaimer: Important Notice Regarding Medical Advice

The information provided in this blog is intended for general informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment.

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Bladder Exstrophy: Treatment and Outlook

Many pediatric urological complications can happen before, during, and after childbirth. Some of them are more serious than others, and some are more easily treatable. Bladder exstrophy is one of those conditions that affect the child as they are developing in the womb. Luckily, there are reconstructive procedures that can repair this congenital abnormality so that children can grow up and enjoy most of the same activities as others.

What is Bladder Exstrophy?

Bladder exstrophy is a developmental abnormality that happens when the lower abdominal skin does not properly form, causing the bladder and part of the urethra to be exposed to outside elements. The bladder is essentially turned inside out when the muscle and skin do not correctly close around it. The inner lining of the urethra is exposed on the top of a boy’s penis or between the separated left and right halves of the clitoris in girls.

Due to the bladder and urethra not being closed properly, the bladder cannot hold urine. Urine continuously leaks out and onto the exposed bladder and the surrounding skin. Bladder exstrophy is slightly more common in boys than girls.

How is Bladder Exstrophy Repaired?

A child born with bladder exstrophy requires some form of immediate treatment after birth. First, the bladder and urethra need to be protected from diaper material with a transparent adhesive dressing. Each child will be different when it comes to a specific plan of treatment that the primary care physician, pediatric urologist, and the urology health care team devise.

There are also different options for the repair; immediate or delayed. Immediate reconstructive surgery will be performed within the first two to three days of a child’s life, whereas delayed surgery will be around six to twelve weeks of age. Sometimes the delayed choice is preferred due to the small anatomy of a newborn. Allowing the body to develop more might be a safer repair option.

Bladder exstrophy reconstructive surgery usually involves multiple operations at different times in a child’s life as they mature to obtain the best results.

Initial Closure and Pubic Bone Repair

The first surgery is either done immediately after birth or delayed at approximately six to twelve weeks. This procedure closes the bladder, abdominal wall, and posterior urethra and reconstructs the belly button and pubic bone repair. Because the pubic bone is separated and spread widely apart in children with bladder exstrophy, correcting this abnormality when the bones are soft is more successful. Bringing the pubic bones closer together helps support the soft tissues of the pelvis.

Babies are put into a device, so their lower legs do not move. This device helps prevent the separation of the pelvic bones and aids in recovery.

Repair of the Urethra

If the initial surgery was delayed, this procedure could be combined with the first at approximately six to twelve weeks of age. The bladder should have increased in size at this point, and the urethra is closed and rerouted through the usual passageway. The ureters may be repositioned within the bladder if they are not connected in the right place.

Common Problems Associated with Bladder Exstrophy

Children with bladder exstrophy can experience problems at any stage of life after their surgical repairs are complete. Often, lifelong follow-up care is needed to help ensure the best quality of life.

Urinary Incontinence

Since the pelvic bones are spread widely apart in a child with bladder exstrophy, there is inadequate support of the soft tissue of the pelvis. Because of this lack of support, there is increased tension on the pelvic bones, leading to involuntary urinary leakage.

Vesicoureteral Reflux

When the ureters are not joining the bladder in the correct place, urine can flow back toward the kidneys. This backflow can lead to kidney damage and recurring urinary tract infections.

Emotional Issues

A psychologist or licensed therapist may need to be considered part of the child’s health care team. They can help the child and the family deal with complex issues together.

What are the Risks Involved with Bladder Exstrophy Surgery?

Wound Site Problems

There is a risk that the wound site will not heal properly and open up, causing the bladder to move out of position. Another surgery is required to repair this problem.

Kidney Damage

The other risk is kidney damage from vesicoureteral reflux when urine flows back into the kidneys. If this condition is left untreated, it can lead to kidney failure.

As with any surgical procedure, there are some risks. However, the health care team will monitor both of these conditions throughout the child’s treatment plan.

What is the Long-term Outlook for Babies Born with Exstrophy?

Children born with bladder exstrophy can live a happy and productive life with an average life expectancy. Many people have a normal sexual function and can have children of their own. Some males with bladder exstrophy may experience fertility issues. However, there are many treatment options available for that and can be discussed with a doctor.

Intermittent Catheterization or Urostomy Surgery Later in Life

little ones urostomy pouchDuring a child’s journey with bladder exstrophy, there may come when they are unable to empty their bladder on their own completely. In this case, the health care team can determine if the use of pediatric intermittent catheters might be an alternate approach. If a more long-term drainage solution is needed, a urostomy can be surgically created as an alternate opening for access to the urinary system. The child will then have complete control over urine flow from their body using an ostomy pouching system with a drainage tap.

Most children with bladder exstrophy go about their daily lives without anyone ever even knowing what is different underneath their clothing. They participate in sports and other activities much the same as any other child. The success stories are endless from families that have had a child undergo bladder exstrophy surgeries.

For any questions related to incontinence products, intermittent catheters, ostomy supplies, or any other product that we carry to manage medical conditions, our Product Experts are available to assist. Our compassionate and knowledgeable team will make it easy for you to choose the right products for your needs so you can get back to doing the things you enjoy most.

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Incontinence in Children with Special Needs

Children with special needs often experience incontinence due to physical, mental, or emotional challenges related to their disability. Contrary to popular belief, incontinence is not limited to an issue for the elderly. The older community has a wide variety of products, support, and available treatment options. For children with special needs, entirely different incontinence solutions are needed to address their specific needs.

Common Conditions Related to Incontinence and Children with Special Needs

Incontinence can be very different for each child with special needs. Some children experience incontinence that extends past their toddler stage, and others may have incontinence that extends into their adult years.

The most common medical conditions related to incontinence in children with special needs are:

Autism

Autism spectrum disorder (ASD) is a developmental disorder that affects communication and social interaction in children. There are a wide variety of symptoms of autism, which can range from mild to severe.

Some common symptoms may include:

  • Disinterest in playing or talking to others
  • Avoiding eye contact or physical contact
  • Preferring always to be left alone
  • Delayed speech and language skills
  • Repetition of words or phrases
  • Inability to stay on topic when answering questions
  • Fixations on particular objects or activities
  • Aggressive behavior toward themselves and others

Autism-related incontinence is typically due to the challenges children with special needs face with any of the above behavioral, cognitive, or functional problems. Simply communicating that they need to empty their bladder or not being aware that they need to urinate are common issues in children with autism.

Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disease that can come on at any point in a person’s life. MS is a chronic condition that affects the central nervous system. This debilitating disease can cause problems with muscle control and other daily bodily functions such as bladder and bowel control. Children with special needs such as MS can experience incontinence due to the disruption of the brain’s nerve signals and the bladder or bowels.

Spinal Cord Injury or Spina Bifida

If a child has a spinal cord injury or spina bifida, they will have damage to their spinal cord, which can cause paralysis and disrupt nerve communication to certain areas of the body depending on the level of severity of spinal damage.

When these nerves are damaged, the signals that are supposed to control our ability to empty our bladder and bowels are not present. Children with special needs such as a spinal cord injury may have a complete loss of bladder and bowel control, or they may have a partial loss and may choose self-catheterization as an option to empty their bladder.

Little girl in a wheelchair playing basketball with her father.

Cerebral Palsy

Cerebral Palsy is damage to a child’s brain as it develops, whether in the womb or after birth. This damage to the brain causes a lack of muscle coordination, muscle control, posture, and reflexes. Because the abdominal muscles are affected in Cerebral Palsy, bladder and bowel control are compromised. These muscles may involuntarily contract and lead to stress incontinence, leakage due to the inability to control the bladder muscles.

Children with special needs such as Cerebral Palsy may also deal with issues such as overactive bladder (failure to empty the bladder fully), overflow incontinence (leakage due to the bladder not fully emptying), or urge incontinence (bladder spasms causing the bladder to shrink before reaching the restroom).

Down Syndrome

Down syndrome is a genetic disorder caused by the partial or full copy of chromosome 21 due to abnormal cell divisions when a child is developing in the womb. Children with special needs such as Down syndrome may have issues such as impaired cognitive ability, developmental delays, and gastrointestinal and urinary complications.

Because of the cognitive impairments children with Down syndrome experience, acquiring bathroom habits takes longer. Children with Down Syndrome tend to have weaker bladder muscles and cannot contract their bladder to release urine, leading to urinary retention and the risk of bladder infections.

girl with down syndrome sitting on a bench

Common Types of Incontinence in Children with Special Needs

Nocturnal enuresis

Nocturnal enuresis, also known as bedwetting, occurs when a child can’t control urination at night while in bed.

Daytime urinary incontinence

When a child with special needs loses bladder control during the day, they have daytime urinary incontinence. This type of incontinence in children with special needs can be caused by an overactive bladder, weak bladder muscles, or any nervous system defect.

Fecal incontinence

A child with special needs due to a spinal cord injury is prone to having accidental bowel movements due to the interruption to the communication between the spinal cord’s nerves and the bowel. The brain cannot control the muscles that coordinate the bowel function resulting in fecal incontinence.

For even more detailed information about fecal incontinence, visit our Fecal Incontinence Pads page.

Lower urinary tract symptoms

When there is a lack of coordination between the bladder muscles and the urinary tract, the bladder will not effectively empty. There are many lower urinary tract symptoms in children with special needs, such as:

  • Urinary incontinence – involuntarily leaking varying amounts of urine when pressure is exerted on the bladder when coughing, sneezing, lifting objects, or exercising
  • Frequency – urinating tiny amounts multiple times throughout the day
  • Infrequency – not going to the bathroom for many hours
  • Urge incontinence – the bladder muscles contract when they shouldn’t, causing a sudden urge to urinate
  • Incomplete emptying – the bladder muscles are not able to contract properly to empty urine from the bladder
  • Urinary tract infections (UTIs) – incomplete emptying of the bladder leads to stagnation of urine that can lead to an infection

Ways to Manage Incontinence in Children with Special Needs

When helping a child with special needs manage their incontinence, it is essential to be understanding and supportive. The National Association for Continence (NAFC) has come up with an approach for caregivers of children with special needs that have incontinence more tolerable and contribute to improvement opportunities. It is referred to as ‘The 5 Ps’.

The 5 Ps

  1. Patience – Setbacks may happen, and it is essential not to place blame on them. Maintaining a positive outlook and a good sense of humor can go a long way.
  2. Persistence – Keeping reminding yourself that progress overcoming or managing incontinence in a child with special needs will take time. Try setting realistic goals, and don’t give up. Keep up with patience and a positive outlook.
  3. Planning – Incontinence episodes usually come as surprises. Planning a routine and sticking to it can help keep everyone on a schedule. If there is a shared responsibility with the child with special needs, communication planning is vital. Make sure everyone involved has the information and incontinence supplies needed to act on it appropriately.
  4. Practice – Keep trying and seek out different treatment options to see if something else might work better. Use your resources, such as your family doctor or family and friends, who might recommend specific programs or products that might produce better results for your child with special needs.
  5. Progress is Possible – Remember that you are not alone. There are so many families of children with special needs that have overcome the stigma that incontinence is unconquerable. There are many strategies, products, and treatments to try to make your child with special needs and your life a little easier and more comfortable. Don’t give up!
the five Ps when managing incontinence in children with special needs

Products That Can Help Manage Incontinence in Children with Special Needs

Incontinence management for children with special needs can be overwhelming at the time. However, Personally Delivered offers a wide variety of incontinence products for children that can help make it easier and your child more comfortable. Children with special needs are all different, and one size or type of incontinence product for children does not fit all.

Baby Diapers

Baby diapers are designed to move with the baby to ensure a comfortable, snug, and secure fit. Typically, baby diapers are hypoallergenic to promote healthy skin and lock away wetness for up to twelve hours. Baby diapers are available in a variety of absorbencies for both day and overnight protection.

black baby getting a diaper put on

Training Pants

Training pants are an incontinence product for children that are less bulky than the baby diaper and are designed to fit more like regular underwear. The sides of training pants open for easy adjustment, and the pull-up style makes them a comfortable option. Many training pants feature a wetness indicator that causes a design to fade away, letting you know when the training pant needs to be changed.

cutie pants training pants for boys and girls

Youth Briefs and Protective Underwear

As a child with special needs gets a little older, they will transition into youth briefs and protective underwear as incontinence products for children. The youth briefs and diapers feature the tear-away sides for easy adjustment and changing and the protective underwear pull-on for a snug, comfortable fit. Youth briefs and protective underwear are available in various sizes and absorbencies for daytime and overnight protection.

Adult Incontinence Products

assortment of three incontinence products showing different pads and linersLarger children with special needs can also wear other types of adult incontinence products.

  • Protective Underwear – Just like the youth briefs and protective underwear, children with special needs larger in size can wear these one-piece pull-ups for protection both day and night.
  • Adult Diapers and Briefs – For a more secure and absorbent option, adult diapers are available. Just like baby diapers, adult diapers feature re-fastenable tabs for easy adjustment.
  • Booster Pads – Add a booster pad to any disposable adult diaper, brief, or protective underwear for increased absorbency. Booster pads can extend the wear-time of a primary incontinence undergarment.
  • Bladder Control Pads – For light to heavy absorbency, bladder control pads protect against leakage and are worn inside regular underwear. The difference between a bladder pad and a booster pad is that fluids are not meant to flow through the bladder pad and into the primary undergarment like booster pads are made to do.

Remember that there may be setbacks when trying to manage incontinence in a child with special needs. Try to implement The 5 Ps in the process and celebrate small accomplishments. If you have any questions about the incontinence products we offer for babies, youth, or adults, our Product Experts are just a phone call away and ready to assist.

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Adult Swimming Diapers – Effective Protection for Urinary and Bowel Incontinence

The weather is warming up across the country, and with continued safe practices and social distancing, the pools are opening. If you live with incontinence, you might think you can’t go swimming. However, you have options. Private swim diapers for adults are made to collect light urinary incontinence before entering a pool and contain minor bowel incontinence while in the pool. Swim diapers for adults can offer discreet incontinence protection in public, helping alleviate stress and insecurity in group settings.

Do swim diapers really work?

Many adults are concerned about how to swim with bowel incontinence. With properly designed incontinence wear for swimming, adults can get back to freely moving in the water with confidence.

By law, most municipal pools require that a person with incontinence wear swim diapers to contain accidents. Swim diapers for adults replace your regular incontinence diaper or brief and are put on underneath your bathing suit or swim trunks. These private adult swim diapers contain minor urine leaks and bowel incontinence, but don’t absorb it. With a proper fitting adult swim diaper, there is no leakage of fecal material in the case of an accident, and you are protected until you can get to a bathroom to clean and change yourself.

Tranquility Swimmates Adult Disposable Swim Diapers

Swim diapers for adults like the Tranquility Swimmates Adult Disposable Swim Underwear, you can get back to water-based activities you enjoy. As a bonus, swimming is a healthy fitness exercise that is easier on joints than most other types of aerobic activity and can be vital to your overall health.

Swimmates adult disposable swim diapers

Swimmates Adult Disposable Swim Diapers are a discreet swim diaper for adults. These adult swim diapers can be worn confidently and comfortably in public, ensuring complete discretion. Swimmates disposable swimwear are worn underneath a regular bathing suit and designed to contain minor urinary and bowel incontinence with their moisture-proof barrier and inner leg cuffs. The material of the Swimmates Adult Swim Diapers help prevent swelling up in the water, which helps prevent them from breaking apart, so adults can enjoy swimming and wading in the water without worrying they are not securely protected. The tear-away sides make them easy to remove and dispose of after use.

These incontinence wear for swimming are available in sizes Small to 2XL to accommodate all body shapes and sizes.

What is the difference between regular diapers and swim diapers?

Regular incontinence diapers are made to be absorbent and wick away fluids from the skin. The absorbent materials used in regular diapers for adults puff up as they fill with liquid and contain any solid matter from escaping.

Since swim diapers for adults are not designed to absorb liquids, they do not swell up like regular adult diapers. Regular adult diapers in a pool or ocean would become very heavy and awkward as they absorb all the surrounding fluids. If there happened to be an accidental bowel movement or a more significant urine leak, it would be much more manageable in a swim diaper than a regular diaper. Swim diapers for adults provide much more discretion and security.

How well do swim diapers for adults actually contain bowel incontinence?

There has been some research1 that has shown how efficient swim diapers for adults are at not allowing any fecal matter to escape and leak into the pool. Incontinence swim diapers for adults are not entirely leakproof, and small amounts can possibly spill out into the water. If solid waste does happen to enter the pool, complete flushing is required to ensure that it doesn’t get into the water supply.

What about diarrhea when using swim diapers for adults?

For those with bowel or urinary incontinence that require frequent bathroom breaks and diaper changes, swim diapers for adults are not suitable. If you suspect you have diarrhea, you should stay out of the water at a pool or the beach. Diarrhea is caused by bacteria in the system, and by sharing that water with others, you are putting everyone else in the water at risk of getting sick.

To learn more about how you can help stop germs from spreading in the water you swim in, visit Steps of Healthy Swimming.

What to remember when swimming with incontinence

  • If you plan on swimming in a pool, buy proper fitting swim diapers for adults. If the adult swim diaper fits well, it will be discreet underneath your bathing suit or swim trunks. The inner leg cuffs help contain any accidental leakage of fecal matter.
  • Urinating in a pool or entering the water while knowingly having diarrhea is never okay. Bacteria will get into the water and cause problems for others, possibly making them sick.
  • Regular diapers and incontinence pads should never be worn in a pool or ocean. These incontinence products will absorb the water around them and swell up. Swim diapers for adults will contain minor urine leaks and bowel movements without causing embarrassment. Incontinence pads and diapers are best used for everyday activities that do not involve water.

If you are concerned about how to swim with minor urinary incontinence or bowel incontinence, consider purchasing Swimmates Adult Disposable Swim Diapers. These men’s and ladies incontinence swim pants will allow you to enjoy water activities and free from stress in group settings.

For questions about Swimmates Adult Disposable Swim Diapers or any other incontinence product we offer, our Product Experts are just a phone call away and ready to assist.

Swim Diapers and Swimpants at Personally Delivered

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InterStim Therapy for Bladder Control Problems in Women

Discussing bladder control problems with friends, family, and physicians can make most people feel uncomfortable. Worrying about bladder control can keep some people from enjoying activities they love. More than 33 million Americans deal with overactive bladder (OAB), sometimes referred to as urge incontinence. A minimally invasive procedure called InterStim therapy is a treatment option available for OAB if other non-surgical options have not worked.

First, we will discuss bladder control signs and symptoms, then conservative treatments to try, and finally discuss Interstim therapy as an option to treat bladder control problems.

Symptoms of Bladder Control Problems

  • Frequent urges to urinate (urgency-frequency)
  • Inability to hold urine/leaking (urge incontinence)
  • Inability to urinate (complete urinary retention)
  • Incomplete bladder emptying (partial urinary retention)

Conservative Treatments for Bladder Control Problems

Conservative or non-surgical treatments for bladder control problems typically come first. Some of the conservative treatment options are:

  • Kegel exercises
  • Medications
  • Physical therapy
  • Dietary and lifestyle changes

If these conservative, non-surgical treatments have not effectively treated the bladder control problems, your physician may discuss InterStim Therapy with you as an option.

What is InterStim Therapy?

InterStim Therapy, also known as sacral nerve stimulation or sacral neuromodulation, is an FDA-approved treatment for several different bladder control problems, most often for women. This therapy is completely reversible and uses a small implantable device to send mild electrical pulses to stimulate the sacral nerves. These nerves are located near the spinal cord and just above the tailbone and control the pelvic floor, urinary and anal sphincters, lower urinary tract, and colon.

InterStim Therapy can be used to treat the following bladder control problems:

  • Overactive bladder (OAB): The sudden, uncontrollable urge to urinate
  • Urinary retention: A feeling of “fullness” with an inability to fully empty the bladder
  • Urinary incontinence: The involuntary leaking of urine due to the loss of bladder control
  • Bowel or Fecal incontinence: Stool unexpectedly leaking from the rectum due to the inability to control bowel movements

InterStim Therapy for bladder control problems is not intended to treat issues like stress incontinence or urinary blockages. Also, it is not recommended for pregnant women, those with a pacemaker, or diabetic patients.

How Does InterStim Therapy Work?

The sacral nerves control the bladder and are located near the tailbone. When these nerves do not communicate effectively with the brain, normal bladder function is disrupted. InterStim Therapy for bladder control problems provides stimulation to these nerves called neurostimulation to communicate with the brain for increased bladder control. Neurostimulation is a reversible treatment that can be discontinued at any time by turning off or removing the device.

How is the InterStim Therapy Device Inserted?

Before the InterStim Therapy device that generates the electrical pulses is surgically implanted, the patient will have a trial period to ensure the therapy will reduce bladder control symptoms. This is the first phase of the two-phase procedure and typically takes 1 to 3 weeks. This trial period determines if InterStim Therapy for bladder control is right for you. With both phases of the process, you can go home the same day but need a driver.

The trial phase takes place in a medical office or operating room. The doctor numbs a small area near the tailbone and inserts a thin, flexible needle attached to a wire placed near the sacral nerves. Once the electrical stimulation starts, a comfortable pulsing or tingling sensation is sent to the vagina or rectal regions.

An external battery is then placed on a belt that is connected to the testing wire. A handheld remote control can then adjust the level of desired stimulation. During the first phase, your doctor may ask you to keep a bladder diary to track daily urinary habits. It is essential to abstain from sexual and strenuous activity to ensure the wires stay in place during this time. The incision sites should also remain dry and the wires free from potential entanglement.

The first phase of the InterStim procedure allows you to try neurostimulation to see if it is right for you without making a long-term commitment. Suppose your symptoms are significantly reduced or eliminated during the testing period. In that case, you may benefit from long-term use of sacral nerve stimulation, and the second stage of the procedure is performed.  A permanent battery is implanted in the upper part of the buttock and is similar to a heart pacemaker’s size. Most all normal activities can be resumed within two weeks after this surgery.

What Are the Risks of InterStim Therapy?

As with any minimally invasive procedure, there may be risks, which could include:

  • Bleeding
  • Infection
  • Swelling
  • Bruising
  • Pain
  • Continued bladder control problems

The good news is that if, for any reason, the InterStim Therapy device can be shut off or completely removed. It is essential to share all health concerns and intentions with your doctor to determine if the device needs to be turned off. For example, if you become pregnant or are trying to become pregnant, the InterStim device would need to be shut off.

For even more information, visit: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672997/

InterStim Therapy for bladder control problems is not suitable for everyone. There are many alternate options to help manage OAB, urge incontinence, bowel or fecal incontinence, or any other symptom you are experiencing. Personally Delivered carries a wide variety of incontinence products to help with bladder and bowel control. If you need assistance choosing what incontinence products are right for your unique needs, our friendly and knowledgeable Product Experts are here to guide you through the purchasing experience. Give us a call today. You’ll be happy you did!

Popular Bladder Control Products for Women

Prevail Overnight Bladder Control Incontinence Pads

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Attends Discreet Bladder Control Pad

Attends Discreet Maximum Long Bladder Control Pads

Abena Abri-San Premium Shaped Bladder Control Pads

Abena Abri-San Premium Shaped Bladder Control Pads

TENA Intimates Heavy Absorbency Bladder Control Pads

TENA Intimates Heavy Absorbency Bladder Control Pads
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