Bowels and Bladder Problems
For information about Bowel and Bladder Problems, please see the list of topics below.
Constipation can be a common problem, but many people find it embarrassing to discuss. Loss of appetite, poorly controlled pain and nausea can all lead to constipation. A lack of fibre (roughage) in your diet, low fluid intake and being less mobile can also contribute. Some medicines can cause constipation, particularly the painkillers morphine and codeine. If you’re taking regular painkillers, you may need a laxative to help prevent constipation. Everyone’s normal bowel pattern is different, but as a general guide you should let your doctor or nurse know if you’ve not had a bowel movement for three days, unless this is usual for you.
Signs of constipation include:
- Having less frequent bowel movements
- Your stools becoming harder
- Straining to pass motions
- A feeling of not having emptied your bowel but being unable to pass any more stool
- Your tummy becoming bloated or uncomfortable
Tips to help with constipation
- Try to have plenty of fibre in your diet. Good sources of fibre include wholegrain breakfast cereals, porridge, muesli, wholemeal bread and flour, brown rice, wholemeal pasta and fresh fruit and vegetables with their skins on.
- Drink plenty of fluids. Aim to drink at least two litres (3½ pints) of fluid a day.
- Gentle exercise will help keep your bowels moving.
- Natural remedies for constipation include apricots, prunes, prune juice and syrup of figs.
- Flaxseed (linseed) can help to ease constipation and soften stools. One teaspoon or dessertspoon of the seeds can be taken daily with a glass of water.
Different types of laxative are available. Your doctor or nurse will recommend a specific type of laxative, depending on the cause of the constipation. Some examples of laxatives are Docusate, Senna, Movicol and Co-danthramer. If you’re very constipated, or if the laxatives aren’t working, your doctor or nurse may recommend suppositories or an enema. These preparations are inserted into the bowel through the back passage. If you have cancer of the bowel, always ask your doctor for advice about dealing with constipation.
Diarrhoea may occur as a symptom of your illness or it may also occur due to infection. Some medicines can cause diarrhoea. Sometimes severe constipation can be mistaken for diarrhoea: when the bowel is blocked by constipation, liquid faeces pass around the solid faeces (sometimes called overflow), so it may seem as though you have diarrhoea.
Diarrhoea caused by radiotherapy
Diarrhoea is a common temporary side effect of radiotherapy to the pelvis, and your doctor will prescribe medicine to help with it. If you have diarrhoea caused by radiotherapy, changing your diet is unlikely to help, and it’s important that you take the anti-diarrhoea medicines prescribed by your doctor.
Tips for coping with diarrhoea
- Cut down on your fibre intake from cereals, fruit and vegetables. Eat peeled and cooked fruit and vegetables instead of raw ones.
- Avoid milk and dairy products, such as cheese, until the diarrhoea has stopped.
- Drink plenty of fluids to replace the water lost with the diarrhoea, but avoid alcohol and coffee. Also avoid fizzy drinks, which can cause wind and stomach cramps.
- Eat small, frequent meals made from light foods - white fish, chicken, eggs (well cooked), white bread, pasta and rice.
- Avoid highly spiced or fatty foods.
- Eat your meals slowly.
- If the diarrhoea continues for more than two days, tell your doctor. They can investigate the cause and prescribe anti-diarrhoea medicines for you.
- Antibiotics can kill off the helpful bacteria normally found in the bowel, but eating live (probiotic) yoghurt can replace them. Live yoghurt can also help to replace the fluid lost by diarrhoea.
- If you have ongoing problems with diarrhoea, knowing you may need to get to a toilet quickly can make going out a source of worry and embarrassment. The National Key Scheme (NKS), for people with continence problems, allows you to use around 9,000 locked public toilets in the UK. Radar or the Bladder and Bowel Foundation can tell you about the scheme.
When to call for help
- If your bowels have not opened for 2-3 days
- If there is any discomfort or pain in your abdomen
- If you are not sure what to do
Urinary problems may occur following some types of surgery to the bladder|, prostate|, bowel| or womb|. These problems may be caused by damage to the valve that controls the flow of urine from the bladder (urinary sphincter), or by nerve damage in the pelvis. The problems are often temporary and improve over weeks or months. If you have urinary problems after surgery, it may help to do exercises called pelvic floor or Kegel exercises. These help to retrain the muscles involved in bladder control. A continence nurse can tell you about these, or you can read more on the Bladder and Bowel Foundation| website.
After surgery to their prostate, some men have urinary problems due to an overactive bladder|. Your doctor can prescribe drugs to help correct this. Most men find that their symptoms improve with time. Rarely however, if symptoms don’t improve over several months, some men may be offered surgery to improve bladder control. Bladder problems may be caused by a cancer pressing on or blocking the tube that urine passes through out of the bladder (urethra). This can lead to incontinence (loss of bladder control) or retention (when urine can’t flow out of the bladder). Rarely, a tumour pressing on the nerves in the spine can cause nerve damage, leading to incontinence.
You may need to pass urine more often than usual and may have some pain when you do. These symptoms can also be caused by a bladder infection, or may become worse if one develops. Let your nurse or doctor know if you develop any pain when passing urine or if your urine is cloudy or smelly. A urine sample can be tested, and any infection can be treated with antibiotics. If you have bladder problems, it can help to drink enough water to keep your urine a clear or pale yellow colour. It may also help to avoid drinking too much alcohol or drinks that contain caffeine, such as coffee, tea and cola. Continence problems can occur if you find it difficult to get out of a chair or bed so can’t get to a toilet quickly. Try to have your bed as close to a toilet as possible, or have a commode, bedpan or urine bottle close by.
If you’re restricted to bed, incontinence can be more difficult to cope with. In this case, or if you have trouble emptying your bladder, a thin flexible plastic tube (catheter) can be inserted into your bladder which will continuously drain urine away. This can prevent the discomfort that may occur with severe incontinence. Catheters need to be changed regularly - about once a month or more often. During the day, if you’re up and about, a catheter bag can be attached to your leg and hidden under clothes. Otherwise, bags and tubes can easily be covered by bedclothes or blankets.
Dealing with incontinence
A wide range of continence aids are available. Your district nurse or a specialist continence nurse can arrange supplies for you. You may need to pay for these products, as what’s available on the NHS varies in different parts of the country. Pads use materials that draw urine away from the body. They are small and easily hidden, but secure enough to prevent leakage. For men, there are also sheaths for the penis and dribble pouches.
Tips for dealing with incontinence
Some drinks, such as tea, coffee, cola and alcohol, cause bladder irritation and may make symptoms worse.
- After any operation that may affect your bladder, build up your physical activities gently. You should usually be able to do all your normal activities within 4-6 weeks.
- Constipation can make bladder problems worse.
- Knowing you may need to get to a toilet quickly can make going out a source of worry and embarrassment. The National Key Scheme (NKS), for people with continence problems, allows you to use around 9,000 locked public toilets in the UK. Radar or the Bladder and Bowel Foundation can tell you about the scheme.
When to call for help
- If you suddenly become incontinent
- If you are passing urine very frequently or your urine has a strong odour as you may have a urine infection and need antibiotics
- If you need practical help to manage the incontinence.