Something To Talk About

Incontinence sufferers who hide their condition are missing out on effective treatments

It’s the sharpest kind of double-edged sword. On one side, you have a problem that’s causing daily stress and moments of fear, even just going to the grocery store or talking and laughing with a group of friends. On the other side, you’re also afraid to talk to your doctor about the problem, and so you have no treatment options available to you.

So let’s end the silence right now. It’s time to talk about incontinence.

Recognizing The Problem (And Knowing You’re Not Alone)

“Incontinence is the loss of conscious control over either the bladder or the bowels,” explains Mark Blankenship, MD, one of the specialists in the Center for Pelvic Health at St. Joseph's/Candler.

Injuries to the pelvic area can lead to urinary or bowel incontinence. Women who had difficulty during childbirth and men who had radiation for prostate cancer may be affected by either or both types of incontinence. People who have had surgery to treat anorectal ailments (such as hemorrhoids or an anal fistula) or who have medical conditions such as diabetes may also be at risk. The pelvic floor can weaken as a person ages as well. In some cases, the cause for the symptoms is unclear.

What is clear to medical professionals, but is unfortunately not well known among the general population, is that incontinence affects millions of people. One in twelve adults, in fact.

“People sometimes feel alone with this,” Blankenship says. “It’s not something they are discussing at the dinner table.”

One place they should discuss it, however, is the doctor’s office.

Having The Conversation

Dr. Blankenship is board certified in General Surgery and in the subspecialty of Colon and Rectal Surgery. He treats bowel incontinence, which he admits can be an embarrassing subject.

“There is a stigma associated with it,” Blankenship says. “So when people go to their doctor for a physical or to get their blood pressure checked, they may not say anything about the symptoms they’re having.”

Physicians aren’t embarrassed by conversations about incontinence, however, and more importantly, they can discuss the options for treatment that can potentially give a person their normal life back.

“We can give people a better quality of life if we can treat it early,” Blankenship says.

The first step is to share your medical history, including any past surgeries, and to talk openly about symptoms. For patients of Dr. Blankenship, those could include pain in the bowel area, diarrhea, or chronic constipation. Dr. Blankenship will often apply medical management, such as the use of bulking agents or anti-diarrheal agents. He may also ask patients to modify their diet.

When A Procedure Is Necessary

“If medical management fails to resolve symptoms, that’s when surgery becomes an option,” Blankenship says.

 There are a variety of procedures available at the Center for Pelvic Health at St. Joseph's/Candler for both urinary and bowel incontinence. Depending on the issue, a patient may need to be treated by a colorectal surgeon like Dr. Blankenship or one of our specialists in urology, urogynecology, or gastroenterology.

For some candidates, a sling (made of either synthetic material or muscle, ligament, or tendon tissue) can be surgically placed around the urethra to keep it lifted in its normal position, aiding in urine retention. Another procedure involves injecting bulking agents around the urethra and thickening its wall to create a tighter seal against leakage. Certain patients may benefit from an implant that works like a pacemaker for the pelvic floor musculature. This device can help with neurological symptoms of incontinence, helping the nerves that control the bowel and the bladder to function properly.

The key to discovering the best treatment plan for you is having an open, detailed discussion with your doctor. Don’t waste time trying to hide the problem or hoping it will go away. The sooner you seek treatment, the better the outcome. Colorectal specialists like Dr. Blankenship, as well as urologists, urogynecologists, and gastroenterologists at the Center for Pelvic Health, are available, ready to talk and eager to help.

“My door is open,” Dr. Blankenship says.

Questions about treatments available at the Center for Pelvic Health? Call for a referral at 912-819-3360 or request a referral online at www.sjchs.org/pelvichealth.