Continence

  • Not being able to control their bladder or bowel is probably one of the hardest problems individuals with spina bifida and hydrocephalus face. However, many people do manage to work out a routine which helps them to stay clean and dry.

Daily Check List to Improve Bowel and Bladder Routine

  • Always drink lots of fluids, but try not to drink too much coffee, tea and cola.
  • Make sure that your bladder empties properly.
  • Eat a balanced diet. If you don’t know which foods to eat, check the Canada Food Guide.
  • Do some exercise every day.

Bladder Management

There are lots of reasons why the bladder needs to be emptied regularly. Most important is the need to prevent infection and to keep the kidneys healthy. A routine which works well will keep skin dry and help to prevent pressure sores.

Helpful hints:

  • Don’t have too many drinks which contain caffeine (such as coffee, tea or cola). Caffeine upsets the bladder which may lead to more infections. Drink fruit juices instead, particularly cranberry juice – they are better for you.
  • Drink plenty of fluids to keep your urine clear and your kidneys healthy.
  • Drink less beer, wine and other alcoholic drinks. If you drink too many of these, they can wreak havoc with your bladder management program.

Different ways to help empty your bladder can include:

  1. Clean Intermittent Catheterisation (CIC). Using a catheter to empty the bladder every three or four hours.
  2. Indwelling catheter. This tube stays in the bladder all the time and drains into a bag.
  3. Medication prescribed by a doctor.
  4. Operations. There are several different operations available to help bladder control (such as sphincter tightening, bladder augmentation or a mitrofanoff procedure). Ask your doctor if one of these is appropriate for you.
Most individuals with spina bifida will require catheterizations for all of their lives. With instruction and support, many children can learn to do the routine themselves as early as age five as part of their daily routine.

Bowel Management

Many people with spina bifida retain stool and develop constipation. The priority of any bowel management routine is to avoid constipation, which can cause some medical problems (including a tendency to develop urinary tract infections) and social disadvantages (such as "accidents" at school). As a result of constipation, stool builds up in the rectum and colon, yet the individual will lack the sensation of rectal fullness. The soft stool above this area may pass from the rectum unpredictably and with embarrassing consequences. It is essential to treat constipation when it occurs and to try to prevent it from reoccurring.

Helpful hints:

  • Drink plenty! This helps to keep the stool soft, so going to the toilet is easier. Fibre without water can actually increase constipation.
  • Eat a high-fibre diet – lots of fresh fruit, vegetables and whole grain cereals. If necessary, add raw bran to baked foods, cereals, casseroles, stews and burger patties for an added fibre boost.
  • Exercise helps to keep your bowel fit.

Different ways to help empty the bowel could include:

  • Enemas or suppositories. These are put inside the rectum as high as possible and help to stimulate a bowel movement.
  • Medication such as bulk formers (like Metamucil), stool softeners (like Colace), and laxatives (such as Senokot).
Digital stimulation. Inserting a gloved finger into the anus will sometimes stimulate a bowel movement.
  • High bowel washout. This is when you use a special tube which you put in your bottom. Water is then put into the tube and this water flushes your bowels out.
  • Operations. There are several operations which may help control your bowel (such as placement of a cecostomy tube). Ask your doctor if this is appropriate for you.

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