Bladder and Bowel Health - Q2 2022

Q2 2022 | A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its content

Read more at www.healthawareness.co.uk

Bladder and Bowel Health

“Please be encouraged to seek help and advice.”

“Living with chronic constipation can be challenging.”

Karen Irwin, Bladder and Bowel UK

Gemma Savory and Louise Hulme, Bladder and Bowel Community

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Do not ignore a bladder or bowel problem Bladder and bowel problems are very common, but many individuals prefer not to openly discuss what, in essence, is private to us all. However, help and support is available.

P WRITTEN BY Karen Irwin Service Manager and Specialist Nurse, Bladder and Bowel UK

eople are often reluctant to come forward and present to health professionals to seek the help and advice they need. This is commonly due to embarrassment, fear or not realising that there are solutions to treating and managing bladder symptoms.

Common problems may include increased urinary frequency and/or urgency, frequently getting up at night to pass urine (nocturia), passing large amounts of urine at night, urinary incontinence or difficulty voiding or passing urine. It is also important not to ignore other symptoms, such as blood in your urine.

Community based support People should be encouraged to know that much can be done to cure, treat and improve continence symptoms. Where this is not achievable, an individualised management plan can help improve the quality of life for most individuals.

The initial assessment, treatment and management for continence issues is best undertaken by staff trained in continence care.

These services, often referred to as bladder and bowel or continence services, are usually based in the community, consisting of a team of specialist of nurses and other We would suggest continence healthcare professionals. speaking to your GP or Increasingly common conditions These professionals assess and advise We would suggest speaking to your GP on conservative treatment options, such other health professional or other health professional in the first as dietary advice, lifestyle adjustments, in the first instance. instance. They will be able to suggest bladder retraining, medication advice and the best way forward, undertake initial pelvic floor muscle exercises. screening and advise if further investigation of symptoms is Those individuals experiencing more complex problems, or required. who have not responded to initial treatment, can be referred It is estimated that 14 million men, women, young people to specialist services, such as urology, urogynaecology, and children of all ages are living with bladder problems geriatrics or specialist physiotherapy. and 6.6 million adults in the UK suffer with some form of Please be encouraged to seek help and advice. By talking bowel problem. According to NHS England, one in 10 of the openly about your condition, you can find the help and population are affected by faecal incontinence. support that is available. Don’t suffer in silence.

“There are a range of effective options for urinary incontinence.”

IN THIS ISSUE

Suzanne Biers Urology Consultant Lead for Female, Functional and Reconstructive Urology Addenbrooke’s Hospital, Cambridge University Hospitals Trust, Cambridge

“Nearly everyone survives bowel cancer if diagnosed at the earliest stage.”

Genevieve Edwards Chief Executive, Bowel Cancer UK

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@HealthawarenessUK

@MediaplanetUK

Bladder & Bowel UK supports bladder and bowel health for everyone. They offer confidential advice from specialist nurses and product experts. Information on preventing and dealing with bladder and bowel issues can be found online at www.bbuk.org.uk/

Contact information: uk.info@mediaplanet.com or +44 (0) 203 642 0737

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How the right catheter can make a difference Retired NHS nurse Alison Hodgson, 51, from the West Midlands has primary progressive multiple sclerosis.

One of the symptoms is her bladder health, requiring the use of an intermittent catheter.

INTERVIEW WITH Alison Hodgson Retired Nurse and Catheter User, Convatec GentleCath™Advocate

What is your experience with catheters? found that when withdrawing the catheter, it left a residue I was shown how to use intermittent catheters to fully in my urethra and I was getting UTIs. When I found that empty my bladder because if there is any stale urine left in GentleCath™ did not have a sticky coating, I cried. I have it increases the risk of urinary tract infections (UTIs). I was been using it for 18 months now and my infections have getting UTIs every month and the infections significantly decreased. would not seem to go. I was really scared as all I could see was a disability and something How has your current catheter improved your life? that would make me more isolated and keep It gives me freedom to go out, to go on I would literally me at home. holiday and socialise with my friends. Before, I would literally plan my route by where the plan my route by What was your first experience of using an toilets are because I could not go 20 minutes where the toilets are intermittent catheter? without needing the toilet. It gives me the I tried several different catheters, and because I could not go freedom to be more independent and live my eventually found this Convatec catheter life.

20 minutes without through trial and error. There is a little sachet of water with the GentleCath™ Glide catheter, What would your advice be to people who are needing the toilet. which activates the hydrophilic properties experiencing continence issues? embedded in the catheter to make it slippery.

Do not be afraid to seek help, especially when you are having infections. Keep going back to speak to your What is good about this catheter?

GP or practice nurse as they can refer you to community With other catheters, the hydrophilic coating is sticky and I continence teams and find the right solution for you.

Scan the QR code to find out more about GentleCath™

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Finding security in the right stoma product Firefighter Glen Neilson, 49, from County Durham, has had an ileostomy for more than 20 years after suffering ulcerative colitis. Here, he discusses stoma technology.

INTERVIEW WITH Glen Neilson Convatec and Amcare Advocate PAGE WRITTEN BY Mark Nicholls

What was life like when you had your stoma created in 2001?

If you had to recommend it to a friend, what would you say to them?

I had just been given the all clear for cancer in my neck The Convatec Mouldable Technology™ products are so when I started having toilet issues. I didn’t seek help secure and there is no cutting required. It rolls over and straight away as I thought it would go away. I was passing hugs the stoma so it is a secure seal, very comfortable, easy a lot of blood, going to the toilet more than to apply. You forget you have a bag on.

40 times a day and in constant pain. I was mortified but my stoma saved my life and as What would your advice be to people experiencing the pain subsided, I began to see the other issues with their current stoma solution?

Do not be afraid to try all side and things improved.

Do not be afraid to try all the products the products out there out there because there is a product for How did you end up finding the right stoma because there is a product everything, whether it is skin irritation or solution?

Ask companies for samples and try for everything, whether it leaks.

My first year was traumatic and I tried them in the security of your own home. is skin irritation or leaks. different products. I phoned companies, searched online and asked for samples How has your stoma bag improved your life? before I began using Convatec products. I couldn’t believe In my day-to-day job as a firefighter, I want the strongest how secure they were and how confident I was in myself bag possible, so that I do not have to worry about it. I have that I was not going to get a burst bag. faith in the product, I climbed Mount Kilimanjaro in 2019 for Crohn’s and Colitis UK with it; the Convatec Mouldable Technology™ gave me my life back.

READ MORE AT HEALTHAWARENESS.CO.UK

Scan the QR code to try Mouldable Technology™ for yourself

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Studies are showing benefits of bladder preservation based approach Bladder cancer is the fourth most common cancer in men behind prostate, lung and colorectal cancer.

About 80% of cases are the highly treatable non-muscle invasive bladder cancer (NMIBC), with a survival rate of around 90%.

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isk factors of bladder cancer include smoking and having a genetic predisposition. Workers in certain industries and exposed to particular materials have also been linked to a higher risk of bladder cancer.

Symptoms include blood in the urine, painful urination, needing to pee suddenly, feeling the urge to go also when nothing seems to come out and the need to get up at night to void.

Treatment for bladder cancer consists of an endoscopic excision, following CT scan and a camera investigation. This will allow accurate staging of the cancer and treatment in most cases. In certain groups the disease has a tendency to come back. To avoid this, chemotherapy or immunotherapy BCG are administered into the bladder to kill cancerous cells directly, or to stimulate the body’s response to fight the cancer. Furthermore, some patients who failed previous BCG treatment go on to have a complete removal of the bladder (cystectomy).

New technologies available Recently, multiple studies have shown bladder preservation approach to be effective in such patients. Results from using Synergo® technology, which utilises the three-way combination of local, non-ionising radiofrequency (microwave) radiation of the bladder, cold chemotherapy and the targeted heating of the bladder, have been promising.

Patients are treated at the hospital’s outpatient clinic with a series of weekly and later monthly, one-hour treatments.

These do not require anaesthesia and patients may resume daily activities after each treatment.

I have developed the service using the Synergo® technology at the new Heatherwood hospital and together with colleagues in other referral centres across the UK we’ve managed to benefit hundreds of patients who wished to preserve their bladders or could not undergo major surgery, for many of whom this was the last hopeful option.

Synergo® has been positively evaluated by NICE Medical Technologies in November 2021 and has also been recommended by the European Association of Urology guidelines since 2017.

WRITTEN BY

Mr Ahmed Ali, MBChB MSc FRCS Urol Consultant Urologist, Bladder Cancer Lead, Frimley Health NHS Foundation Trust

Paid for by Synergo Find out more at synergo-medical.com

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Urinary incontinence can be managed effectively and should not just be accepted or ignored.

Don’t let urinary incontinence stop you doing what you want to do Urinary incontinence does not need to be accepted as part of getting older, recognising the signs and symptoms is the first step to finding the right treatment.

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rinary incontinence is the involuntary leaking of urine. It affects around 13% of women and 5% of men and becomes more common as people get older.

Stress urinary incontinence is a urine leak which can be triggered by exertion, exercise, coughing, laughing and sneezing. In women, it accounts for nearly 50% of all incontinence and is influenced by childbirth and the menopause. In men, it is much less common but can occur after prostate surgery or radiotherapy.

Urgency incontinence is a urine leak when the toilet cannot be reached in time, usually accompanied by passing urine frequently (day and night-time).

This is also referred to as an overactive bladder. It affects around 17% of people over the age of 40 and increases steadily with age. A combination of stress and urgency incontinence symptoms is termed mixed urinary incontinence.

Treatment options are available Urinary incontinence can be improved with simple measures and changes to lifestyle alone. However for some, medication or surgery may be needed.

Stress incontinence can be helped by physiotherapy supervised pelvic floor exercises, weight loss and avoiding constipation. After trying this, surgical options are generally more effective than medicines.

Operations involve supporting or ‘bulking-up’ the waterpipe (urethra). Different operations have their pros and cons and carry risks which will be discussed by your specialist. Sometimes additional tests are offered to help with decision making, such as urodynamics (bladder function test). The National Institute for Health and Care Excellence (NICE) and the British Association of Urological Surgeons (BAUS) provide guidelines for the management and treatment of urological conditions.

Urgency incontinence can be treated by moderating the volume and types of fluids consumed, such as avoiding caffeinated drinks, fizzy drinks and alcohol.

Several different types of medication can be offered.

If these are ineffective, procedures (injection of Botox into the bladder under local anaesthetic) and operations can be considered.

Urinary incontinence can be improved with simple measures and changes to lifestyle alone. However for some, medication or surgery may be needed.

Speak to your GP for advice There are a range of effective options for urinary incontinence including lifestyle and diet changes, pelvic floor physiotherapy and medications. If these fail, surgery may be considered. Alternatively, containment devices (pads or sheaths) or catheters may be opted for after consideration of the pros and cons. The aim of treatment is to facilitate a full and active life. Urinary incontinence can be managed effectively and should not just be accepted or ignored.

WRITTEN BY Suzanne Biers Urology Consultant, Lead for Female, Functional and Reconstructive Urology, Addenbrooke’s Hospital, Cambridge University Hospitals Trust, Cambridge

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Strong bladder leak protection.

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Always Discreet’s Rapid Dry Core absorbs heavy leaks in seconds, locking liquid inside…without the bulk.

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Lifestyle changes can help manage chronic constipation Normalising and supporting people living with a stoma or an internal pouch

One in seven adults and one in three children in the UK have constipation at any one time. A condition that can be easily resolved in most, yet many people are needlessly suffering.1

WRITTEN BY Gemma Savory Community Marketing Manager, Bladder and Bowel Community

Between 165,000 - 200,000 people in the UK live with a stoma, with an estimated 21,000 requiring stoma formation surgery each year, and a smaller number live with an internal pouch, so why do people still feel it’s an under-discussed topic?

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stoma is an artificial opening in the abdomen used to divert the flow of faeces or urine from the body, over which a stoma bag is worn. In the case of an ileostomy, it is the end of the small bowel (the ileum) that is brought out to the surface of the abdomen. An ileostomy bag is typically emptied several times during the day and for many, overnight.

An ileoanal pouch is the creation of a reservoir (internal pouch) from the remaining small bowel after the removal of the colon and rectum and is connected to the top of the anus, acting as a substitute to the rectum.

Providing the right support Feelings of embarrassment, fear, anger and frustration are not uncommon after surgery. Thankfully, a stoma or internal pouch can also be a welcome relief and an opportunity to move forward, resulting in an improved quality of life for many.

Gaining confidence post-surgery is key. A lack of confidence can affect what many consider to be the simplest of tasks, such as socialising or leaving the house. Whilst there is a physical change to the body, it is important to recognise that for many, there can also be an impact on how they feel about themselves or concern for how others may perceive them.

Campaigns such as #GladRagsAndOstomyBags and #IAmStrong are helping people to grow their confidence and normalise living with a stoma or internal pouch.

Talking through feelings with their

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Stoma Care Nurse, a One2One Support Volunteer, friend or family member can often alleviate apprehension too.

In our experience of connecting people living with an ileostomy or internal pouch, we have found that some prefer to share their concerns with someone unknown to them; someone who understands having been through a similar experience, offering guidance and practical lifestyle tips.

WRITTEN BY Louise Hulme Living with chronic constipation

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ouise Hulme, aged 45, from Gravesend has suffered from chronic constipation since 2018, after a complication with ulcerative colitis (UC) caused her bowel to stop working.

“In 2018, I started experiencing stomach cramps, sickness and dizziness and I was unable to pass stools for seven days.

I went to hospital and was told I was severely constipated.

I was diagnosed with ulcerative colitis when I was 16. Up until this point, my symptoms had been mild, I was told my constipation was most likely caused by my UC. I was given enemas to help clear the impacted stool, but I have been suffering with chronic constipation since.

“Initially when I was diagnosed, it was recommended that I change my diet and increase my activity. I now eat a high fibre diet and cutting out bread has done wonders for me. I started practising yoga and meditation. This has made a big difference to my condition.

The advice I would give to people with this condition is don’t fight it, work with it.

Challenges of living with chronic constipation “Mostly, I have my condition under control but living with chronic constipation can be challenging. I don’t feel like I have any support from family or friends because of the nature of the condition and it has taken a toll on my private life.

“The advice I would give to people with this condition is don’t fight it, work with it. Making some easy life adjustments can really make a difference.”

How can society help?

We must continue to encourage dialogue around the subject. When it comes to stoma and internal pouch, age doesn’t discriminate and neither should society. For those who have alleviated chronic illness with their surgery, it can mean they are no longer controlled by disease.

It’s time for society to accept that a stoma or internal pouch is part of normal life for so many; they can be life-changers and lifesavers.

What is constipation?

• Bowel movements occurring fewer than three times a week.

• Stools are dry, hard, or lumpy and can be abnormally large or small.

• In practice, constipation is defined as the passage of stools less frequently than the person’s normal pattern.

• Chronic constipation usually describes symptoms, which are present for at least three months.2

Read more at iasupport.org For guidance and support on living with an ileostomy or internal pouch please contact IA on 0800 0184 724 or email info@iasupport.org

What can I do about constipation?3 • Increase your water intake and slowly increase the amount of fibre you eat.

• Allow enough time to go to the toilet and try to keep to a regular time each day.

• Do not ignore the urge to go to the toilet.

• If possible, raise your knees above your hips using a stool for optimal position.

• Increase your level of activity such as walking or running.

• Visit your GP to see if there is an underlying condition or any medications that could be contributing to your constipation.

Our volunteers are themselves living with an ileostomy or internal pouch.

WRITTEN BY Caroline Bramwell PR & Communications Manager, Ileostomy & Internal Pouch Association

Find out more about the Bladder and Bowel Community bladderand bowel.org/

Please consult your GP before following any advice in this article.

References 1. The 2020 BIG report https://bowelinterestgroup.co.uk/wp-content/uploads/2020/07/ Cost-of-Constipation-2020.pdf 2. NICE https://cks.nice.org.uk/topics/constipation/₂ 3. NHS https://www.nhs.uk/conditions/constipation/₃

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The value and differences of water-based probiotics The way probiotics are manufactured could have an impact on their ability to multiply and thrive in the gut.

INTERVIEW WITH Professor Simon Gaisford Head of Pharmaceutics, UCL School of Pharmacy WRITTEN BY Mark Nicholls

Paid for by Symprove

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he live bacteria and yeasts added to supplements are thought to help support the natural balance of bacteria in a person’s gut. However, experts stress an important thing to consider when choosing a supplement is the way products containing probiotic bacteria are manufactured.

Probiotic products Professor Simon Gaisford is an expert in the field and has spent several years studying probiotic products in his role as Head of Pharmaceutics at University College London School of Pharmacy. His research programme looks at the use of probiotics in various gut conditions. He talks of growing evidence that suggests that if you feel unwell, the balance of bacteria in the gut has shifted, known as dysbiosis.

He describes how probiotics are most often contained in yogurt-type products or capsules, where freeze-dried or powdered probiotic bacteria are added at a later stage.

However, with water-based probiotics, the bacteria are fermented and incorporated live from the early stages of the manufacturing process.

Reaching the gut alive Dairy-based products trigger digestion, with the stomach releasing enzymes and acid normally used to break down food.

9 out of 10 customers feel the difference.

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Live bacteria for gut support.

Not only will this potentially destroy the bacteria in these products, it also means dairy products and capsules are less likely to reach the part of the gut that matters – the large intestine - alive or in the quantities needed to be able to thrive and multiply.

In water-based products the bacteria are primed to withstand stomach acid as the fermentation process allows the bacteria to become used to low pH (the measure of acidity), thus passing through the stomach to reach the gut successfully.

A positive impact Professor Gaisford says: “Water-based products are more likely to have a positive impact in the body and help to support the natural balance of bacteria, due to the way they are delivered into the system.”

British Gastroenterology guidelines recommend initially taking a probiotic for up to 12 weeks to assess the potential benefits.

Future research Symprove Ltd use a scientific approach to developing bacteria-based products and their research with leading institutes increases the understanding of the role and function of the gut, uncovering just how many aspects of people’s health are linked to it.

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advice is best practise, but the embarrassment of bladder and bowel remains a barrier with this. ACA is fortunate to have senior regional clinicians supporting our campaign to make bladder and bowel questioning mandatory as part of holistic care.

I invite you to work together to rid the embarrassment behind bladder and bowel symptoms. Encourage patients to take opportunities to inform their healthcare professional if they have any bothersome bladder or bowel symptoms, and clinicians please make time for your patients so they can feel able to talk.

Let’s put bladder and bowel conditions centre stage The embarrassment of bothersome bladder and bowel disorders has been a huge contributing factor to the Cinderella status associated with these conditions.

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hen we talk about Cinderella status, we are referring to a lack of awareness or a greater need for attention on a given cause of subject, as it is not recognised as a priority. In our case that’s bladder and bowel disorders. But now it is time for Cinders to go to the ball!

Breaking down taboos I am so grateful to Dame Deborah James, known as @bowelbabe on Instagram. She is a writer, journalist and podcaster who has shared her personal bowel cancer diagnosis and treatment journey with the

WRITTEN BY Polly Weston Chair, Association for Continence Advice

Recognising key symptoms Please don’t ignore the following symptoms: nation, raising awareness on bowel dysfunction and encouraging us to talk about poo!

At our recent annual ACA conference, our patron Melanie Reid, writer and journalist with The Times, succinctly said “Nobody’s ready for you until they need you.” She is inviting us to slay the taboo, citing comedians who have used humour to breakdown the bladder and bowel taboo with the audience.

Addressing fear and embarrassment In healthcare we know that early detection, prompt treatment and the correct access to specialist

Bowel - Blood in your poo, changes to your bowel movement, abdominal pain after eating, unexplained weight loss, extreme tiredness.

Bladder - Persistent and strong urge to urinate, cloudy urine, pain or burning on urination, urinating frequently in small amounts, bladder leakage.

Let’s honour Dame Deborah and Melanie with our support and talk, say goodbye to Cinders, it’s time for bladder and bowel disorders to take centre stage and shine.

Knowing the symptoms of bowel cancer could save your life Bowel cancer is the fourth most common cancer in the UK. Every 15 minutes someone is diagnosed with the disease, that is nearly 43,000 people every year.

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owel cancer is the UK’s second biggest cancer killer.

As a charity we see firsthand the devastating impact that bowel cancer can have on people of all ages.

The disease steals away time they could spend with loved ones and cuts short the life of more than 16,500 people every year.

WRITTEN BY Genevieve Edwards Chief Executive, Bowel Cancer UK

Early diagnosis is crucial However, bowel cancer is treatable and curable especially if diagnosed early. Nearly everyone survives bowel cancer if diagnosed at the earliest stage. Yet this drops significantly as the disease develops. Early diagnosis really does save lives.

That is why findings we released earlier this year were shocking. More than four in ten (45%) people in the UK cannot name a single symptom of bowel cancer.

Knowing symptoms of bowel cancer One of the key ‘red flag’ bowel cancer symptoms is blood in your poo but only a third of people (35%) are aware of it. The other four main symptoms, experienced by many who go on to be diagnosed with the disease, have an alarmingly low rate of awareness: • Change of bowel habits (12%) • Pain in your tummy or abdominal pain (11%) • Weight loss (8%) • Unexplained fatigue (2%)

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Men are less likely than women to recognise any bowel cancer symptoms with half of UK men (55%) unable to spot any signs of bowel cancer, compared to 36% of women.

If you notice any signs of bowel cancer, or if things just don’t feel right for you, please visit your GP. Speak to your healthcare professional If you notice any signs of bowel cancer, or if things just don’t feel right for you, please visit your GP. While the disease largely affects people over the age of 50, more than 2,600 under 50s are diagnosed each year. It is really important people seek advice as soon as possible - whatever their age - if they’re worried.

As a charity we’re determined to save lives and improve the quality of life of everyone affected by bowel cancer.

We support and fund targeted research, provide expert information and support to patients and their families, educate the public and professionals about the disease and campaign for early diagnosis and access to best treatment and care.

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London researchers developing novel drug to reduce bowel cancer development A new drug to intervene before bowel cancer has chance to develop is showing promise to test in the clinic.

B INTERVIEW WITH Jeff Moore, PhD Founder & CEO, Curileum Disovery

WRITTEN BY Linda Whitney

Paid for by Curileum

owel cancer is the fourth leading cause of cancerrelated deaths globally. Five-year survival rates are 60%, even after surgeries and current therapies.

Despite a USD 12 billion worldwide market for treating bowel cancer, there remains no medical cure.

Now London-based biotechnology company Curileum Discovery Ltd is working on an oral drug candidate they discovered to intervene early in the development of bowel cancer.

The drug candidate has been shown to work in the laboratory and the company is currently looking for business partners to conduct clinical trials.

Early intervention Dr Jeff Moore, founder and CEO of Curileum, explains how the drug would work: “The single cell gut mucosal layer is the body’s most highly regenerative tissue. It’s replaced every week from a reserve of stem cells located below the surface.

Inherited genetic mutations and mutations that accumulate throughout life can disrupt the tight regulation of cell production and lead to bowel cancer and inflammatory bowel disease.”

“This is why we focus on intervening early, using small molecules to correct abnormal cell production.”

Potential advancements “The drug is a small molecule derived from a plant used in Chinese traditional medicine. We have found that when it is administered orally over two months it reduces both polyp formation and advanced polyps in a preclinical bowel cancer model.”

Polyps, which form on the single cell mucosal wall of the gut, often are benign. However, bowel cancer develops from advanced stage polyps called adenomas.

“We have identified modulators to correct imbalances in the gut mucosal wall cell production, intervening in disease before it develops,” says Dr Moore. “As a botanical product with an excellent safety and efficacy profile, the drug has the potential to reduce polyp formation and progression to bowel cancer for high-risk individuals.”

Focus on reducing development of bowel cancer Dr Moore envisages the use of the new drug among people who are newly diagnosed and undergoing treatment, those with family histories of bowel cancer and individuals identified in UK bowel screening programmes.

He adds: “Reducing the development of bowel cancer at this early, cellular stage, might reduce or even avoid the necessity for surgery and the toxicities of cancer treatments.

It might also reduce the risk of recurrence.”

There are a range of treatment options for bowel conditions Bowel dysfunction can have an emotional, social and physical impact on those who struggle to manage the debilitating symptoms.

C INTERVIEW WITH Sarah Kinsella Clinician & RGN Bowel Specialist Nurse, Renew Medical WRITTEN BY Mark Nicholls

onstipation and faecal incontinence are symptoms of bowel dysfunction and cause distress, discomfort and anxiety, with many sufferers struggling alone and often too embarrassed to seek medical help. But experts emphasise the importance getting advice from the right healthcare professionals to access a range of solutions that can enable people to confidently carry on with their lives.

Bowel dysfunction Sarah Kinsella, a specialist nurse with many yearsw experience in bowel management, runs clinics in the Bristol area. She sees patients with faecal incontinence and constipation

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who are referred into the service by their GP with symptoms. She recognises the importance: “Problems with bowel function affect people’s wellbeing and ability to get out and enjoy life.”

Anyone can suffer from bowel dysfunction, for example as a result of neurological conditions like multiple sclerosis, perhaps menopause-related issues, or muscle damage from childbirth. “People of all ages can find themselves isolated at home, unable to socialise, perhaps with a new baby, or having had to give up work as a result of bowel dysfunction.”

Therapeutic management Specialist nurses or physiotherapists assess an individual holistically to

fully understand the extent of the problem. Lifestyle and diet will be reviewed during this process and generally a conservative management plan will often be the first step to recovery.

In addition, therapeutic medical devices, such as trans anal irrigation or inserts, can be added to the treatment plan at any point with the clinicians involved being well placed to advise and support the patients understanding.

“The right product can have a positive impact on quality of life for patients that are having continence issues and do not want to leave the house because of the fear of having a bowel accident,” explains Sarah, who underlined the importance of raising awareness of treatment choices for patients.

Regaining confidence The devices are simple to use and allow patients to self-manage their symptoms with dignity. She says: “It can be a massive positive for patients to be able to start returning to their usual activities. People often say to me that it has been life-changing,” says Sarah, who is a senior nurse under the Renew Medical umbrella and has been a bowel dysfunction specialist for 10 years.

“Patients need to know they are not alone. They often say they felt totally isolated and did not realise how many people had the same problems until they started talking to health care professionals. They then wish they had sought help earlier.”

Find out more at curileum.com

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Be Confident, Be in Control, Be You

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Are you aware of the signs and symptoms of UTIs? For many a urinary tract infection (UTI) is a painful but short-lived complaint, for others it can be an ongoing issue.

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or many people, as has now been acknowledged by the NHS via NHS Digital, a UTI can turn in to a recurring chronic problem that blights lives.

These episodes can result in a large cost to the NHS and a significant amount of time off work.

WRITTEN BY Roland Morley Consultant Urologist, The Urology Foundation

Recognising signs and symptoms It is important to be aware of the signs and symptoms in order to seek prompt diagnosis and treatment. Common symptoms include: • Pain or a burning sensation when peeing (dysuria) • Needing to pee more often than usual during the night (nocturia) • Pee that looks cloudy • Needing to pee suddenly or more urgently than usual • Needing to pee more than usual • Blood in your pee (in which case see your GP as matter of urgency, as this can also be a symptom of a urological cancer) • A high temperature, or feeling hot and shivery Predisposing factors There are a number of factors which can increase the likelihood of a UTI, including the use of spermicide and diaphragm contraceptive devices. Intercourse with a condom in the preceding two weeks as well as poor fluid intake can also be causes.

However, there is no evidence to suggest that vaginal douching, bubble baths or failure to pass urine following intercourse result in an increased risk of UTI. Dipstick tests are often used to help diagnose UTIs. These are paper tests with a chemical strip which are dipped into a urine sample. The paper changes colour depending on what substances are present.

However, these tests can miss up to 50% of urinary tract infections. If the dipstick is negative but there are recurring issues, your GP will send a sample for analysis.

If a patient has four or more infections in one year, or if there is any blood in the urine, despite treatment then this warrants prompt referral to a specialist.

Treatment options for UTIs UTIs are treated with antibiotics. If the infection is simple and there is no obstruction, then it can be cured within one to two days of treatment. However, you should always finish your course of antibiotics.

To help ease the pain, many people find a warm bath or hot water bottle useful. Try and avoid coffee, alcohol and spicy foods.

However recurring episodes of UTIs should not be dismissed and causes, such as deep-seated infection in the bladder, should be investigated.

The Urology Foundation is a charity funding research and training in all areas of urological cancers and diseases in order to improve survival and quality of life for sufferers. It runs the Urology Awareness Month campaign throughout September.

For more information visit theurologyfoundation.org

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Helping bladder cancer patients shape their care through technology An innovative app has been designed for patients to record the severity of side effects from their bladder cancer therapy and shape their treatment plan.

P

atients experience differing side effects from specialist therapy for bladder cancer. As a result, regular and accurate monitoring is crucial to support decisions on treatment progression for people with non-muscle invasive bladder cancer (NMIBC) receiving intravesical therapy, which delivers drugs direct to the disease site in the bladder.

INTERVIEW WITH Sister Anne Marie Wilkinson Urology Nurse Specialist, Freeman Hospital, Newcastle WRITTEN BY Mark Nicholls

Paid for by medac Pharma

Innovative app Nurses in the north-east of England, however, were noticing that some patients were having difficulty remembering the specific details of side effects - such as severity - when asked to provide the information a few days after the treatment.

This, according to Urology Nurse Specialist Sister Anne Marie Wilkinson, has potentially serious consequences when it comes to making adjustments to treatment.

To counter this, an innovative app developed by medac Pharma has been designed to help patients accurately record their response to treatment and make the data available to clinical staff in a timely manner. “As nurses, if we have a better record of side effects, we can make more informed decisions about treatment progression,” she says.

Empowering patients In her role at the Freeman Hospital, Newcastle, Sister Wilkinson administers intravesical treatments to patients

in their own home. But she explains: “With some patients having difficulty remembering what had happened a week post event, I felt an app was the right way forward; it is a way of empowering patients to take control of their own monitoring.”

Patients download the app, with nursing assistance if required, then enter their details, the treatment and at what stage they are at in the cycle, with the data forwarded to Sister Wilkinson by email and available for her to review the following morning. It can also be scanned into a patient’s electronic health record for other clinicians to see.

Timely intervention As side effects predominantly occur between three- and 24-hours post treatment, patients get a phone reminder after 24 hours to fill in the symptom assessment log. “If the reaction has been severe, or particularly troublesome, I can ring the patient and offer support,” she adds.

“That gives the patient confidence and as a nurse it enables me to assess more accurately how significant the side effects have been and to make a timely intervention if required.”

She says feedback from the app - which lists side effects from mild, moderate to severe – has been positive. She also believes it has to potential to be rolled out to patients across the UK.

Find out more at medacpharma.co.uk bc-care.co.uk

Urgency incontinence can be treated by moderating the volume and types of fluids consumed, such as avoiding caffeinated drinks, fizzy drinks and alcohol. ~Suzanne Biers Urology Consultant, Lead for Female, Functional and Reconstructive Urology, Addenbrooke’s Hospital, Cambridge University , Hospitals Trust, Cambridge

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Ask your healthcare professional for support with bedwetting Bedwetting is a common medical condition, affecting as many as one fifth of five year olds and one tenth of seven year olds.

It can have a significant impact on those living with the condition.

N

umbers of people affected by bedwetting reduces with increasing years, but it persists in about 2% of teenagers and young adults. Many mistakenly believe that children and young people will grow out of it and that, although inconvenient, it is harmless.

WRITTEN BY Davina Richardson RGN/RSCN BSc (Hons) Specialist Nurse, Bladder & Bowel UK

Paid for by Ferring Pharmaceuticals

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Impact on quality of life Despite beliefs to the contrary, bedwetting causes distress and anxiety to children and young people and stress to their families. Embarrassment, reduced self-esteem, a negative impact on relationships with friends and family, social isolation and reduced quality of life are frequently experienced.

Bedwetting may affect sleep quality, resulting in daytime tiredness, reduced school performance and poorer behaviour. There are also financial consequences associated with the need for additional bedding and washing or purchase of disposable pants or nappies.

Factors causing bedwetting The condition occurs when the kidneys are unable to reduce overnight urine production in the usual way, and/or the bladder cannot hold the urine that is produced. When the brain is unable to wake the child or young person in response to bladder signals, urination will happen during sleep.

Other factors, such as constipation, poor daytime fluid intake, the wrong types of fluid intake (caffeine and fizzy drinks can irritate the bladder lining making the wetting worse) may cause or exacerbate bedwetting.

Additionally, some children are more prone to the

condition, including those with autism, attention deficit hyperactivity disorder or learning disabilities. For these children and young people assumptions may be made that wetting is inevitable due to the additional needs.

Finding available support Families looking for help will often turn to the internet but may not find all the information available is valid and based on current research and treatment recommendations.

As well as being used to discussing sensitive issues, healthcare professionals understand that successful treatment can be life changing. They can provide reassurance that the condition is not the result of laziness, naughtiness or anything the child or family have or have not done.

In many areas there are clinics run by specialist nurses, that offer individualised assessment and can recommend treatment options, including combinations of treatments that often result in improvement or dry nights. Therefore, if you have a child who is five years old or more and experiences bedwetting talk to their healthcare professional and ask for advice and support.

Job code: UK-MN-2200006 Date of preparation: May 2022 Ferring statement: This article was fully developed and funded by Ferring Pharmaceuticals

• Two thirds of parents have said their child had to miss out on school holiday trips, stays overnights or summer camps etc as a result of bedwetting.

• Over a third of parents are concerned about the cost of extra bedding for their child in 2022.

Bladder & Bowel UK research report conducted amongst 1,045 parents of 5-18 year olds between 27th May 2022 - 31st May 2022 through Opinion Matters.

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