A Mediaplanet campaign focused on
Bladder and Bowel Health
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01/06/2021
“Bowel cancer is treatable, and curable, if diagnosed early.” ~ Genevieve Edwards Chief Executive, Bowel Cancer UK
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“Now is the time to see your GP.” ~ Sarah Hillery Urology Advanced Nurse Practitioner, Trustee, British Association of Urological Nurses
Read more at www.healthawareness.co.uk
TIME TO TAKE ACTION WORLD CONTINENCE WEEK I 21–27 JUNE www.stopbedwetting.org
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This disease awareness information is initiated and funded by Ferring Pharmaceuticals Ltd
Bowel cancer services face their toughest challenge The COVID-19 pandemic has had a huge impact on bowel cancer services, with nearly 100,000 people in England alone waiting for crucial diagnosis tests.
WRITTEN BY
Genevieve Edwards Chief Executive, Bowel Cancer UK
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colonoscopy. It is a capsule, no bigger than a large vitamin pill, that a patient swallows which contains small cameras that take pictures to look for any problems or signs of disease. This can help the NHS prioritise those who urgently need further tests.
Reshaping bowel cancer diagnosis Prior to the pandemic, bowel cancer survival in the UK was improving and had more than doubled in the last 40 years. Yet, we still lagged behind international counterparts, so as we emerge from the pandemic, we have an opportunity to innovate and do things differently. Right now, a new procedure known as colon capsule endoscopy is being piloted as an alternative to
More resources are urgently needed Frustratingly, staff shortages continues to be the biggest barrier to improving earlier diagnosis and meeting commitments in NHS England’s Long Term Plan. A lack of endoscopy and pathology staff is preventing the UK from having a world-leading bowel screening programme. We know screening is the best way to diagnose bowel cancer early, when curative treatment is more likely. It can also prevent it by identifying and removing polyps (noncancerous growths) that may develop in cancer. With a growing ageing population, the capacity crisis is only going to become more urgent, as more people will need to be referred for tests. To improve bowel cancer outcomes and meet the Government’s ambition to diagnose 75% of all cancers at an early stage by 2028, they must act now by using this year’s Spending Review to provide multi-year funding to train more staff, and provide more equipment in cancer diagnostic and treatment services to meet current and future demand.
ver 42,000 people are diagnosed each year with bowel cancer. Yet, sadly around 16,500 people die from the disease each year, making it the second biggest cancer killer. But this shouldn’t be the case. Bowel cancer is treatable and curable, if diagnosed early. The COVID-19 pandemic continues to have a significant impact on cancer services. The most concerning has been nearly an eight-fold increase, compared to pre-pandemic levels, in the number of people in England waiting longer than six weeks for a colonoscopy – a test which is crucial for diagnosing bowel cancer. Many of those waiting for an endoscopy test won’t be diagnosed with bowel cancer, but we know that almost a quarter of bowel cancer patients are diagnosed every year through this routine GP referral.
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For more information visit: bowelcanceruk. org.uk
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Project Manager: Emma Shahbazi emma.shahbazi@mediaplanet.com Business Development Manager: Ciara Barker Managing Director: Alex Williams Head of Business Development: Ellie McGregor Head of Production: Kirsty Elliott Designer: Thomas Kent Digital Manager: Harvey O’Donnell Paid Media Strategist: Jonni Asfaha Production Assistant: Henry Phillips All images supplied by Gettyimages, unless otherwise specified
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23/05/2021 22:16
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Why we need to act to address the bowel and bladder cancer emergency
Overcoming the cancer backlog To overcome the backlog and ensure cancers such as bladder and bowel do not increase mortality, innovation and collaboration are key. Diagnostic capacity needs to be ramped up significantly, and this should include collaboration with the independent sector to overcome the diagnostics bottleneck in the system. National cancer screening programmes, which halted during and after the pandemic, need to be re-established and beefed up with community diagnostics and screening hubs across the country. This will reduce the rate of patients presenting with symptoms of advanced cancers to our frontline services including emergency services. Furthermore, there is an urgent need to expand provision of advanced cancer therapies, whether it’s conventional treatments such as surgery, radiotherapy and chemotherapy or more advanced proton beam therapy, robotic surgery and immunotherapy. The expected backlog and higher number of late-stage cancer patients will put increasing strain on limited treatment resources. As more patients present with late-stage cancers, having advanced treatment options that can treat and cure these patients whilst limiting the risk of side-effects is critical not least because of the pressures this can alleviate from cancer care services, as well as other frontline services dealing with side effects of treatments generally.
Delay in diagnosis impact on survival For bowel (colorectal) cancer and bladder cancer, a three-month delay in diagnosis is predicted to result in a reduction in long-term (10-year) survival of more than 10% in most age groups. Delays of six months are predicted to reduce 10-year mortality by more than 30% in many of these
IMAGE PROVIDED BY RUTHERFORD CANCER CENTRES
The pandemic saw thousands of cancer patients miss their treatments due to the lockdown. Innovation and collaboration are key to helping clear the post-pandemic cancer backlog.
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ome estimates suggest over 40,000 fewer people received treatment for cancer from April 2020 compared to the previous year. Referrals via the two-week wait urgent pathway decreased 84%. Whilst hospitals had no alternative, these delays created a cancer backlog that will take years to overcome. Concern is becoming particularly acute for bladder and bowel cancer patients, two of the 10 most common cancers in the UK.
To overcome the backlog and ensure cancers such as bladder and bowel do not increase mortality, innovation and collaboration are key.
patients. Over 42,000 patients are diagnosed with bowel cancer and over 20,500 patients with bladder cancer each year in the UK. Earlier diagnosis for these patients can make the difference between curable or incurable conditions. Bladder cancer has a mortality rate of around 50% but early diagnosis can lead to an 80% survival rate. As we continue to return to normality, it is vital that we address the cancer emergency. Not acting now, both for diagnosis and treatment, can lead to tens of thousands of extra cancer deaths. The entire health system risks longer term difficulties without immediate action. Delayed diagnosis leads to more late-stage cancer patients requiring more invasive treatments, resulting in turn to lower chances of longer-term cure and higher risks of treatment related side-effects – a vicious treatment cycle that can consume cancer care services for years to come.
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WRITTEN BY Dr Cheng Boon Consultant Clinical Oncologist, Rutherford Cancer Centres
As we continue to return to normality, it is vital that we address the cancer emergency. Checking your symptoms The public also have an important role to play. Anyone who thinks they have cancer symptoms should get checked without delay. All cancers have clear signs and symptoms. Noticing blood in the urine for instance is the most common symptom of bladder cancer. Bleeding or blood in the stool is also the most common symptom of bowel cancer and should immediately be checked. It is only through a comprehensive national effort, one that includes collaboration and participation from the Government, hospitals, the independent sector with providers such as the Rutherford Cancer Centres and the general public, that we realistically stand a chance of reversing the cancer backlog. The COVID-19 pandemic response has shown the way to respond to a genuine healthcare emergency with collaboration between academics, clinicians, patients, politicians and citizens to save countless lives. Let us recognise the coming cancer emergency and act accordingly. Late-stage cancer is a medical emergency.
Paid for by Rutherford Cancer Centres
Find out more by visiting our website therutherford.com or call us on 0800 210 0402
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Bladder problems: When is it time to see your GP?
Why patients must speak up about incontinence Incontinence is one of the last health taboos in modern society. Embarrassment stops many people from accessing the NHS services that can help them.
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If you have been struggling with bladder problems throughout the COVID-19 pandemic, don’t wait any longer. Now is the time to see your GP.
ncontinence is surprisingly awareness, embarrassment and common. It’s estimated that one stigma. When presented to a GP, in four of us will have a problem their symptoms were often dismissed with bladder control at some and unaddressed until they became time and one in 10 will have problems more severe. with bowel control. This means that Therefore, I urge health care more people have incontinence professionals to ask open ended than asthma, diabetes or epilepsy questions. Following NHS guidance combined. clinicians should make every The prevalence of bladder and contact count, ensuring that clinical bowel dysfunction has been spoken assessment is holistic and includes about many times, most recently questions on bladder and bowel to colorectal surgeon and lecturer Daren encourage early symptom detection Francis (The Royal Free NHS Trust) and treatment. The pelvic floor report spoke at the ACA published in April national conference 2021, led by Professor May 2021 stating Charles Knowles that the percentage (consultant colorectal of postnatal women surgeon Barts Women often delayed with pelvic floor NHS Heath Trust), seeking help for their injury remains supports this and high at 22%. early intervention for symptoms due to However, clinical consultation lack of awareness, access to the right can ensure correct healthcare advice diagnosis and embarrassment is hindered due to treatment. and stigma. the embarrassment I would like to of the problem. The encourage patients LeDeR (Learning to have confidence Disability Mortality Review to speak up. In order for a patient to Programme) shockingly highlighted get the best outcomes, an open and high incidence of mortality due honest description of symptoms is to constipation, this could have needed. Informing their GP of the been avoided if early detection and impact the bothersome bladder or intervention had taken place. bowel issue is having on their quality of life is a good Removing the taboo around incontinence starting point. Doreen McClurg (past ACA Chair, WRITTEN BY physiotherapist and researcher Polly Weston Glasgow Caledonian University) Chair, Executive Committee reminds us that patients find bladder for the Association for and bowel symptoms too embarrassing Contience Advice (ACA), Team Lead Baywide Bladder to discuss. The issue continues to be and Bowel Service, University the elephant in the room that they Hospital of Morecambe Bay ‘didn’t want to bring up’. Doreen reports that women often delayed seeking help for their symptoms due to lack of
WRITTEN BY Sarah Hillery Urology Advanced Nurse Practitioner, British Association of Urological Nurses (BAUN)
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hroughout the global pandemic, many people have kept their worrying urological symptoms to themselves. The changes to healthcare provision, such as virtual clinics, may also have made it seem more difficult to see your doctor than ever. However, it is very important that you do book in to see your GP if you are troubled by any of the following: • • • • • • • •
Seeing blood in your urine Finding a lump or bump anywhere on your genitals Struggling to empty your bladder Difficulty controlling your wee Pain or discomfort around your bladder, kidneys or genitals Feeling pressure in your pelvis or lower tummy Wetting the bed Worrying about prostate cancer
Common problems Bladder problems are so common that most people will have a brush with them at some point in their life. Whether you’re having difficulty with needing to urinate too frequently or at the wrong times, difficulty with keeping urine in (or getting it out!) or you’re worried about lumps, bumps or bleeding, it’s important to find out what the cause is. Even though fear of embarrassment may be making you drag your heels somewhat, please be reassured that help is out there. Now is the time to get these problems treated. They do matter and we do want to know about them so we can help you get better. Getting better Many common concerns can be relieved with a quick consultation and perhaps a course of medication or even a minor change of lifestyle. Your GP can help you with common urological symptoms but if you do require referral on to a specialist urology service in a hospital, worrying symptoms (such as seeing blood in your urine) or troublesome symptoms (leaking urine) will be assessed and treated very quickly. Although it may feel daunting to discuss embarrassing or worrying symptoms, you can be reassured that GPs and urology specialists hear about them day in and day out and they are certainly not embarrassing to us. Remember, if you’ve been keeping quiet about the problems listed above, don’t think your GP is too busy to see you. Your healthcare professionals are keen to help you get better.
SUFFERING FROM BLADDER WEAKNESS? Diveen® intravaginal device supports the bladder, helping to prevent urine loss associated with female stress incontinence. Available on NHS prescription.
SCAN ME
More information? email diveen.bbmuk@bbraun.com
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Helping women feel free from worry of stress incontinence In the UK alone, over 3 million women experience stress incontinence (aka little leaks). It affects everyone differently, but no matter your experience, it’s never easy. We want to empower more women to live life without worry.
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tress incontinence happens when the pelvic floor muscles are weakened or damaged through pregnancy, obesity, or simply as you get older. This means that if any pressure is put on your bladder, a little leak may slip out. So, if you cough, exercise, sneeze, or giggle, you can expect to have one of those whoops moments we all know a little too well.
INTERVIEW WITH Anne Davidson Co-Founder, Giggle Knickers WRITTEN BY Ellie Davidson
Paid for by Giggle Knickers
Tackling the stigma Due to the stigma stress incontinence carries, many women go to extreme lengths to conceal it. Changing how they dress, where they exercise, who they hang out with and even going as far as not going out at all. The emotional impact of this condition shows how important it is to break down these taboos whilst also give women a practical solution. What solutions are out there? First and foremost, you should speak to your doctor about what you’re going through. They can give you medical support and point you in the right direction for successful treatment. Physiotherapists can help to alleviate the symptoms of stress incontinence. They’ll show you a variety of exercises that can strengthen your pelvic floor muscles. For some, these exercises can cure little leaks all together! Pelvic floor
First and foremost, you should speak to your doctor about what you’re going through. They can give you medical support and point you in the right direction for successful treatment. exercises also help to prevent stress incontinence so, even if you don’t have little leaks, it’s a good idea to practice them. Giggle Knickers are a discreet, eco-friendly and feminine looking pair of washable knickers that support women with little leaks. They are an alternative to disposable pads that not only reduce sanitary waste and its impact on the environment, but also help to destigmatise little leaks. By creating a “normal” pair of knickers, women can feel comfortable and confident no matter where life takes them. Today, it’s more important than ever for women to talk about their experiences. It’s time we break this taboo. It’s time we talk about little leaks.
The ultimate taboo? Why we need to talk about incontinence
prostate gland in men, all point to incontinence. Rather than getting help, many people will avoid drinking liquids or will stay at home to avoid embarrassing situations. Reassuringly, most cases can be cured and if they can’t be, they can be successfully managed with a variety of techniques. Pharmacists and GPs can point the way to specialist continence nurse advisors and reliable information. The earlier that people seek help for incontinence, the better the chance is to cure it, or to manage it with the correct treatment and products.
Incontinence is as widespread as it is misunderstood. Embarrassment makes it difficult for people to talk about, but the right advice and support can make a big difference.
W INTERVIEW WITH Jane Smith Clinical Product Manager, Attends and Chair of Ireland Branch, Association for Continence Advice (ACA)
WRITTEN BY Judith Ozkan
ith incontinence affecting as many people in the UK as hay fever, you would expect to hear more about it. Although most people will share their experiences of hay fever, very few will talk about living with incontinence – even to their doctor. The figures of those affected – is estimated one in 10 men and one in three women - are at best a guesstimate. Incontinence can affect anyone and everyone from teenage girls to women of childbearing age, men with prostrate trouble and is common in the elderly population. Getting help is vital but according to Clinical Product Manager Jane Smith of Attends UK, stigma and lack of education is a huge barrier for
many people. “Embarrassment is a big problem. Men are not used to talking about their bodies and are reluctant to visit the doctor. Women often think it is just part of getting older or the result of childbirth and young girls are particularly embarrassed as they see it as an older person’s disease.” Signs and symptoms Because the subject is not talked about as much as it needs to be, people may not be aware of the signs and symptoms. Leaking urine in large or even small quantities when you laugh, cough or sneeze is an indication that something is not right. Frequent visits to the toilet, leakage at night, feeling as if your bladder never really empties, or an enlarged
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Read more at giggleknickers.co.uk
Paid for by Attends
Find out more at attends.co.uk
The earlier that people seek help for incontinence, the better the chance is to cure it, or to manage it with the correct treatment and products. In addition to consulting a specialist advisor, people can do a lot to help themselves, Smith says. “Simple lifestyle changes, like cutting down on caffeine which irritates the bladder, drinking more water (up to eight glasses a day, eating healthily to avoid constipation as well as maintaining a balanced weight and pelvic floor exercise are effective if taught correctly all help to maintain good bladder function.”
Attends Elearning is a free online tool that helps consumers, carers and healthcare professionals learn more about the symptoms, treatments and support for incontinence. Visit us at learning. attends.co.uk
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Getting lives back on track by tackling the taboo of poo Bowel health, in particular constipation and incontinence, represent taboo subjects in the UK, with many people failing to access NHS treatments that could transform their quality of life.
Bowel incontinence doesn’t rule my life anymore
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t St Thomas’ Hospital, London, continence nurse practitioner Carlene Igbedioh regularly sees patients who have waited five to 10 years before seeking medical help. “Once they’ve experienced soiling outside, many people become too embarrassed to venture out. They give up jobs, avoid socialising and stop going on holiday.” says Igbedioh. “It’s all because as a society we have a real taboo about discussing our bowels, even with health professionals.” Bowel issues represent an epidemic in the UK, with estimates suggesting one in seven adults are affected by constipation. Data from the Bowel Interest Group shows that in 2018 to 2019, 76,929 people in England were hospitalised with constipation, equivalent to 211 a day. Constipation symptoms include straining, lumpy or hard stools, sensations of incomplete emptying and experiencing fewer than three bowel movements per week. Faecal incontinence, involuntary loss of faeces, is surprisingly common; affecting one in 100 UK adults it can often be triggered by overflow from constipation. A misconception, says Igbedioh, is that constipation is an inevitable part of ageing. “This isn’t the case. There are usually underlying causes which can be easily treated, dramatically improving quality of life.” Getting lives back on track Once any more serious cause has been ruled out (such as bowel cancer or inflammatory bowel disease), treatment is based on a ‘pyramid’ approach. At the base are simple measures like encouraging people to eat regularly, drink adequate fluid, take physical exercise and checking whether any drugs are responsible. “If these fail, other interventions can be explored such as transanal irrigation or using electrical stimulation to strengthen anal muscles. It’s tragic that so many lives are made a complete misery from letting embarrassment get in the way of wellbeing,” says Igbedioh. “The first step to getting your life back on track is to talk to a health professional. My patients are always completely surprised to learn how many others are in the same situation.” Further information can be obtained from Bladder & Bowel UK www.bbuk.org.uk
There are 6.5 million adults in the UK who suffer from some sort of bowel problem, with over half a million experiencing faecal incontinence that has a negative impact on their life.
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aving ‘tummy troubles’ can have a huge psychological impact on a person’s life as well as the obvious physiological symptoms and is a problem that we are still reluctant to see our GP about. Angela Fowler, 53, has a condition called Bile Acid Malabsorption (BAM/BAD), which causes painful and urgent diarrhoea several times a day and can lead to bowel incontinence. BAM is estimated to affect one in 100 people in the UK although it is a relatively unknown condition due to limited access to diagnostic testing. “Around seven years ago, I was a healthy, tee-total gym goer. One night, I went to bed with what I thought was a bad case of wind and ended up in A&E with acute gallstone pancreatitis.
BAM is estimated to affect one in 100 people in the UK although it is a relatively unknown condition due to limited access to diagnostic testing.
Major life changes “Having BAM and bowel incontinence has changed my life in so many ways and although my confidence has been greatly impacted, I’m determined to carry on with life as best as I can. I’m not ashamed to admit that I’ve had accidents in public, although I did cry the first time it happened. My motto for life now is ‘be prepared’; I wear incontinence pads and carry my ‘Just Can’t Wait’ card and Radar key in case I urgently need the toilet. I also pack a change of clothes and a toilet roll.” “I have good and bad days, but I always try to stay positive. I would say that if anyone is suffering from these issues, it’s important to speak to your doctor. Don’t be embarrassed as doctors aren’t easily shocked. If I can learn to live with this, then so can you!” There are tools available that can help you feel more secure whilst you’re out if you have bowel incontinence such as the Digital Just Can’t Wait card from the Bladder and Bowel Community. This can be downloaded to your smartphone easily and quickly accessed if an emergency arises.
Find out more at bladderandbowel.org INTERVIEW WITH
Carlene Igbedioh Integrated Continence Advanced Nurse Practitioner, St Thomas’ Hospital WRITTEN BY
Janet Fricker
Paid for by Wellspect
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“After surgery to remove my gallbladder, I started to experience issues with my bowel. Everything I ate literally went straight through me and I started to experience bowel leakage. I was told this would settle down over time but it didn’t, so I was sent to a gastroenterologist for further tests. The consultant suspected I had BAM, so I was sent to have a SeHCAT scan, a non-invasive procedure which involves swallowing a tablet containing synthetic bile acids and being scanned four hours later and then a week later. The test confirmed I had BAM.”
WRITTEN BY Gemma Savory Community Marketing Manager, Bladder & Bowel Community
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How a new therapy can help you restore your pelvic floor Despite adverts telling us bladder leaks are normal - just a fact of life you can manage with pads - scientifically leaks can be fixed and not necessarily by having drastic surgery either.
U INTERVIEW WITH Dr Ruth M. Maher, PT, PHD, DPT, MISCP Co-Inventor, INNOVO
INTERVIEW WITH Kath Hamblett Former sufferer of bladder leaks
WRITTEN BY Gina Clarke
rinary incontinence is a condition that affects millions of people across the globe, it can have a significant and detrimental impact on quality of life. When Dr Ruth Maher, a physiotherapist originally from Dublin, found herself treating countless women (and men) experiencing bladder leakage, she knew that there must be a therapy that could restore the pelvic floor. Having spent many years studying the benefits of electrical stimulation (NMES) for other conditions, Dr Maher perfected prototypes that would deliver the perfect dose of painless electrical impulses targeted to stimulate the pelvic floor. The evidence soon spoke for itself and eventually became INNOVO therapy. Not only did Ruth discover that urinary leaks were reversible and treatable, but she also realised that a contributing factor with the pelvic floor was that most women didn’t know where to find it – or how to exercise it.
I’d always viewed urinary leakage as an invisible ball and chain for a woman. The silent condition only ever joked about – but living with urinary leakage or urgency is never a joke. Providing better education on bladder weakness For 54-year-old Kath Hamblett from Warrington, INNOVO has helped not just to treat her bladder leaks, but also provided a much needed education. She says, “As a busy mother-of-one, I put up with the bladder leaks for years, carrying an extra pad and hoping it would get better. But once I made the decision to lose weight and go to the gym more, everything seemed to get worse. I chose the INNOVO therapy because it was non-invasive, and I haven’t looked back.” Not only was the product easy to use for Kath, “I could use it while watching the TV and no-one would know!” but the stimulation meant that she now knew exactly what exercising her pelvic floor felt like. Within weeks Kath felt a big difference, and now only uses the shorts once or twice a month. “I now remember to exercise my pelvic floor while washing the dishes or waiting for the kettle to boil” she says.
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What’s more, Kath’s experience has re-taught her body to empty her bladder when full, not just when passing a toilet. Treating bladder weakness causes It’s comments like these that delight Dr Maher, now based in Georgia, America, as a professor for PCOM. She says, “I’d always viewed urinary leakage as an invisible ball and chain for a woman. The silent condition only ever joked about – but living with urinary leakage or urgency is never a joke. Women have to make their lives smaller to fit the condition, like being close to a toilet or limiting travel and exercise.” Bladder leaks currently affect 1 in 3 women and 1 in 10 men, with the supermarket aisles packed full of pads and other incontinence products, there’s often a reluctance or unawareness that it is possible to treat the cause. Dr Maher adds, “With studies showing that up to 50% of women have difficulty performing pelvic floor exercises or cannot perform pelvic floor exercises correctly, there’s a huge need to talk to each other, educate and try new products. Because urinary incontinence isn’t something you need to live with.” Dr Maher wants to reassure women and men that their lives can improve. “Whether it’s picking something up, not going to the gym or having sex, bladder leaks shouldn’t have to limit your life.” For Kath, they have certainly helped her regain control of both her bladder – and her body. “I can now enjoy a gym session or sprint without leaking,” she says. “It had got to the point where I asked myself ‘do I really need to carry a pad everywhere with me in my 40’s?’ Now my pelvic floor is so much more improved and I tell all my friends about it. Finally, it’s not a subject I’m embarrassed about anymore.”
Find out more at myinnovo.com/uk
Let’s Pee Honest. Women Leak. A leak-free summer could be a reality. www.myinnovo.com/uk
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What you need to know about ISC
The importance of good bowel health and the cost of constipation
Dr Angie Rantell, Lead Nurse, Urogynaecology, King’s College Hospital demystifies intermittent self-catheterisation, a useful solution to support people who may need assistance to empty their bladder.
A new report uncovers the significant cost of constipation and offers guidance on good bowel health.
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onstipation isn’t talked about much, but it needs to be. Up to one in seven adults and one in three children in the UK is affected by the condition, which is not only affecting lives, but also puts a financial strain on the NHS. The true cost of constipation In its Cost of Constipation report, The Bowel Interest Group found that nearly 77,000 people in England were admitted with constipation in 2018/2019. That’s more than 200 people a day. Add to this the fact that £168 million was spent by NHS England on treating the condition, through emergency admissions and laxative prescriptions; and it goes to show the cost of constipation on everyone involved. Laxatives are often seen as a shortterm, quick fix. However, many people have chronic constipation which needs tailored solutions. Chronic constipation can be caused by slow transit constipation, opiate use, antihistamines, antidepressants and coexisting medical conditions such as neurological disorders or diabetes. But there’s a lot you can do to support your bowel health • Don’t be embarrassed. Bowel health can be seen as a taboo subject and people don’t like to talk about it, but constipation can become a bigger issue if you leave it. • Is it constipation? Your bowel movements are unique to you, so constipation for one person might be different for another.
• Seek advice. Speak to a pharmacist if you are experiencing constipation and would like some professional guidance and speak to your doctor if it’s an ongoing issue. • Food and fibre. Your diet is important to your bowel health. The NHS recommends eating 30g of fibre every day from a variety of sources including fruit and vegetables, beans and oats. Keep hydrated too. • Prioritise pooing. Go to the toilet when you feel the urge, delaying the need to poo can lead to constipation. • Get comfortable. If you struggle to poo, consider how you sit on the toilet. Place your feet on a low step or similarly raise your knees, use your stomach muscles instead of straining from your head and neck. Constipation doesn’t need to impact your life, take action today.
The Bowel Interest Group is dedicated to improving bowel health and provides education for healthcare professionals. We receive funding from commercial organisations to support our work. bowelinterestgroup.co.uk
WRITTEN BY Professor Anton Emmanuel, Consultant Gastroenterologist at UCLH and the National Hospital for Neurology & Neurosurgery and Chair of The Bowel Interest Group
WRITTEN BY Dr Angie Rantell Lead Nurse, Urogynaecology, King’s College Hospital and Faculty Member, The Bladder Interest Group
What is intermittent self-catheterisation (ISC)? ISC involves using a catheter (a thin hollow tube) to drain the bladder, after which the catheter is removed. It is performed by a person independently (or by their designated carer) and it is considered the gold standard for urine drainage. Why do people have to perform ISC? People who may have to perform ISC in the long-term include those with neurological disorders such as a spinal cord injury or multiple sclerosis. They rely on this procedure for bladder emptying or to help control bladder function. In the shortterm, this may also be used for managing post-operative voiding difficulties or to instil medication directly into the bladder.
According to a report by the Unplanned Admissions Consensus Committee (2019), in 2016/2017, there were 5.8 million emergency admissions due to urinary tract infections (UTI). What are the benefits of ISC? There are many advantages to performing ISC compared to the alternative methods of bladder emptying, which include indwelling urethral (via the water pipe) or supra-pubic (through the tummy) catheterisation (i.e. catheters that stay in situ). One of the main advantages for ISC is the reduced incidence of catheter associated urinary tract infections (CAUTIs). CAUTIs are one of the most frequently acquired infections occurring in a healthcare setting. According to a report by the Unplanned Admissions Consensus Committee (2019), in 2016/2017, there were 5.8 million emergency admissions due to urinary tract infections (UTI) and up to 56% of these were associated with catheterisation, costing the NHS £13.9 billion. Some of the other benefits of ISC include: • Increased independence and dignity • Reduced urinary tract complications • A healthier bladder, allowed to fill up and empty completely • Increased ability to participate in leisure activities • In the UK these devices are available on prescription • Maintaining sexual relationships Although for many, ISC has a positive impact on their quality of life, it’s important to note that this is not true for all. Some feel embarrassed, fearful and shame at having to perform the procedure and for those with mobility difficulties, performing ISC can be challenging especially when not in the home setting. Getting the right support from an experienced health care professional can make a huge difference to patient experience and ongoing compliance performing ISC. References REDUCING UNPLANNED ADMISSIONS TO HOSPITAL AS A RESULT OF URINARY INCONTINENCE (2019), accessed 07/06/2021 SCREEN_Best_Practice_Guide_Version_4. pdf (squarespace.com)
Dr Rantell is a faculty member of the Bladder Interest Group, an independent multi-disciplinary organisation dedicated to improving bladder health. The Bladder Interest Group website will be launched soon. The group receives funding from commercial organisations.
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Intermittent self-catheterisation takes anxiety out of toilet visits
I started playing wheelchair tennis about a year after this happened and had I been hooked up to a catheter 24/7 with a bag attached to me, I don’t think I would have had the confidence to try something new.
A discreet catheter device has helped a young woman find a new lease of life after she awoke with mystery condition which has left her in a wheelchair.
INTERVIEW WITH Tabitha Fung Patient WRITTEN BY Mark Nicholls
Paid for by Coloplast
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lmost seven years ago, Tabitha Fung awoke one morning unable to feel anything below her waist. While doctors are still not sure of the cause, Tabitha found herself adapting to a life-changing condition and having to use a wheelchair. Now 38, Tabitha says: “The medical changes that have come with that have been quite major and coming to terms with self-catheterisation has been one of them.” She was initially given an indwelling catheter with a tube running out of her urethra to a bag attachment, which had to be regularly emptied into a toilet. Intermittent self-catheterisation But a few months later, a district nurse spoke to her about intermittent self-catheterisation (ISC). She tried various models, and eventually made the transition from indwelling to an intermittent catheter. “An indwelling catheter is very limiting and does not do anything for one’s self-confidence,” she says, “whereas ISC is incredibly freeing because you have control over when you want to empty your bladder, and you are not carrying a bag of urine strapped to you.” With the ISC, which for Tabitha is about the size of a mascara tube, users sit on a toilet, open it and insert into the urethra to use the single-use device to drain the bladder. “For me, it has made a massive
change,” says Tabitha. “I started playing wheelchair tennis about a year after this happened and had I been hooked up to a catheter 24/7 with a bag attached to me, I don’t think I would have had the confidence to try something new. “Having an intermittent catheter was such a major milestone for me and in building my life as a wheelchair user.”
ISC is incredibly freeing because you have control over when you want to empty your bladder, and you are not carrying a bag of urine strapped to you. New-found confidence Tabitha admits to not previously being sporty but having been persuaded to try wheelchair tennis when attending her accessible gym, she now plays at international level and achieved a world-ranking of 160. The ICS has given Tabitha a new self-confidence. Initially, she found her choice of clothing was restricted and was conscious of having a bag beneath her garments. But now, she wears leggings and stretchy fabrics and feels empowered again. “I was worried about leaking, or smelling, or just unpleasantness that
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goes along with going to the toilet and also that indwelling catheters are a heightened risk of infection. I spent a while not being able to go anywhere,” says Tabitha, who lives in the West Midlands. “But when I started to self-catheterise, I realised I was no longer attached to this bag and could go out like a normal person and start doing normal things. The only thing I had to check was if there were disabled toilets. It basically gave me my independence and my confidence back.” Freedom and independence She works at the Queen Elizabeth Hospital in Birmingham as co-chair of disability network for University Hospitals Birmingham Trust. This also gives her the opportunity to talk to other medical staff about ISC as she has found that many are not aware of self-catheterisation and its benefits. “I truly believe if more medical staff knew about ISC, it would give so many more people freedom and independence,” she says. “It is the difference between somebody being hooked up to a bag and having low self-confidence and not going out, to someone like myself who goes out, works, plays sport, and has an active role in the community.” Coloplast’s SpeediCath Compact Eve is unique in triangular shape to support ease of grip and avoid rolling off surfaces. Single use and prescribed on the NHS, it fits easily into a small handbag, and has a triple layer hydrophilic, pre-lubricated coating, with polished eyelets that are designed for smooth, comfortable insertion. SpeediCath Compact Eve can be opened with a single twist and securely reclosed for hygienic, discreet, disposal.
coloplast.co.uk/HealthAwarenessISC
MEDIAPLANET
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UTIs affect a large percentage of the population Urinary tract infections (commonly referred to as UTIs) are the second most common kind of infection after chest infections, but what is a UTI exactly?
T WRITTEN BY Serena Wyman, Fundraising and Events Manager, The Urology Foundation
he urinary tract system consists of the bladder, urethra (the tube which carries urine out of the body from the bladder), kidneys and ureters (tubes which carry urine from the kidneys to the bladder). A UTI usually occurs when bacteria enter the tract causing infection and inflammation which makes urination both difficult and painful. A more serious side effect of a UTI is that the bacteria can multiply and spread from the bladder up into the kidneys and cause damage, it can sometimes result in septicaemia. Common symptoms of a UTI are: • 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) • Tummy pain or pain in your back, just under the ribs • A high temperature, or feeling hot and shivery In milder cases, symptoms can be relieved with basic measures such as taking painkillers and drinking plenty of water to flush out the system. However, if there is no improvement within two or three days it is important that you see your GP swiftly so they can prescribe something to end the infection.
If there is no improvement within two or three days it is important that you see your GP swiftly so they can prescribe something to end the infection. Generally, you are more likely to develop a UTI if: • Your bladder is unable to empty properly. Urine left over in the bladder encourages bacteria growth. • Pregnancy or an enlarged prostate can cause an inability to fully empty one’s bladder. • You have kidney or bladder stones. These also cause blockages and the build-up of bacteria. • You have a weak immune system. • You use a urinary catheter. This is a tube inserted into the urethra to drain fluid. The catheter’s surface can provide bacteria with a place to multiply and a route for the bacteria to enter the urethra. Although it may be uncomfortable to discuss when and how you urinate, urinary infections must be addressed and can be treated swiftly, so if in doubt speak to your GP.
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. For more information visit theurologyfoundation.org
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READ MORE AT HEALTHAWARENESS.CO.UK
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An open letter to every woman whose bladder leaks. You’re not alone. 1 in 3 women in the UK suffer every time they laugh, cough, run or sneeze, or face a sudden and uncontrollable urge to urinate – or both. Yet in most cases, it’s an unnecessary and bothersome issue to put up with. For years it’s been described as normal, just a fact of life “You’ve had kids”, “You’re menopausal”. These along with high-impact exercise or being overweight can worsen or cause urinary leakage. Activities once enjoyed are curtailed or abandoned and leaks just managed with pads…daily…Forever. Often termed ‘bladder weakness’, when really it’s the pelvic floor. When this indispensible support system is compromised, it can play havoc. Urinary leakage is an invisible ball and chain. My practice focuses on this condition and I would encourage you to seek help from your GP or a specialist physiotherapist. Talk to your inner circle - you’d be surprised how many could be suffering too. Try pelvic floor exercises, but if you struggle to get them right, or still experience leaks, there are other options. I developed INNOVO to give people their lives back. Get back to living on your terms. Don’t let your bladder rule you.
PT, PHD, DPT, MISCP & Co-Inventor of INNOVO
0800 028 5687
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www.myinnovo.com/uk
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SCN11782_Ferring_WBD 2021_Full Page Infographic_265x325mm_v2.2_AM.pdf
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02/06/2021
15:22
TIME TO TAKE ACTION WORLD CONTINENCE WEEK 21–27 JUNE
Bedwetting, also known as nocturnal enuresis, is involuntary urination while asleep Bedwetting is a common childhood condition
BEDWETTING MAY IMPACT A CHILD
Parents and carers are encouraged to seek support from a healthcare professional
School and social performance
Emotional well-being, self-esteem
Daytime functioning
Bedwetting can be managed and families are advised to seek further support from a healthcare professional
www.stopbedwetting.org For more information on bedwetting, please visit:
UK-MN-2100018 I June 2021
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This disease awareness information is initiated and funded by Ferring Pharmaceuticals Ltd
READ MORE AT HEALTHAWARENESS.CO.UK
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