Bladder & Bowel
“IBD forces over half of patients to forgo career advancements.”
Amy Kelly, Chief Operating Officer, Crohn’s & Colitis Ireland Page 02
“Anyone who thinks they may have incontinence should not be embarrassed about asking for treatment.”
Sorcha O’Meara, Urology Specialist Registrar, Blackrock Health/RCSI Page 04
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~Emer Molloy, Clinical Nurse Manager, Coloplast
THIS ISSUE
“There are three types of urinary incontinence.”
Sorcha O’Meara Urology Specialist Registrar, Blackrock Health/RCSI
Page 04
Report reveals patient struggles and true costs of IBD in Ireland
Patients living with inflammatory bowel disease (IBD) in Ireland encounter financial, emotional and health challenges. Many find gaps in healthcare services and experience burdens in both work and daily life.
“Around 2,600 people are diagnosed with bowel cancer in Ireland every year.”
Dr Aimée Drudy Gastroenterology Specialist Registrar Cork University Hospital
Page 05
“If bowel cancer is found early, it’s easier to treat and there’s a better chance of recovery.”
Professor Pádraic Mac Mathuna Clinical Director, BowelScreen
Page 05
Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, affects thousands across Ireland. The findings of our 2024 IBD Patient Survey reveal the significant daily struggles faced by patients, from health and employment challenges to financial burdens.
IBD
forces over half of patients to
forgo career advancements.
The daily impact of IBD
Our survey highlights how IBD affects patients' working lives. Many IBD patients are of working age. Yet, their conditions make it hard to maintain steady employment, with 60% of respondents reporting that fatigue was a significant factor in altering their work situation, whether by reducing hours, changing roles or stopping work altogether. Over half of people living with IBD do not pursue additional career responsibilities or promotions due to IBD. More workplace accommodations are needed, plus greater understanding from employers.
Senior Project Manager: Robert Joyce robert.joyce@mediaplanet.com Business Development Manager: Kate
Phillips All images supplied by Getty Images, unless otherwise specified
Gaps in healthcare
Despite receiving regular care from gastroenterologists, many patients feel unsupported by their primary healthcare providers. Less than half of those surveyed believe that their GP has sufficient knowledge of IBD and access to specialist care like dietitians or mental health professionals is often limited.
The financial burden
Living with IBD also places a significant financial strain on patients. Over 50% of respondents spend more than €1,000 annually on managing their condition. Despite these expenses, IBD is not officially recognised as a disability in Ireland, meaning patients miss out on potential financial support that could alleviate some of this burden.
Advocacy for change
Recognising IBD as a disabling condition is essential to providing the financial support and healthcare services that patients require. Through continued advocacy, Crohn’s & Colitis Ireland is committed to ensuring that those with IBD are no longer overlooked.
Amy Kelly Chief Operating Officer, Crohn’s & Colitis Ireland
Why we need to dispel myths about stomas
If you have a stoma, professional medical support is always available to help you adjust, solve any issues and live life to the fullest.
On social media, people seem to be very happy to discuss every intimate aspect of their lives. Money, jobs, sex, relationships: nothing appears off limits. Yet, for some reason, in the non-virtual world, it’s still taboo to talk about the normal human functions of emptying your bowels and bladder.
Open bladder and bowel conversations “Part of our mission is to have a more public conversation about bladder and bowel issues,” says Natasha Creenan, Country Manager Ireland at Coloplast, a company that manufactures medical devices and services related to ostomy, urology, continence and wound care. “Talking openly could help people who have a stoma to empty their bowels or a catheter to empty their bladder — because it’s just another way to go to the toilet and nothing to be ashamed of.”
How nursing services reduce fears and help patients adjust
It is, however, normal for new stoma patients to have worries and questions. “For example, will the bag smell or make a noise? Will people notice it? Could it leak?,” says Molloy. “Thankfully, expert support is available to help people adjust. In hospitals, stoma care nurses do an amazing job supporting and educating patients in the early days postsurgery. There’s also lots of expert support available in the community, to help resolve any clinical issues and advise on lifestyle adjustments.”
Talking openly could help people — because it’s just another way to go to the toilet and nothing to be ashamed of.
Living an independent and normal life with a stoma
A stoma is a surgically created opening in the abdomen wall that allows urine or faeces to be diverted out of the body and into a bag. Patients may need a stoma for various reasons, including colorectal cancer, Crohn’s disease, ulcerative colitis, diverticular disease, birth trauma or a neurological condition.
“The idea of a stoma can be daunting,” admits Emer Molloy, Clinical Nurse Manager at Coloplast. “People do have to adjust to it, but if they’ve been unwell because of a particular condition, it can give them back independence and improve quality of life.” People can live completely normally with a stoma. “They could run a marathon, go to the gym, swim, go on holiday, eat a varied diet and have sex,” insists Creenan. “They can do everything they did before.”
It’s recommended that patients have regular check-ins with their stoma team, ideally on an annual basis. This progress check may include a review (via telephone or face-to-face appointment) of skin health, device used, routines and selfcare. “If you haven’t seen a specialist for a while, you may be experiencing common problems — such as leaks or sore skin — that are not normal and could be solved with specialist support,” says Molloy. “Please don’t hesitate to contact Coloplast Nursing Service for help with signposting.”
How selfcatheterisation can improve quality of life for patients
Intermittent self-catheterisation (ISC) can help patients with bladder issues. With professional support, ISC may help contribute to reducing infection risks and could be an alternative to permanent indwelling catheters. Learn more about ISC benefits and guidance.
When can ISC help patients with bladder conditions?
“The bladder is a muscle that, over time or due to trauma or a neurological condition, may not work how it’s meant to,” explains Natasha Creenan, Country Manager, Coloplast Ireland. “So, some patients may be advised by their nurse to insert a catheter into their urethra, empty their bladder of urine, take out the catheter and then dispose of it. It means there’s less chance of infection. Plus, they don’t need a permanent catheter in place or to carry around a urine bag under their clothes.”
Support is also available for ISC patients ISC can sound like a daunting prospect, admits Emer Molloy, Coloplast Clinical Nurse Manager. However, with the right professional guidance and support, it doesn’t have to be. “The point with stomas and ISC is that support is available to help patients with issues or problems they may have,” she says. “Contact an HSE or company stoma nurse because you don’t have to suffer in silence.”
Patients who use ISC to empty their bladder should also see a healthcare professional if they are experiencing frequent urinary tract infections. “As with a review of technique and device, nurses can also support patients with infection prevention,” reminds Molloy.
How to contact Coloplast for support:
Regardless of your device manufacturer, our nursing service is available to support you, free of charge.
Call our local office landline on 01 9190190* or email nurseteam@coloplast.com
To receive our details in your inbox and access more information, scan the QR code.
*Standard rates apply; check with your provider for details
Find out more at Coloplast.ie
Sponsored by Coloplast
Emer Molloy Clinical Nurse Manager, Coloplast
Natasha Creenan Country Manager Ireland, Coloplast
WRITTEN BY Tony Greenway
Image provided by Coloplast; Lucie Belosoukinski, ostomate
Three types of urinary incontinence and how to manage the symptoms
Urinary incontinence is the unintentional leak of urine and is a common problem affecting people of all ages. People should not suffer in silence, as healthcare professionals are there to help.
There are three types of urinary incontinence.
The first is called stress incontinence; this is the leakage of urine with exertion such as coughing, sneezing or exercise. This is more common in women and can especially be an issue after pregnancy or post-menopause. Urge incontinence is the second type; you might leak on your way to the bathroom or have the need to pass urine. This can be associated with an overactive bladder. Finally, there is mixed incontinence, which is a mixture of both types.
Who can I talk to about urinary incontinence?
A lot of people suffer in silence and can feel embarrassed or upset
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about their symptoms. However, it is important to know there are treatments that can help, and healthcare professionals are used to talking about this problem. If you are suffering from incontinence, discuss it with your general practitioner, see a urologist or urogynaecologist or see a chartered physiotherapist who specialises in pelvic health and continence. The Continence Foundation of Ireland website contains helpful information and links to other websites and resources.
Incontinence management options Management of incontinence usually starts with small lifestyle changes, such as reducing caffeine intake, fizzy drinks and alcohol, as these can irritate the bladder.
It is important to see a healthcare professional, so any conditions that may worsen incontinence can be ruled out or managed, such as infections. Physiotherapy can also be helpful to re-train the bladder, strengthen the pelvic floor and reduce urinary symptoms. If these management options are not improving symptoms enough, some people may need medication or surgery to help. There are wellestablished guidelines with safe and effective treatments available to help with symptoms. Anyone who thinks they may have incontinence or urinary problems should not be embarrassed about asking for advice or treatment.
Sorcha O’Meara Urology Specialist Registrar, Blackrock Health/RCSI
Mr James Forde Consultant Urologist
Steps to take if you are worried about your bowel symptoms
Asking for help is not always easy. This may be particularly true when it comes to talking about your bowel habits or stool.
While issues related to bowels vary from person to person, there are a number of symptoms for which to seek medical advice.
When to ask for help with bowel issues
Essentially, it’s important to communicate any new or unusual bowel issues. This specifically refers to any persistent changes in bowel habits, such as differences in how often you have bowel movements or changes in the consistency of the stool. Moreover, passing blood or black bowel motions, unintentional weight loss, tummy pain, bowel symptoms waking from sleep or a feeling of persistent fullness in the back passage all warrant review.
Finding the underlying cause of bowel symptoms
Your doctor will explore such symptoms. Often, the history will suffice for diagnosis. It’s natural to feel concerned about the possible underlying cause, but finding out sooner is always better. The answer may even be a simple test away. Others may require referral to a gastrointestinal specialist.
There are multiple modern options for investigation, depending on symptom history. Blood tests can often be helpful, and non-invasive methods to check bowel movements for blood — such as faecal immunochemical tests (FIT) like BowelScreen — or for inflammation, faecal calprotectin tests, are now widely used.
Colonoscopy and capsule endoscopy options
A colonoscopy will likely always be the standard for direct visualisation of the large bowel. Most people can manage the invasive nature of this test without issue. For various valid reasons, some people may be unable to undergo a full colonoscopy. In certain cases, a limited left-sided colon endoscopy can be sufficient, requiring less bowel preparation. Other less invasive options include CT colonoscopy and, more recently, intestinal ultrasound and colon capsule endoscopy. Capsule endoscopy involves swallowing a pill-sized recording camera that captures images while passing through the gastrointestinal tract. These options may be discussed with your gastroenterologist or GP. Ultimately, if you’re concerned about your bowel symptoms, talk to your doctor who can help find the best tests and treatment for you.
Living with IBD also places a significant financial strain on patients. Over 50% of respondents spend more than €1,000 annually on managing their condition.
Amy Kelly Chief Operating Officer, Crohn’s and Colitis Ireland
Dr Aimée Drudy Gastroenterology Specialist Registrar at Cork University Hospital
Access free bowel screening to help find or prevent cancer
Bowel screening aims to find signs of bowel cancer at an early stage, when there are no symptoms.
Bowel screening involves taking a sample of your poo (stool sample) using a home test. Place the sample in a special tube, and send it back in a sealed envelope for laboratory testing. This test looks for blood in your poo and most people get a normal result. If the amount of blood found in your poo is above the screening limit, you will be referred for a further test called a colonoscopy.
Who can get free bowel screening?
You are eligible if you are aged 59 to 69, live in Ireland and are on the BowelScreen register. To check that you are on the register and your details are current, contact 1800 45 45 55 (freephone) or info@bowelscreen.ie.
Limitations of bowel screening
The bowel screening test looks for a certain level of blood in your stool. If the amount of blood is below the screening limit, or no blood is found in your sample, it is not a guarantee that you do not have bowel cancer. Not all cancers or polyps bleed all the time. No screening test is 100% reliable. Changes can also happen between screening tests.
Facts on bowel cancer
Bowel cancer is also known as colon, rectal or colorectal cancer. Around 2,600 people are diagnosed with bowel cancer in Ireland every year. Bowel cancer is the second most common of all cancers in men and the third most common of all cancers in women in Ireland.
If bowel cancer is found early, it’s easier to treat and there’s a better chance of recovery. If you have any of the following symptoms, contact your GP and do not wait for your next screening test:
• Changes in your poo, diarrhoea or constipation that is unusual for you
• Needing to poo more or less often than usual
• Blood in your poo, which may look red or black
• Bleeding from your bottom
• Tummy pain
• Feeling a lump anywhere in your tummy
• Bloating
• Losing weight for no reason
• Feeling very tired for no reason
• Breathlessness
Professor Pádraic Mac Mathuna Clinical Director, BowelScreen
