Psyllium for Bowel Management

Psyllium husk, often prescribed for constipation

 

One of the main lifestyle changes you can make to manage your prolapse is to avoid constipation. Straining to pass a bowel motion can put a lot of pressure on your pelvic floor, which should be avoided to prevent your prolapse from getting worse.  

 

While you should begin by drinking enough water and getting enough fibre in your diet, your doctor may also prescribe medication to help you have regular bowel motions.

 

One product often suggested is Psyllium. Because this is a natural supplement, it can be more difficult to get scientific information about how effective it is, and about how it interacts with other medication.

 

Luckily, New York University Medical Centre has put together a very thoroughly researched fact sheet on the uses of Psyllium, including preventing constipation: Psyllium.

 

There is some very important information on this sheet that you should read, including when to take Psyllium to prevent it from interfering with the absorption of other medications. I strongly recommend you read this information before using this product.

A Not-For-Profit Organisation Providing Cheap Continence Aids in Australia

 

Independence Australia is a not-for-profit organisation that aims to help people with disabilities lead full lives.

 

They fund their work partially through their store, which sells a variety of disability aids and continence products. You can visit their store online here: Independence Australia.

 

Because Independence Australia want more people to be able to access the items that they sell, they often offer good discounts. They also offer online shopping, and discreet delivery. Any profits go to supporting their other work, such as providing attendant care and counselling to people with disabilities.

 

This information is provided merely to make you aware of the services available. The Prolapse Information Project has no association with Independence Australia, and does not endorse any one retailer or product.

The Cost to Society of Leaving POP Untreated

 

Women make up half of the population. Approximately 86% of Australian women will have a baby over their lifetime, and of those, roughly half will experience POP.

 

Many of these women have symptoms such as incontinence or pain that restrict them from doing activities they would like at home or at work. For some women it even prevents them from continuing work, volunteering, or caring for children or other relatives. The unsatisfactory nature of so many current treatments, and the lack of knowledge about the condition, really compounds this.

I have often wondered what the cost is to society of 1 in 5 Australians being so limited in their activity.

 

Deloitte Access Economics was commissioned in 2011 by the Continence Foundation of Australia to try and answer this question. They were looking at all incontinence, not just prolapse - but prolapse is one of the leading causes of incontinence among women, who suffer from incontinence far more than men.

 

The figure they came up with was that incontinence cost the Australian economy $42.9 billion a year, not including the cost of actually treating or managing incontinence.

 

Considering this figure, prolapse and other conditions that cause incontinence (many of them, like prolapse, often related to childbirth) need to be a much larger focus of research and public awareness campaigns. The economic cost, and the human cost, is too high.

A Tool to Help you Gain Confidence if you are Incontinent

Leaving the house can be daunting when you are incontinent, let alone going on long trips. This can affect your family life, your relationship with your partner, and your career.

One tool that may be useful if you have a smart phone is an app showing you where the nearest publicly-accessible toilet is at any given time. Many of these apps are free, and show toilets in places like parks, town halls, libraries, medical centres and shops.

To find these apps, go to the iTunes store (for Apple), the GooglePlay store or the Android AppStore (for Android), and use search terms such as "toilet finder". Each app should tell you its price (try looking for ones that are free), and also have a summary of its features and ratings from users.

Some Australian apps (all free) are:

• Aussie Loo - this app has three options: "I'm busting!" which gives you directions to the nearest toilets; and two search options (using the map or entering an address) which allow you to plan ahead.
• Street' Loo - lists the opening hours of toilets, and has an 'emergency' button you can press to get walking, biking or driving directions to the nearest toilet. It also has a search feature.
• Toilet Finder - tells you the 10 nearest toilets in either a list or a map.

The great thing about these apps is that you don't have to plan your trip as closely as you may otherwise have to. At any time you can take out your smart phone, open the app, and be directed to the nearest public toilet. For someone who has urge incontinence this can greatly increase the number of places they can travel to.

If you are in Australia and do not have a smart phone, you also can access this information on the following webpage from the Department of Human Services: National Public Toilet Map. You will need to plan your trip ahead if you want to use this resource.

For people who are not incontinent, this can also be a useful resource if you have a toddler who is toilet training.

If you know of any resources like this for your country, please share them in the comments below.

Prolapse Management: Are you Eating Enough Fibre?

Eating brown bread instead of white is a simple way to increase the amount of fibre you eat

 

As I pointed out in the earlier post "Are You Going to the Toilet Correctly?" managing constipation is a really important part of preventing prolapse from becoming worse. Straining to defecate puts a lot of downward pressure on the pelvic floor, which may cause further damage.

 

A big part of preventing constipation is having a high fibre diet, which doesn't necessarily mean using supplements or additives.

 

The Australian Government's health resource, The Better Health Chanel, has put together a great resource about dietary fibre: Fibre in Food.

 

This resource includes information on:

• The importance of getting enough fibre
• How much fibre is enough
• The two types of fibre and the different roles that they play
• How to make the best use of the fibre in your diet (for instance, drinking enough water)

Perhaps the most useful part of this page is a comparison between a sample low fibre diet and a high fibre diet, showing how you can make a few simple substitutions to improve your fibre intake without radically changing your whole diet.

Prolapse on "The Conversation"

The Conversation is an Australian news website on which specialists (usually academics) write articles about their field of expertise.

 

Caroline Gargett, one of the researchers in the Monash/CSIRO team currently working on improved prolapse repair surgery, has written an article about prolapse on The Conversation: What is Pelvic Organ Prolapse?

 

This article includes a good general introduction to prolapse, some thoughts about the impact it can have on a woman's life, and some of the developments in treatment.

 

She uses the following example to show just how common prolapse is:

 

"Considering these statistics, three generations of women in a family may potentially be affected at any given time – the new mum, her mum and her grandmother."

 

She also acknowledges the devastating and ongoing effect that prolapse, particularly if it causes incontinence, can have on a woman's life:

 

"...the impact of incontinence on the quality of life and daily functioning can be severe. Indeed, it’s comparable to the effects of having a stroke or dementia."

 

Gargett also speculates about why research in this area is just gathering momentum now, and why so many women still do not seek treatment:

 

"The reason so little is known about pelvic organ prolapse in the community is that these symptoms are incredibly embarrassing for women."

 

At the end of the article, Gargett mentions that she and her team are in the early stages of testing their new mesh and stem-cell combination surgery. As the article is from September 2012, this research has since been completed, and the results look very promising. The abstract (a short summary of the study) can be found here: Human endometrial mesenchymal stem cells modulate the tissue response and mechanical behavior of polyamide mesh implants for pelvic organ prolapse repair.

 

Prolapse Management: Are You Going to the Toilet Correctly?

Are you going to the toilet correctly?

It might sound like a trick question, but for a woman managing her prolapse, there is a 'correct' and 'incorrect' way to go to the toilet.

Making sure that you are in the correct position to empty your bowels is important for two reasons. The first is that women who have prolapse often also have urge or stress incontinence. Some types of incontinence can be managed better by improving toileting habits. Secondly, one of the main things that all women are told when they are diagnosed with prolapse (or should be told) is to avoid constipation and straining. This is because either of these things can put a lot of downward pressure on the pelvic floor, potentially worsening the prolapse. One of the ways to avoid this is to position your body in a way that makes passing stools as easy as possible.

Sue Croft, a Women's Health Physiotherapist and advocate has put together a great resource explaining how the bowels work, the importance of regular bowl movements for a woman with prolapse, and how to achieve this. Her resource includes clear diagrams, and can be found here: Managing Your Bowels Well.

This is a topic we are taught not to discuss, or even necessarily to think about, but it is a relatively small change that you can make privately and without seeing a specialist that, in some cases, may make a big difference to your continence and prolapse management.