, Bridge Magazine , Health Articles
Dr Dinara Markhabullina
Dr Dinara Markhabullina, a passionate advocate for women's health and family medicine, was born and raised in Uzbekistan. In 2006, she graduated from Kazan State Medical University (Russia) with outstanding academic achievements, earning a Doctor of Medicine degree with distinction.
With a genuine dedication to preventive medicine, Dr Markhabullina's career has centred around empowering individuals to take charge of their wellbeing. Her commitment to providing comprehensive healthcare has led her to pursue further specialisation in the field of General Practice (GP), where she aspires to acquire her fellowship degree. We speak with Dr Markhabullina on how patients can get the most informative and actionable information from their GPs.
Why is it important to be open about your incontinence with your doctor?
Being open about incontinence with your doctor is crucial for several important reasons:
Accurate Diagnosis: Incontinence can be a symptom of various underlying health issues, ranging from urinary tract infections to neurological disorders. By openly discussing symptoms, your doctor can conduct a more thorough evaluation, including medical history, physical examinations and diagnostic tests to accurately identify the cause.
Effective Treatment: Many treatment options are available for incontinence, including lifestyle changes, medication, physical therapy and sometimes surgery. Your doctor can tailor a treatment plan based on the specific type of incontinence (stress, overactive bladder, urinary retention with overflow, functional) you are experiencing and the underlying cause.
Improved Quality of Life: Incontinence can significantly impact your quality of life, affecting daily activities, social interactions and emotional wellbeing. Effective management and treatment can improve comfort and confidence, reducing the social stigma and embarrassment often accompanying these conditions.
Prevention of Complications: Untreated incontinence can lead to other health issues, such as skin infections and urinary tract infections, and impacts on mental health, like anxiety and depression. Early and open discussion with a healthcare provider can help prevent these complications.
Personalised Care: Discussing incontinence with your doctor allows for a customised approach to care. It helps the doctor understand how incontinence affects your life and tailor potential treatments that suit your lifestyle and preferences.
Educational Opportunity: Conversations with your doctor can be educational. They can help you understand the mechanisms behind incontinence, how different treatments work and what lifestyle modifications might be beneficial. This knowledge empowers you to participate actively in your care and management.
Being transparent and communicating with your doctor about incontinence is crucial to effectively managing the condition and improving your overall health and quality of life.
Do GPs follow any specific procedure while assessing patients with incontinence?
During an assessment, it is crucial for a GP to fully understand the individual's health background to determine their risk of developing urinary or bowel incontinence. For instance, if you are a 50 year old woman who experienced a traumatic childbirth delivery in the past, your GP is likely to ask specific questions related to incontinence because your historical data suggests you might be susceptible.
The approach differs significantly when dealing with a patient who has recently suffered a spinal injury, affecting the ability to control bladder and bowel functions. There is no immediate urgency in the first scenario, allowing the GP to focus on a thorough diagnostic process. However, in the case of a spinal injury, the GP must act quickly to organise an urgent referral to a neurosurgeon to address the acute needs and prevent further complications.
What simple things can people do to manage their incontinence and leakage?
Ideally, it would help if you visited your GP. You need to undergo a proper diagnostic process and implement an effective management plan. You need to get an appropriate diagnosis and see what's happening to you: for example, is it stress urinary incontinence or an overactive bladder?
Which questions about incontinence do GPs usually ask patients?
A GP will cover history. Doctors will need to exclude any other conditions as possible causes or contributory factors of incontinence, such as recurring urinary tract infections, a decrease in oestrogen, poorly managed diabetes, some medications or dietary preferences, as these conditions can play a significant role.
Lifestyle modification, such as reducing strenuous work (especially heavy lifting, pushing and pulling), weight loss strategies, physical activities and diet, should be addressed. Additional attention should be paid to chronic complaints such as a cough or constipation. This way, doctors will get a clear picture of your health. It's like a puzzle. The more details you collect, the clearer the final picture will be. From here, a management plan will be commenced.
A management plan can be diverse; it's not just about giving a patient a magic pill. In most cases, it is possible to start with lifestyle modifications and some primary interventions, such as pelvic floor muscle exercises, bladder training (which includes techniques to help you hold on when you need to rush to the toilet) and simple education about diet and fluids.
The pelvic floor muscles, which support the bladder, can weaken due to various factors, such as oestrogen deficiency during menopause, traumatic childbirth delivery or other injuries to the pelvic area.
The weakening of pelvic floor muscles and increased mobility can adversely affect the function of the urinary sphincter, the muscle responsible for retaining urine in the bladder.
When the sphincter or the pelvic floor muscles are weak, it can lead to stress urinary incontinence, where activities that increase intra-abdominal (or tummy) pressure (like coughing or lifting) cause unintentional urine leakage.
A management plan can be diverse; it's not just about giving a patient a magic pill. In most cases, it is possible to start with lifestyle modifications and some primary interventions, such as pelvic floor muscle exercises, bladder training (which includes techniques to help you hold on when you need to rush to the toilet) and simple education about diet and fluids.
Your GP can then refer you to a continence health professional or service for a more detailed assessment and education, which can contribute significantly to management.
What prompts discussion about incontinence?
Whatever causes discomfort should be addressed seriously. Urination and bowel movements are basic human needs. If they dramatically affect one's quality of life, they need to be addressed.
Whatever causes discomfort should be addressed seriously. Urinary and bowel movements are basic human needs. If they dramatically affect one's quality of life, they need to be addressed.
Health literacy is empowering
When a GP describes the condition to patients and gives more detailed medical information, patients often feel empowered and their anxiety about their situation decreases significantly. Patients start understanding what's happening and what can be done to fix that. Historically, there has always been a stigma surrounding incontinence. However, stigma and not being comfortable to discuss leaking can also be related to a lack of knowledge.
It can be a long process and you can’t promise any miracle, but GPs can provide you with real hope and real advice, and at least you will then be able to start to get back to doing all the things you love with greater confidence and comfort.