Coping with bowel or bladder changes after pelvic radiotherapy
The day-to-day issues caused by bladder and bowel changes are often similar, so we’ve covered them in this one page.
If you’re having difficulties, you may feel worried about going out and social occasions. But there are many practical things you can do and lifestyle changes you can make to help you feel more confident and in control.
If you have problems with leaking (incontinence) from your bladder or bowel, it can make the surrounding skin in that area sore. You can protect your skin by keeping it clean and dry. There are many products available, and your continence adviser will be able to give you more information.
Here are some suggestions:
Keep your skin clean and dry.
Try using unperfumed baby wipes rather than toilet paper, as they are gentler on your skin.
Using absorbent pads and barrier creams (such as Cavilon®) help protect your skin.
Wear cotton underwear - it allows your skin to breathe more than other materials.
You may feel worried about going out, especially to somewhere new, if you have problems with bowel control. Planning ahead so that you are prepared can help you feel more confident.
Access to toilets
If you’re going somewhere you’re not familiar with, it’s a good idea to find out where the toilets are in advance. Many towns and counties keep information about the public toilets in their area as lists or maps. Often these are on local authority websites. There are too many of these websites to list here, but you’ll be able to find them on the internet. Try putting the term 'public toilets' and the name of the place you plan to visit in a search engine to find out what’s available.
Carrying a Just Can’t Wait card may help you get access to a toilet more quickly when you’re out. The card can be used in places such as shops and pubs, and states that the card-holder has a medical condition that requires urgent access to a toilet. You can get a Just Can’t Wait card from the Bladder and Bowel Foundation or Disability Rights UK.
You can use disabled toilets too. These often offer more privacy, have a wash basin and more space if you need to change. The National Key Scheme for toilets offers disabled people access to about 9,000 locked public toilets across the UK. You can buy a key for £20 from Disability Rights UK. They can also send you details of where the toilets are located.
Take a bag with supplies
Pack a bag of the things you may need when you go out. This will help you feel more confident.
You may want to include:
wet wipes or baby wipes
barrier cream such as Cavilon® or Sudocrem®
pads and pants
a change of clothing
a sealable bag
loperamide (if you have problems with diarrhoea).
If you have bladder problems, you might find it helpful to take a portable urinal with you in the back of the car.
Always remember to take your Just Can’t Wait card with you when you’re going out.
Specialist products for leakage or soiling
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If you have problems with leakage or soiling (incontinence), there’s a wide range of products you can wear to help you feel more confident and to help if an accident does happen.
Pads for mild to moderate incontinence are available in most supermarkets, pharmacies and online. If these aren’t absorbent enough, you can get bigger pads from your continence adviser. They’ll also explain what’s available to you on the NHS, which can vary from region to region. The Bladder and Bowel Foundation offers advice and support via its helpline and website.
Pads and pull-ups have a layer that draws urine away from the surface and absorbs it, so your skin stays dry. There’s a variety available. Some can be worn inside your underwear, while others can be worn as a replacement for underwear. Some pads can be used to cover your bed.
Having a portable urinal near your bed may help you have a better night’s sleep, because you won’t have to walk to the toilet every time you need to go. Have it handy during the day if you’re worried about getting to the toilet in time.
Sheaths and leg bags may be useful for men who don’t want to use pads. A sheath fits over the penis (like a condom) and urine is stored in a bag that’s strapped to the leg. You can get underwear with a built-in pocket to hold the bag.
A continence adviser can help you choose a product that suits you for the daytime. There are also various types of pads you can use to cover your bed at night.
Anal plugs are made from soft foam and stop any leakage from the bowel for up to 12 hours. A cord attached to the plug allows you to remove it when you’re ready. Some people find them uncomfortable to begin with, but most people get used to them after using them a few times. Your continence adviser can tell you more about anal plugs.
Keep to a healthy weight
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Being overweight puts pressure on your pelvic floor muscles, so it’s especially important to keep to a healthy diet if you have stress incontinence or problems with bowel control. Talk to your GP about the right weight for your size.
Keep physically active
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Keeping active will help you manage your weight and avoid getting constipation. This is important to help look after your pelvic floor muscles. Exercise also encourages you to go to the toilet more regularly and avoid constipation. It helps you feel better and can reduce stress, too.
If you have stress incontinence, it’s best to avoid anything involving running or jumping. Walking or swimming are lower impact and are less likely to be a problem. When your symptoms are under control, you may want to gradually introduce other types of exercise.
This is important to help look after your pelvic floor muscles. Our food guide lists foods that help ease constipation. Make sure you drink plenty of fluids and keep physically active.
How you feel can affect both your bladder and bowel. Anxiety and stressful situations can make your symptoms worse and may make accidents more likely.
Learning to relax may help to improve some of your symptoms. Stress reduction is taught at some continence clinics. Your doctor or specialist nurse can tell you about relaxation classes in your area, and some support groups also offer this.
Relaxation CDs are available from bookshops and some health shops, and you can download relaxation podcasts from the internet.
Some people find that complementary therapies help them feel less stressed. Talk to us for details of what’s available in your area.
Bladder or bowel problems can be embarrassing and difficult to talk about, which can make you feel isolated. Health professionals can give you lots of support and advice if you let them know about problems you’re having. They’re used to dealing with and discussing intimate problems and can refer you to a counsellor or specialist if you need more help.
Support groups, online community sites and specialist organisations, such as the Pelvic Radiation Disease Association can also provide invaluable support. They’re a good way of meeting people who’ve been through similar difficulties and you can share experiences and solutions with each other. Partners, family and close friends can also help you keep things in perspective and reassure you that you’re valued for who you are.