Continence Resources

This two-part article aims to help healthcare professionals understand constipation; the possible causes, and the anatomical and functional problems. In the first part, the author explained anatomy and physiology of the lower gastrointestinal tract, what are normal bowel motions, frequency and variation, which includes the Bristol Stool Chart to view the types of bowel motions sufferers may often experience. Here, the focus is on conservative treatment interventions for constipation, exploring the four ‘Fs’ acronym (Rex, 2013): fibre (in diet); fluids (those best for health reasons); fitness (‘if you do not move, it will not move’); and finally feet, which relates to the best sitting position to help achieve bowel evacuation successfully.

Patients in the community often have a long-term catheter in place and so their management inevitably becomes the responsibility of community nurses. As urinary incontinence can cause patients discomfort and have a negative impact on their day-to-day life, it is important that healthcare professionals understand the reasons for catheterisation and are aware of the different treatment options available, such as urethral and suprapubic, in order to provide patients with the most suitable device according to their needs and lifestyle. This paper explores the issues involved with indwelling catheterisation and looks at one new product range that aims to promote patient comfort and reduce associated risks.

Bowel dysfunction is a common problem for adults and children, and yet many people do not seek help and when they do it is not up to standard. Unmanaged symptoms impact on the health of the patient, both physically and mentally, and add extra cost to the NHS. This article, by a clinical nurse specialist working with people suffering from bladder and bowl dysfunctions, will help healthcare professionals understand the possible causes of anatomical and functional bowel problems, especially constipation, and the conservative treatment interventions. This first article in a two-part series, explains anatomy and physiology of the lower gastrointestinal tract, what constitutes a normal bowel habit, frequency and variation. The second will focus on the causes of constipation, which are often misunderstood and misdiagnosed, and how they can be assessed and managed, as well as treatment options available.

Continence is an area that requires many community nurses to prescribe from the Nurse Practitioner’s Formulary to promote good patient care and appropriate service delivery. Recently in West Berkshire, with the full support of GPs, the continence advisory service has taken over the non-medical prescribing of all continence products, with the aim of providing a safe, cost-effective and timely service. This initiative is aimed at changing the way continence prescriptions are issued to patients. This second article of a two-part series, as well as featuring a case report looking at the management of a patient with multiple sclerosis (MS) and bladder dysfunction, looks at the importance of holistic assessment to ensure appropriate catheter provision in line with prescribing principles.

Continence is an area that requires many community nurses to prescribe from the Nurse Practitioner’s Formulary to promote good patient care and appropriate service delivery. Recently in west Berkshire, with the full support of GPs, the continence advisory service has taken over the non-medical prescribing of all continence products, with the aim of providing a safe, cost-effective and timely service. This initiative is aimed at changing the way continence prescriptions are issued to patients. As well as examining the problems of bladder dysfunction in people with multiple sclerosis (MS), this first article of a two-part series, looks at the background to MS and bladder problems, as well as focusing on treatments such as clean intermittent self-catheterisation (CISC). The second part of the series will feature a case study looking at the management of a patient with MS and bladder dysfunction.

Functional bowel disorders such as faecal incontinence and constipation are relatively common conditions, which have a significant negative impact on patients. This can often affect the social, psychological and financial areas of life, as well as leading patients to become isolated due in part to the social taboo surrounding bowel issues (Lukacz et al, 2011; Holroyd, 2015a). Constipation can affect up to 25% of the population at some point in their lifetimes (Belsey et al, 2010), and it is a condition that crosses all genders, ages and cultures, although it is more prevalent in the very young or older adults (Holroyd, 2015b).

With over a million devices used in the NHS every year, indwelling urinary catheterisation is widely acknowledged as one of the most commonly used invasive healthcare procedures. Despite its widespread use, there is also extensive evidence of the risk of infection, blockage and bypassing associated with indwelling catheters, all of which can adversely affect patients’ health and quality of life, as well as placing a significant burden on the supportive health services that manage the caseloads of catheterised patients in both community and acute settings. This article looks at the reasons for the use of long-term catheters, the complications that can arise and the positive impact the use of a triclosan-based solution can have when instilled into the inflation balloon of the catheter. A selection of case studies highlight the use of Farco-fill® Protect (CliniMed) in complex patients whose only management option for effective bladder drainage is to use an indwelling catheter.

Urinary incontinence is a common problem in the UK, and one often seen by community nurses. While it is often associated with ageing, urinary incontinence can in fact have a number of causes and it is important that the community nurse is aware of the full range of aetiologies and presentations. Community nurses should have a good basic understanding of the causes of incontinence, be able to provide a basic first assessment, become adept at asking the right questions and be able to offer some conventional treatment and problem-solving strategies for immediate relief of symptoms. Most importantly, they should be able to identify when a patient will need referring to a specialist practitioner for more extensive assessment and investigation. This article looks at the assessment of urinary continence in the community, and outlines the common presentations that nurses should look out for.

The Colostomy Association is a national charity that provides support, reassurance and practical advice to anyone in the UK who has, or is about to have, a colostomy. We are here to help and support patients, their families and carers. Our helpline is manned 24 hours a day by volunteers who all have a stoma. Our wide range of leaflets, quarterly magazine Tidings and closed Facebook group offer information and support to anyone affected by life-changing stoma surgery.

Interstitial cystitis or painful bladder syndrome (IC/PBS) is a chronic condition presenting with symptoms including pain, urinary urgency and urinary frequency. IC/PBS is often poorly diagnosed and many patients may have seen multiple healthcare professionals over a period of years and undergone a variety of unsuccessful treatments. The lack of a definitive definition of IC/ PBS and diagnosis of its aetiology, cause and successful treatment contributes to a poor quality of life for many patients. This article looks at the main symptoms, diagnostic techniques and treatments for the IC/PBS. The author outlines how comprehensive history taking, physical examination and appropriate clinical tests all help community nurses to arrive at an appropriate and timely diagnosis, which, when combined with individualised treatment plans, can offer patients effective relief of their symptoms.