Question
Why should occupational therapy practitioners (OTPs) assess both bowel and bladder function when addressing incontinence?
Answer
It is essential to assess both bowel and bladder function when evaluating incontinence, as they are closely interconnected. Many patients may initially report concerns only about urinary leakage, but underlying bowel dysfunction—such as constipation or straining—can contribute to or exacerbate pelvic floor issues. Chronic constipation, for example, increases pressure on the pelvic floor muscles, potentially worsening urinary symptoms. Therefore, a comprehensive assessment of both systems is necessary to develop an effective treatment plan.
Clarifying what "regular" bowel habits mean is important in this assessment. Normal frequency can range from three times a day to three times a week, but other factors, such as straining, incomplete evacuation, and stool consistency, also play a role in determining pelvic health. Tools like the Bristol Stool Chart provide a visual reference to help patients describe their stool characteristics accurately, making it easier to identify potential concerns. Even though it may seem unconventional, engaging patients in this discussion fosters awareness and helps guide appropriate interventions to support overall pelvic health.
This Ask the Expert is an edited excerpt from the course, Incontinence and Pelvic Health: The Role of Occupational Therapy Practitioners, presented by Krista Covell-Pierson, OTR/L, BCB-PMD.
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