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Why are we still battling the continence taboo?

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Julie Fawcett finds it hard to believe that in a climate of health promotion patients still struggle to talk about continence

In my daily practice of seeing patients I am often surprised to see how long it takes for them to seek help. One of the questions we ask is how long they have had a problem. A large number of patients say that they have had these symptoms for “years”, ranging from one to five, and more.

Many say that they feel they have “just got on with it”, despite the fact that their continence has had a major impact on their quality of life, often restricting their work and social activities. It is also surprising to know that these same patients have accessed health professionals in this time, for other health problems, but have never admitted to living with bladder or bowel problems.

In a world where health promotion is ubiquitous, it is hard to believe that this can be the case. I feel it is such a shame that there is still a taboo about talking about continence. Surely, going to see your GP or nurse, it should be just as easy to discuss stress incontinence as it is back pain?

When I ask patients about what made them eventually seek help, they often say that they realised their continence problems were controlling their whole life and thought that they had better do something about it. While I am pleased that have finally sought help, I feel so disappointed that they have often had a great deal of anxiety and stress about their symptoms that could have been improved much earlier.

There are a few patients, of course, who would not discuss their symptoms with their GP but would see a specialist nurse, which is why it is great that our patients can self-refer.

On the other side of the coin, the advertisement of containment products doesn’t appear to encourage patients to seek help from a health professional, encouraging them only to use these products. Obviously, containment products are needed for specific patients, but for many these are being used as a sticking plaster, rather than the patient actually seeking treatment to improve their symptoms.

One of our roles is to promote the service to the general public so that patients are aware of our existence. Every year we have an article in our local newspaper which seems to create a number of self-referrals. We are always trying to create awareness through leaflets and posters in health centres, pharmacies and GP surgeries.

Despite this, there are still many patients who suffer unnecessarily. As a busy service it is difficult for us to spend a great deal of time on public awareness. Yet it is vital we endeavour to promote ourselves to ensure we can help those patients who need our help.

Julie Fawcett works as a specialist nurse at the Bladder and Bowel Service, NHS South of Tyne and Wear Community Health Services.


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