Loss of bladder and bowel control is common in adults with cystic fibrosis (CF), and such incontinence problems can affect a patient’s quality of life and breathing, regardless of the severity of pulmonary symptoms. ) could compromise care, the study found.

“Persistent cough,” a common symptom of cystic fibrosis, “induces pelvic floor dysfunction.” [problems]” the researchers wrote, “In this study, [incontinence] in men and women with CF. ”

A team of scientists from across France said the findings highlight the need to address the problem of incontinence with individualized treatments.

“The multidisciplinary team must have knowledge of the symptoms, diagnostic tools, and management strategies to provide specific treatment,” they wrote.

the study, “Prevalence and severity of functional urinary and anorectal diseases and impact on quality of life in cystic fibrosis” was published. Cystic Fibrosis Journal.

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Most patients do not report bladder or bowel control problems to their doctors

For people with CF, persistent coughing can put repeated pressure on the pelvic floor (the group of muscles located between the coccyx or coccyx and the pubic bone in the pelvis). These muscles help support the bladder and intestines.

Changes in the pelvic floor can cause an inability to control the flow of urine from the bladder (urinary incontinence) or stool to leak from the intestines (fecal incontinence), and these problems are common in men with sexually transmitted diseases. It is unknown how common it is among women. C.F.

To learn more, researchers studied symptoms of bladder and bowel incontinence and their impact on quality of life and respiratory care in 178 adults with a confirmed diagnosis of CF. 93 men and 85 women participated in the survey, with an average age of 30.6 years.

According to the results of the self-report questionnaire, 105 patients (64.8%) had overactive bladder, 91 (52%) had fecal incontinence, and 61 (34.3%) had stress urinary incontinence, i.e., urine leakage during moments of physical activity. was suffering from. , including coughing and sneezing.

Stress urinary incontinence was significantly more common in women than men (63.5% vs. 7.5%), as was fecal incontinence (63.5% vs. 41.1%). The mean overactive bladder score ranged from 0 to 21, with higher scores indicating more severe symptoms, and was higher in women (2.29 vs. 1.03 points).

Neither urinary nor fecal incontinence was associated with more severe pulmonary dysfunction. Lung dysfunction was assessed based on forced expiratory volume in 1 second (FEV1), a measure of the amount of air that can be forced out in 1 second.

Decreased quality of life due to urinary incontinence. It is measured using the SF Qualiveen questionnaire, with higher scores indicating poorer quality of life. The mean total SF Qualiveen score was higher in women with urinary incontinence than in women without urinary incontinence (0.54 vs. 0.11 points).

The majority of people who have [urinary or fecal incontinence] Even though effective treatments and management strategies exist, they have never discussed their problem with their medical team. Perhaps it is considered too intimate and difficult to talk about, or secondary to other symptoms directly related to this disease.

In both men and women, the presence of stress urinary incontinence influenced respiratory symptoms. It also had moderate to strong negative effects on respiratory care, particularly during physical therapy (a treatment that helps CF patients clear mucus), and on coughing. In women, it affected the results of lung function tests.

The man’s stress urinary incontinence was associated with diabetes and a history of genital mycosis, an infection caused by fungi. For women, older age was the only risk factor for stress urinary incontinence.

Loss of bladder and bowel control impacts quality of life and respiratory care, but [urinary or fecal incontinence] “Despite the fact that effective treatments and management strategies exist, they have not discussed their problems with their health care team,” the researchers wrote.

“Maybe it’s considered too intimate and embarrassing to discuss, or it’s considered secondary to other symptoms more directly related to the disease…and… Its management is often a huge burden,” they added.

At the time the study was conducted, CFTR modulators, a class of drugs that address the root cause of CF, were not widely available. The researchers say these treatments have been shown to improve lung function and reduce coughing and sneezing, making it likely that urinary and fecal incontinence becomes less common.

Still, “it’s important to be regularly tested for pelvic floor dysfunction.” [problems]…regardless of the severity of the lung disease, even in those receiving treatment. [CFTR] modulator,” the researchers concluded.

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