Strength

The following article showed some of the problems I had with bladder and bowel related issues at the early stages of my adapting to the medication for heart failure. For most part, the problem subsided later, but it is important to maintain positive thoughts and understanding what medication impacts you may be suffering from. Be encouraged that all things must happen to help you return to a manageable health. Chronic Heart Failure Issues by Continence Foundation of Australia 2015

http://www.continence.org.nz/pages/chronic-heart-failure-issues/126/

"This condition can affect the quality of a person’s day to day life. Some of the symptoms of heart failure include:

• tiredness

• shortness of breath

• low blood pressure, and

• swelling of the ankles (from fluid build up).

Treatment for heart failure can include, fluid and salt restriction, and a range of important medicines, which include diuretics (commonly known as ‘fluid’ or ‘water’ tablets) such as Frusemide or Lasix.

Some of the symptoms and treatments of heart failure may lead to bladder and bowel problems such as:

• frequently passing urine in the toilet (frequency) i.e. more than 8 times a day

• feeling a sudden, strong desire to pass urine (urgency)

• leaking urine while rushing to the toilet (urge incontinence)

• waking several times overnight to pass urine (nocturia) i.e. more than 2 times per night, or

• experiencing small, hard and infrequent bowel motions that often require straining or pushing to pass (constipation).

More than half of people with heart failure experience continence issues such as urgency and urge incontinence. Depression and a lowered quality of life can also occur in people with heart failure, as well as people with continence problems. People may go out less often because of worrying about having to find a toilet frequently and quickly. Having an ‘accident’ and leaking urine can be very embarrassing. People may use a continence product (e.g. a pad) for protection in case they leak. It may be difficult to know where to buy these pads and which one works best.

Bladder problems

Frusemide (Lasix) is a common type of medicine that people with heart failure take. It helps reduce the build up of excess fluid in the body (e.g. around the ankles). It is a fast acting medicine that causes the kidneys to produce urine, which quickly fills the bladder, often with large volumes of urine. This causes people to go to the toilet more often and in more of a rush. Sometimes people may start to leak urine while rushing to the toilet.

These medicines are an important part of managing heart failure and should not be stopped unless your heart failure specialist instructs you to do so. If you notice continence problems linked to your medicine talk to your specialist about changing the time of day that you take them. This may be adjusted to better fit in with your day to day activities.

People with heart failure can feel tired due to less blood being pumped around the body by a weakened heart. Having to get up several times during the night can interrupt a person’s sleep making them feel even more tired.

Rushing to the toilet, day or night can also be difficult when a person easily becomes short of breath. Dizziness from low blood pressure can affect a person’s ability to get out of bed at night with the need to pass urine. Elderly people have also been shown to be at increased risk of falling, because of needing to go to the toilet often, rushing to the toilet and getting up at night.

Bowel problems

Constipation can be a problem in people with heart failure due to the following:

• reduced fluid intake

• reduced mobility (e.g. walking and other physical activities)

• medications

• loss of appetite (and poor fibre intake), or

• reduced blood flow to the digestive tract.

It is important to reduce and if possible, avoid constipation. Straining or pushing to pass a bowel motion may contribute to chest pain, shortness of breath or an irregular heart rate in a person with heart failure. Straining also weakens pelvic floor muscles which are important for good bladder and bowel control. Constipation can make a person feel uncomfortable and bloated, and it can irritate the bladder causing the urgent need to pass urine."