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Few With Incontinence Actually Cut Fluid Intake


 

MONTREAL — Fluid reduction is not a common coping strategy among people with urinary incontinence, although many practitioners believe it is, according to Australian researchers.

“Anecdotally, as continence advisers, we have the perception that the majority of our patients actually reduce their fluids in order to cope with their urinary symptoms, but surprisingly only a third of people actually do,” said Charmaine Bryant, a clinical nurse consultant at Prince of Wales Hospital in Randwick, Australia.

In a study she presented at the annual meeting of the International Continence Society, Ms. Bryant administered a questionnaire to 356 consecutive adult patients presenting with urinary incontinence and/or overactive bladder symptoms. The patients were seen at community health/hospital continence clinics.

The results on fluid intake (last 24 hours), 5-year history of change in fluid intake, personal demographics, and quality of life were compared with answers given from 353 age- and sex-matched control subjects drawn from the local community.

There were three groups of patients: those seeking treatment for bladder problems, control subjects who reported no bladder problems, and controls who reported some bladder problems but were not seeking treatment.

The study found that among patients seeking treatment, only 34% had reduced their fluid intake over the past 5 years while the remaining 66% had either increased or not changed it. Among controls who reported bladder problems but were not seeking treatment, only 20% had reduced their fluid intake, while 30% had increased it, and 49% reported no change.

By comparison, 7% of asymptomatic controls had reduced their fluid intake over the past 5 years (largely because of caffeine or alcohol problems), 24% had increased it, and 69% reported no change.

In the two groups reporting bladder problems, the decision to reduce fluids was largely self-directed rather than medically directed—and the method of reduction consisted primarily of reducing fluids before going out and before going to bed, Ms. Bryant said.

Another surprising finding was the total amount of fluids that subjects consumed.

“The mean was well over 2 liters a day, whereas I thought that the mean would probably be somewhere around 1.5 liters a day,” she said in an interview.

“Significant numbers reported moderate intake levels of between 2 and 3 liters, and high levels of more than 3 liters, suggesting that intake levels among people with continence-related dysfunction are typically quite high,” she added. A significant minority reported very high intake levels of up to 9 liters a day.

The information should be useful to practitioners as they counsel patients on fluid manipulation, she commented.

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