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Understanding Continence Promotion: Effective Management of Bladder & Bowel Dysfunction in Adults

Welcome to the course

Introduction to Module 1

1.1 – Capturing your thinking

1.2 – What do we mean by ‘continence’ and ‘incontinence’?

1.3 – Attitudes towards incontinence

1.4 – Incontinence is a ‘Big Issue’!!!

1.5 – How does a person’s bladder and bowel affect their life?

1.6 – Impact of bladder and bowel dysfunction on a person with spinal cord injury

1.7 – Impact of incontinence

1.8 – The continence paradigm

1.9 – Is incontinence inevitable and normal?

1.10 – Separating continence promotion from managing incontinence

1.11 – Reflection

Welcome to Module 2

2.1 – Anatomy of the lower urinary tract

2.2 – Lower Urinary Tract Quiz

2.2 – Lower Urinary Tract

2.3 – Male urethra

2.4 – Male urethral sphincters

2.5 – Female urethra and urethral sphincter

2.6 – The pelvic floor

2.7 – Pelvic floor muscles

2.8 – How continence is acquired and maintained

2.9 – Bladder cycle of filling and emptying

2.10 – Pressures acting on the bladder to maintain continence

2.11 – Innervation of the bladder

2.12 – Micturition control centres

2.13 – Check your understanding

2.13 – Check your understanding

2.14- Reflect on what you have learned

Welcome to Module 3

3.21 – Urinary tract infection

3.22 – Constipation and faecal impaction

3.23 – Medication

3.24 – Fluid intake

3.25 – Endocrine disorders

3.26 – Bladder pathologies

3.27 – Factors affecting the person’s ability to cope with their bladder function

3.28 – Reflection

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Welcome to Module 4

4.1 – Anatomy and physiology of the large bowel

4.2 – Functions of the large bowel

4.3 – Stool production: what is normal and what influences it?

4.4 – The structures involved in maintaining continence and defaecation

4.5 – Physiology of defaecation

4.6 – Extrinsic and enteric nervous systems

4.7 – Gastro intestinal Reflexes

4.8 – Check your understanding

4.8 – Check your understanding

4.9 – Faecal incontinence

4.10 – Common causes of faecal incontinence

4.11 – Gut motility, stool consistency and diarrhoea

4.12 – Anal sphincter and pelvic floor damage

4.13 – Ano-rectal pathology

4.14 – Rectocele

4.15 – Neurological bowel disease

4.16 -Autonomic dysreflexia

4.17 – Neurological levels associated with bowel disorders

4.18 – How neurological conditions affect bowel function

4.19 – Incontinence secondary to degenerative neurological disease

4.20 – Case study: Jim who has faecal incontinence

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Welcome to Module 5

5.1 – Principles of assessment

5.2 – Components of a comprehensive bladder and bowel assessment

5.3 – Assessing bladder dysfunction – taking a history

5.4 – Assessing bowel dysfunction – taking a history

5.5 – Bladder diary analysis

5.6 – Urinalysis

5.7 – Bladder scanning

5.8 – Physical examination – female

5.9 – Digital vaginal assessment

5.10 – Physical examination – Male

5.11 – Digital rectal examination – men

5.12 – Assessing in practice

5.13 – Diagnosing type of bladder and/or bowel dysfunction

5.14 – The ‘Incontinence’ Poem

5.15 – Reflection

Welcome to Module 6

6.1 – What does self-management of continence involve?

6.2 – Behavioural Intervention Groups

6.3 – Using ISC to self-manage bladder dysfunction

6.4 – Self-managing bowel dysfunction

6.5 – Evidence on effectiveness of lifestyle changes

6.6 – Fluid management

6.7 – What is behavioural therapy?

6.8 – Pelvic floor muscle exercises

6.9 – Bladder training

6.10 – Toileting Assistance Programmes (TAPs)

6.11 – Abdominal massage

6.12 – Electrical stimulation

6.13 – Medication

6.14 – Laxatives

6.15 – Challenges of bladder and bowel problems

6.16 – Promoting continence in people with dementia

6.17 – Reflection

Welcome to Module 7

7.1 – Managing incontinence by containing leakage using absorbent products

7.2 – Managing urinary incontinence by containing leakage using indwelling catheters

7.3 – Exploring the effectiveness of health and social care support services

7.4 – Sharing ideas for service improvement

7.5 – Delivering better services for people with long-term conditions

7.6 – Facts and myths about effects of ageing on continence

7.7 – Is using the toilet a fundamental human right?

7.8 – Do bladder and bowels get sufficient media and government recognition?

7.9 – Thank you and goodbye

7.10 – Reflection

7.11 – Key resources to support effective management of bladder and bowel dysfunction

7.12 – Continue learning with the Association for Continence Professionals

4.8 – Check your understanding

Understanding Continence Promotion: Effective Management of Bladder & Bowel Dysfunction in Adults
Welcome to Module 4
4.8 – Check your understanding
4.8 – Check your understanding

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Question 1 of 10

1. Question

The internal anal sphincter (IAS) is important in maintaining continence. Which ONE of the following is not true?

It is under involuntary control
Correct Incorrect Correct answer

It is smooth muscle
Correct Incorrect Correct answer

The reflex response is 'contraction'
Correct Incorrect Correct answer

A defect can cause passive soiling
Correct Incorrect Correct answer

Correct

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Question 2 of 10

2. Question

What is the name of the internal nervous system of the bowel?

Autonomic nervous system
Correct Incorrect Correct answer

Parasympathetic nervous system
Correct Incorrect Correct answer

Extrinsic nervous system
Correct Incorrect Correct answer

Enteric nervous system
Correct Incorrect Correct answer

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Question 3 of 10

3. Question

The large bowel, the colon, has a number of functions. Which ONE of the following is not a function of the colon?

Storage
Correct Incorrect Correct answer

Absorption
Correct Incorrect Correct answer

Chyme production
Correct Incorrect Correct answer

Elimination
Correct Incorrect Correct answer

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Question 4 of 10

4. Question

During defaecation, if the correct posture on the toilet is adopted which muscle relaxes to widen the anorectal angle and open the anal canal?

Puborectalis
Correct Incorrect Correct answer

Gracilis
Correct Incorrect Correct answer

Rectus abdominus
Correct Incorrect Correct answer

External oblique
Correct Incorrect Correct answer

Correct

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Question 5 of 10

5. Question

Which nerve(s) is/are responsible for defaecation by stimulating the rectum and anal canal to contract and the internal muscle to relax?

Cranial nerves
Correct Incorrect Correct answer

Hypogastric nerves
Correct Incorrect Correct answer

Pelvic nerves
Correct Incorrect Correct answer

Pudendal nerves
Correct Incorrect Correct answer

Correct

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Question 6 of 10

6. Question

When there is no sacral arc reflex what bowel dysfunction will the individual suffer from?

Reflex bowel
Correct Incorrect Correct answer

Autonomic dysreflexia
Correct Incorrect Correct answer

Anorectal fistula
Correct Incorrect Correct answer

Flaccid bowel (atonic bowel)
Correct Incorrect Correct answer

Correct

Incorrect
Question 7 of 10

7. Question

What happens when the gastro-colic reflex is initiated?

You start to feel hungry, needing something to eat and your stomach starts to gurgle
Correct Incorrect Correct answer

Excessive burping and/or flatulence
Correct Incorrect Correct answer

Epigastric discomfort
Correct Incorrect Correct answer

Mass peristalsis leads to an urge to have your bowels open 'call to stool' often within 20-30 minutes
Correct Incorrect Correct answer

Correct

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Question 8 of 10

8. Question

If an individual presents with the following symptoms what is the most likely diagnosis? – feeling of incomplete bowel emptying, straining most of the time, hard pellet-like stool, difficult evacuation.

Constipation
Correct Incorrect Correct answer

Overflow faecal incontinence
Correct Incorrect Correct answer

Irritable bowel syndrome
Correct Incorrect Correct answer

Crohn's disease (a type of inflammatory bowel disease)
Correct Incorrect Correct answer

Correct

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Question 9 of 10

9. Question

Which ONE of the following is not a possible cause of loss of anorectal angle?

Trauma at childbirth
Correct Incorrect Correct answer

Rectal prolapse
Correct Incorrect Correct answer

Constipation
Correct Incorrect Correct answer

Haemorrhoids
Correct Incorrect Correct answer

Correct

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Question 10 of 10

10. Question

What is meant by faecal impaction with overflow?

Hard faeces forms a plug in the rectum, which faecal fluid bypasses
Correct Incorrect Correct answer

When you have your bowels open you pass urine at the same time
Correct Incorrect Correct answer

The toilet gets blocked
Correct Incorrect Correct answer

You get hard and soft stools passed at the same time
Correct Incorrect Correct answer

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