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MSWA Bulletin Magazine Winter 2023

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Unravelling the mysteries of multiple sclerosis | Ambilympics champion Chris McEncroe takes home silver for Australia | John Robertson: Nurturing a decades-long vocation | Don't think of the pink elephants!


NURSING WATER, LIFE, THE UNIVERSE AND EVERYTHING! – PART 4 For part four of this series, we explore the important role water plays in digestive and urinary system health. ROCHELLE BROWN MSWA NEUROLOGICAL LIAISON NURSE Chronic Constipation Dehydration is one of the leading causes of chronic constipation. The food we eat makes its way through the body via the stomach to the large intestine (colon). If you don’t have enough water present in your body already, the colon soaks up water from the waste products present in the colon. This results in hard stool which is difficult to pass. An over-full bowel due to constipation can press on the bladder, reducing the amount of urine it can hold or make you feel like you need to pass urine urgently. Severe constipation is one of the most common causes of faecal incontinence. Hard bowel motions are difficult to pass and may cause a partial blockage higher in the bowel. This results in watery bowel motions flowing around the constipated stool without warning, which can be mistaken for diarrhoea. Adequate Hydration vs Infections A Urinary Tract Infection (UTI) is an infection in any part of your urinary system - your kidneys, ureters, bladder and urethra. The majority of UTIs are associated with the lower urinary tract i.e. the bladder and urethra. Increasing water intake will help women avoid UTIs. This widely held belief was backed by an independent study published in the Journal of the American Medical Association (JAMA). Women are at a greater risk of developing a UTI than men due to their shorter urethras. UTIs don’t always cause signs and symptoms in men and women. However, when they do, they may include: / A strong, persistent urge to urinate / A burning sensation when urinating / Passing frequent, small amounts of urine / Urine that appears cloudy / Urine that appears red, bright pink or cola-colored, a sign of blood in the urine / Strong-smelling urine / Flank pain (the area between the upper abdomen and the back) / Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone If you suspect you or someone you know may have a UTI, it is important to see a doctor as soon as possible, as there could be serious consequences if the infection spreads to your kidneys. In part five of our hydration series, you can learn more about continence and ways to help manage bladder and bowel dysfunction. Kidney Stone Disease The incidence of kidney stone disease is rising worldwide. Currently, increasing fluid intake is recommended as the most ideal prevention. However, to date there has been inconsistent evidence surrounding optimum volumes and types of fluid that affect stone formation. Stone formation has been directly associated with a lack of fluid intake and is by far one of the most common causes of kidney stone formation. Kidney stones are formed from minerals and salts present in the urine, which combine to create hard deposits inside the kidney. This is likely due to the effect low fluid intake has on the production of urine, which results in concentrated urine and therefore an increase in the concentration of these minerals and salts in the urine. Over 80 per cent of kidney stones are made up of calcium oxalate, whereas uric acid stones make up 8 – 10 per cent of stones worldwide. As we highlighted in the previous articles in this series, our bodies use some of the water that we drink for necessary processes, like digestion, and we also lose water through sweat. Urine volume is therefore not identical to fluid intake. For this reason, people who are prone to kidney stones may be directed by their doctor to increase their fluid intake. You might have seen advertisements in magazines or on social media promoting different types of water and listing their health benefits. So, you may ask if there is a ‘best’ type of water to prevent the formation of kidney stones. The answer is simple: there is no scientific data that demonstrates that one type of water is better than another in preventing kidney stones. The key to preventing kidney stones is to increase and maintain an adequate urine volume. Soft Drinks With this information in mind, you might think it is OK to include soft drinks towards your fluid intake. But beware! Research shows dark soft drinks such as cola have been shown to increase the risk of kidney stones. So, if water is not your ‘thing’ we recommend reading Gemma’s article Stay Hydrated this summer in our Summer 2023 Edition of Bulletin for her tricks of the trade on how to increase your fluids in a fun and tasty way. If you have recurrent kidney stones, you may need to follow a special diet. First, your doctor will run tests to find out what type of stones you form. From these, your doctor or dietician can determine which diet changes might be right for you. References: Kidney Stone Prevention: How Much water Should You Drink? K. McCallum (Jan 2023) The role of fluid intake in the prevention of kidney stone disease: A systematic review over the last two decades. Turk J Urol. (Nov 2020) 46 (Suppl 1): S92–S103. DOI: 10.5152/tud.2020.20155 Can drinking more water help women fight urinary tract infections? D. Sparks. (Oct 2018) Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections A Randomized Clinical Trial. JAMA Internal Medicine. T. M. Hooton, et al. (July 2018) Faecal Incontinence: Constipation. Continence Foundation of Australia. (Aug 2021) 18 19