DEAR DR. DONOHUE: I have had loss of bladder control for well more than a year, and, as a result, I stay pretty much at home all the time. The doctor says that this happens to older women and there is nothing you can do for it. Do you have any suggestions? I am 67. – H.J.

ANSWER: Urinary incontinence – loss of bladder control – strikes older people, but 67 doesn’t seem old to me. Furthermore, there are many things that can be done for it.

It is important to identify the kind of urinary incontinence, for different kinds have different treatments. The kind that happens when a person coughs, laughs or strains to move a heavy object is called stress incontinence. It comes from the laxity of tissues supporting the bladder and weakness of the sphincter muscle that closes the urinary bladder’s drainage tube, the urethra. Kegel exercises help this kind of incontinence. To learn what muscles are the ones to exercise, stop the urinary stream while voiding. Those are the muscles to exercise. When not urinating, contract those muscles 10 times and repeat the exercise at least three times a day. Week by week, increase the number of contractions, the length of time the muscles are held contracted and the number of times a day the exercise is performed.

Urge incontinence comes from a bladder that empties well before it is completely full. People with urge incontinence have to dash for the bathroom innumerable times, and often they do not make it in time. Bladder training helps this kind of incontinence. People have to time the interval between bathroom visits and then increase the intervals by 15 minutes. They gradually increase the time between urinations until there is a space of three hours.

I have mentioned only two treatments. There are surgical procedures that can restore bladder control, and there are medicines, such as the Oxytrol skin patch, that also restore continence. Collagen injections around the urethra are another often-effective treatment. See a urologist or gynecologist before you lose another year of your life.

DEAR DR. DONOHUE: I am a 70-year-old female in good health. I have never had a colonoscopy, and there is no history of cancer in my family. Several close friends have had colon cancer. Is it time for me to have my colon checked? – B.W.

ANSWER: It was time to have your colon checked 20 years ago. The experts tell us to begin colon cancer screening at age 50, and colonoscopy is one of the best ways to have such screening. A colonoscope is a flexible, soft tube with a viewing lens that can traverse the entire 5 feet of the colon – the large intestine. The scope is equipped with instruments that can remove any suspicious polyps for microscopic examination.

Sigmoidoscopy is done with a viewing tube whose length is 2 feet (60 cm). It explores the lower part of the colon, where 65 percent of cancers occur. Coupled with yearly tests for blood in the stool, it yields valuable evidence for colon cancer.

Special barium enemas for X-ray detection of colon cancer are also useful.

The pamphlet on colon cancer explores this subject more deeply, as well as its detection and treatment. Readers can order a copy by writing: Dr. Donohue – No. 505, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I can accurately predict changes in the weather by the way my joints feel. They begin to hurt more than usual. I have osteoarthritis. My wife says I am crazy. Can you support me? – T.D.

ANSWER: Many arthritic patients say they can detect weather changes by an increase in joint pain. A drop in barometric pressure and a rise in humidity have been found to increase the pain of arthritic joints in two studies, so there is support for your claims.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.