Causes
AD is caused by an irritant below the level of injury, usually related (but not limited) to
bladder or bowel function
The most common cause
(in 80% of cases)
is over-distension of the BLADDER:
- This may be due to a blocked urinary catheter or kinked tubing.
- This is easily rectified by repositioning the tubing or changing the catheter promptly, using a lidocaine based lubricating gel to reduce pain and dull sensations.
- Over distension may also be due to insufficient frequency of intermittent catheterisation.
- Other urinary tract triggers include infection, bladder spasm or possibly bladder stones.
The 2nd most common cause
(10% of cases)
is related to the BOWEL:
- This may be due to constipation (less frequent bowel movements and/or harder faeces/stool), rectal distension (stretching of the back passage), overloaded bowel or haemorrhoids (piles) and anal fissures (small tears in the back passage).
- An overloaded rectum should be evacuated (faeces / stool removed) immediately using a lidocaine based lubricating gel and gentle digital stimulation to encourage the rectum to empty.
- Laxatives should be increased as directed by your doctor and bowel care should be carried out on a daily basis until any constipation has been resolved.
- Haemorrhoids should be treated with medications available from the pharmacist or on prescription from the GP.
It is sometimes easier to remember causes by the five B’s:
Examples:
irritation of the bladder wall, urinary tract infection (UTI), blocked catheter, overfilled collection bag or full bladder
Examples:
Distended or irritated bowel, constipation or impaction, haemorrhoids
Examples:
Sunburn, hot objects, scalds from hot water
Examples:
Bone fractures or sprains
Examples:
AD can be triggered by sexual activity, period pains, pregnancy, labour and delivery, ovarian cysts
Sexual/fertility issues – ejaculation, vibrostimulation
Epididymitis/orchitis (infection in male scrotum)
Sometimes if the cause cannot be found you need to “think outside the box”
Although more uncommon than the others shown on this page, some examples may be:
- Gastrointestinal problems/abdominal pain – eg Gastric or Duodenal ulcer, cholecystitis, colitis appendicitis, inflammation of the gallbladder or pancreatitis
- Surgical and medical procedures
- Deep Vein Thrombosis (DVT) or Pulmonary Embolus (PE)
(ie blood clot in legs or lungs)
