How can I tell if my complaints are a consequence of aging or an actual problem?

DEAR DOCTOR K: Every time I complain about a new medical issue, my husband says, "You're 84. What do you expect?" How do I know if my complaints are just a consequence of aging or if there's an actual problem?

DEAR READER: I'm not 84, but I ask myself that question regularly. You don't have to be a doctor to understand that new symptoms develop as we age. But some changes aren't a normal part of the aging process. I'll discuss some common age-related health changes, as well as changes that suggest there might be a problem.

What could cause fecal incontinence?

DEAR DOCTOR K: I'm in my late 50s, but I have fecal incontinence. What could be causing it?

DEAR READER: We begin having bowel movements soon after birth, and controlling the process soon thereafter. So it is a surprising and disturbing event when we cannot hold our stool long enough to reach the bathroom, or experience unexpected leakage of stool when we haven't felt any urge. You should know that there are many people with this problem.

How can I control mild urinary incontinence?

DEAR DOCTOR K: I have mild urinary incontinence. I've heard that something called "fluid management" can help.

DEAR READER: It can, and it's a simple concept. The less water in your bladder, the less pressure your bladder feels to urinate. For some people, eliminating excess fluid intake is all it takes to bring urinary incontinence under control.

What does urodynamic testing for incontinence involve?

DEAR DOCTOR K: I'm a 65-year-old woman with urinary incontinence. My doctor isn't sure what's causing it, so I need to have urodynamic testing. What information will this test give my doctor?

DEAR READER: Urodynamic testing is a series of tests that evaluate your urinary system in action. A doctor may want to do these tests if the cause of your incontinence isn't clear. Perhaps your symptoms point toward more than one type of incontinence. Testing is also recommended if standard treatments haven't helped.

How can I control bowel incontinence?

DEAR DOCTOR K: Sometimes my bowel movement leaks onto my undergarments. What can I do to control this?

DEAR READER: Take heart — you are not alone. Depending on how fecal, or bowel, incontinence is defined, some studies have found that 10 percent or more of adults in the United States (not including people living in institutions) have this condition. And there are many things you can do to prevent it.

Can “holding it” hurt your bladder?

DEAR DOCTOR K: This may seem like an odd question, but can "holding it" when you need to urinate damage your bladder? I sleep on the second floor of my house, but the only bathroom is on the first. Sometimes I just don't feel like getting up! Am I hurting myself?

DEAR READER: I'd say you're in good company — we've all "held it" before, for whatever reason. Many of my patients ask me the same question you have. I've even had a patient ask if her bladder could actually explode from holding it too long.