BLAASKLACHTEN – incontinentie bij vrouwen vanuit een Oosters en een Westers perspectief

Barbara Blok is huisarts (niet praktiserend) en Annemiek Groen heeft zich verdiept in de Traditionele Chinese Geneeskunde (TCG). Ze is Qigongdocent en bestudeert de Acupunctuur.

Zij gaan samen in gesprek.

 

Barbara:

“Ik wil graag eerst vertellen welke twee vormen van incontinentie bij vrouwen het meest voorkomen en hoe wij in het Westen gewend zijn deze vormen te behandelen.

 

Er zijn vrouwen die urine verliezen bij hoesten, lachen of sporten. Dat noem je ‘stress-incontinentie’. Mogelijke oorzaken kunnen zijn: een zwakke sluitspier, zwakke of juist te sterk werkende bekkenbodemspieren, oestrogeentekort (bijvoorbeeld tijdens de overgang), een operatie in de onderbuik, bevallingen enz. In zo’n geval helpt het om af te vallen en je bekkenbodemspieren te trainen met bepaalde oefeningen. Je kan daarbij ook een ring in je vagina dragen (een pessarium) of bij ernstige klachten kiezen voor een operatie, waarbij je een plasbuis-bandje krijgt. 

Untitled design kopie

Er zijn ook vrouwen die ineens heel erg nodig moeten plassen en dan de wc niet op tijd halen. Dat noem je ‘urge-incontinentie’. Mogelijke oorzaken kunnen zijn: een urineweginfectie, hyperactiviteit van de blaas, een belemmering van de urinelozing door bijvoorbeeld blaasstenen of tumoren (de kans is klein), maar ook bijvoorbeeld door (bijwerkingen van) geneesmiddelen. Na een lichamelijk onderzoek en onderzoek van de urine wordt ook hier in eerste instantie afvallen geadviseerd en een specifieke blaastraining waarbij je oefent om te wachten met plassen. Helpt dat na drie maanden onvoldoende dan moet er verder gekeken worden en zijn er eventueel medicijnen die voorgeschreven kunnen worden. Deze medicijnen kunnen bijwerkingen geven zoals bijvoorbeeld hoofdpijn, een droge mond, slechter zien en een harde ontlasting, maar dat hoeft niet het geval te zijn. 

Het is wat mij betreft belangrijk dat een vrouw met incontinentie-klachten naar de dokter gaat, dat er gekeken wordt naar de oorzaak en dat de juiste behandeling geadviseerd wordt. Het is namelijk in veel gevallen te verhelpen of sterk te verminderen.

Annemiek, hoe zou jij incontinentie bij vrouwen behandelen?”

 

Annemiek:

“In de Traditionele Chinese Geneeskunde (TCG) worden klachten niet uitgedrukt in een verzamelnaam als ‘blaasontsteking’ of ‘incontinentie’ maar in een disbalans in het lichaam. Net als in de Westerse Geneeskunde is de functie van de blaas om de urine vast te houden. Als er onvoldoende energie is om de urine binnen te houden, d.w.z. als de blaas lekt, dan is er ergens in het lichaam een disbalans. De behandelaar gaat op zoek naar die disbalans door een uitgebreid vraaggesprek met de patiënt. Tijdens dit vraaggesprek wordt de patiënt nauwkeurig geobserveerd, de pols wordt gevoeld en de tong wordt bekeken, zoals ik in ons voorgaande gesprek heb uitgelegd. De disbalans wordt dan aan de hand van de verzamelde informatie uitgedrukt in een diagnose.

In de Chinese Geneeskunde staat een disbalans nooit op zichzelf. Alle processen hebben invloed op elkaar, want het hele lichaam, met alle organen, bloed, vloeistoffen, en ook de geest, wordt als één geheel gezien. Zo is de (Chinese) milt bijvoorbeeld verantwoordelijk voor het stijgen van de energie. Bij het lekken van de blaas voert de (Chinese) milt zijn functie niet goed uit, want in plaats van de energie omhoog te houden, lekt het naar beneden. Daarom moet ook de (Chinese) milt betrokken worden in het behandelplan. En ook de nieren zijn betrokken, want de nieren ondersteunen de blaas in z’n functie om de onderste poort goed te openen en te sluiten. De nieren en blaas horen bij elkaar als het orgaansysteem dat hoort bij het Waterelement. Beide spelen een belangrijke rol bij het reguleren van de vloeistoffen. In de theorie van de Chinese geneeskunde zijn de nieren de opslagplaats van onze vitale energie. Ze zorgen voor de stuwende Qi-energie. Dus ook de nier wordt betrokken bij het behandelplan. 

Naast acupunctuur zijn er nog andere behandelmethoden die geadviseerd kunnen worden. Zoals bijv. het gebruik van Yoni Jade eitjes bij incontinentieklachten als gevolg van verzwakte bekkenbodemspieren.”

 

Barbara:

“Wat voor eitjes?”

 

Annemiek:

“Yoni Jade eitjes. Die worden gebruikt in een eeuwenoude therapie die al sinds het Taoïsme in China wordt toegepast. Dat het heel goed werkt, blijkt wel uit het feit dat een Nederlandse Westerse arts op deze therapie een cursus heeft ontwikkeld en deze aanbiedt aan vrouwen met urineverlies. Je kunt deze cursus tegen een bepaald tarief online volgen. Dat legt deze arts bepaald geen windeieren, haha…. “

 

Barbara:

“Dat klinkt als een lucratieve business. Maar wat doe je met die eitjes? Moet je ze slikken?”

 

Annemiek:

“Slikken? Nee joh, haha, het zijn eitjes van het edelsteen Jade, Je brengt zo’n eitje vaginaal in.”

 

Barbara:

“Haha! Ik begrijp het nu pas. Je stopt dus een ei in je vagina en hiermee kan je je bekkenbodemspieren trainen. Ik plas bijna in mijn broek van het lachen omdat ik er even geen beeld bij had. Maar het klinkt als een goede manier om je spieren te trainen. Of het beter is dan oefeningen zonder ei of het dragen van een pessarium zou ik niet weten.

Maar hier stimuleer je niet de (Chinese) nieren en de (Chinese) milt mee, neem ik aan. Kan je hier nog wat meer over vertellen?”

 

Annemiek:

“Haha… dat in je broek plassen van het lachen is ook incontinentie. 

Voor de behandeling met acupunctuur duiken we toch weer het specifieke vak van de TCG diagnostiek in. De disbalans wordt namelijk uitgedrukt in een TCG medische term die ons Westerlingen eigenlijk niets zegt. De diagnose kan bijvoorbeeld luiden: Nier Qi Leegte. En voor de behandeling van de leegte van de nieren, van het energietekort, kies je dan acupunctuurpunten met een versterkende werking voor de Nieren, maar ook voor de (Chinese) Milt die de energie beter omhoog moet gaan houden, en uiteraard kies je ook punten die regulerend werken op het urineren, en punten die invloed hebben op qi (energie). 

Daarnaast wordt bij deze klacht ook veel gewerkt met kruiden zoals moxa (bijvoetkruid). Er zijn dus diverse mogelijkheden. En uiteraard geldt altijd het advies om bij medische klachten naar je huisarts te gaan. Jij noemde ook al verscheidene opties om incontinentie aan te pakken.”

 

Barbara:

“De benadering van de TCG blijft voor mij nog steeds moeilijk te bevatten. Maar voor acupunctuur geldt in ieder geval dat het niet schaadt. Dat is overigens niet perse het geval voor kruiden. Planten kunnen bijwerkingen, contra-indicaties en interacties met andere geneesmiddelen hebben. Houden jullie hier rekening mee?”

 

Annemiek:

“Ik heb zelf geen kennis over Chinese kruiden die voorgeschreven kunnen worden. Daarvoor moet je een zware studie van een aantal jaren volgen. Maar ik heb je (weer) op het verkeerde been gezet met mijn opmerking over moxa, ofwel bijvoetkruid. Moxa is een behandelmethode die boven de huid wordt toegepast, boven een acupunctuurpunt. Nooit direct op de huid, maar wel met bijvoorbeeld een schijfje gember er tussen, of de acupuncturist houdt het moxa zelf vast boven het acupunctuurpunt. Het wordt dus niet ingenomen.

Er zijn een aantal punten waar je moxa niet bij mag gebruiken, omdat het tegenstrijdig is aan de werking van het punt, of omdat het punt te dicht bij een bloedvat ligt, of omdat het punt in een kwetsbaar gebied ligt. Iedere acupuncturist is van die punten op de hoogte. Ook bij zwangerschap mag moxa niet gebruikt worden.

Moxa werkt heel erg verwarmend, dus als een persoon bijvoorbeeld heel koud is, het inwendig heel koud heeft, dan werkt het bijzonder snel om de kou er uit te drijven. Maar het is niet de bedoeling om het in te zetten als iemand koortsig is, of last heeft van ontstekingen. Dan is die persoon al warm genoeg.” 

 

Barbara:

“Weer wat geleerd van de TCG! Dank je. Wat mij betreft hebben we dit onderwerp nu voldoende vanuit beide kanten belicht. Ik ben heel benieuwd of onze lezers reacties of vragen hebben. Stel ze gerust. We zullen alles beantwoorden. Welk onderwerp stel je voor de volgende keer voor?”

 

Annemiek:

“Het lijkt mij wel leuk om naar het mentale stuk van het orgaansysteem ‘Blaas en Nieren’ te kijken. TCG heeft een holistische kijk op gezondheid; waarbij lichaam en geest onlosmakelijk met elkaar verbonden zijn en elkaar beïnvloeden. Als het Blaas-Nieren systeem uit balans is, steekt de emotie angst de kop op. We kunnen de volgende keer angst gerelateerde problematiek bespreken?”

 

Barbara:

“Bedoel je hiermee bijvoorbeeld een angststoornis?”

 

Annemiek:

“Zo zou je het Westers kunnen noemen.” 

 

Barbara:

“Dat gaan we doen. Ik kijk er nu al naar uit!”



Heb je vragen of opmerkingen bij deze blog? We lezen het graag.

Met vriendelijke groeten, 

Barbara (https://lijfplein.nl / https://barbarablok.nl) en Annemiek (https://inbalansmetqi.nl)




















 

 

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