Overactive Bladder
What is an overactive bladder?
Overactive bladder represents a constellation of symptoms that include:
- urinary urgency -- inability to postpone the need to urinate
- urinary frequency -- the need to urinate at least eight times per day
- urge incontinence -- leakage of urine when one gets the urge to urinate
- nocturia -- the need to get up and urinate at least two times per night
What causes an overactive bladder?
Urine leakage and bladder control problems can have many possible causes. These include:
- Weak pelvic muscles -- muscles that have become stretched and weak due to events such as pregnancy and childbirth.
- Medications, alcohol, caffeine -- alcohol can dull the nerves, affecting the signal to the brain, resulting in bladder overflow. Diuretics and caffeine can cause rapid bladder filling and may cause bladder leakage.
- Infection -- a urinary tract infection can irritate bladder nerves as well as the lining of the bladder and cause the it to squeeze without warning, in turn causing urinary urgency and leakage.
- Excess weight -- being overweight puts pressure on the bladder and contributes to urge incontinence.
- Nerve damage -- sending signals to the brain and bladder to empty at the wrong time. Diseases that can cause nerve damage include diabetes, Parkinson’s, multiple sclerosis, and stroke. Trauma that can cause nerve damage includes pelvic or back surgery, herniated disc, accidents causing direct damage to spinal or pelvic nerves, and radiation.
How is overactive bladder treated?
There are a number of different methods to treat bladder control problems. Your doctor will typically begin with a number of behavioral modification techniques are best suited to address the issues causing your bladder problems.
Behavioral Modification Techniques to Help Your Overactive Bladder
Monitor your diet
Eliminate or decrease foods or beverages that may worsen bladder symptoms. These include:- Tea
- Coffee
- Alcohol
- Chocolate
- Caffeinated soft drinks (even decaffeinated coffee and tea contain some caffeine)
- Citrus juices and fruits
- Tomatoes and tomato-based products
- Spicy and acidic foods and drinks
- Foods and drinks containing artificial sweeteners
Maintain bowel regularity
Constipation can place added pressure on the bladder and have a negative effect on bladder function. By keeping healthy bowel habits, you may be able to avoid constipation and help to lessen bladder symptoms. The following are some suggestions for maintaining bowel regularity:
- Increase fiber intake by eating foods such as beans, pasta, oatmeal, bran cereal, whole wheat bread, and fresh fruits and vegetables.
- Every morning take 2 tablespoons of this mixture: 1 cup apple sauce, 1 cup unprocessed wheat bran, and ¾ cup prune juice.
- Exercise to maintain regular bowel movements.
Maintain a healthy weight
Being overweight can add pressure on your bladder, which may contribute to bladder control problems.
Stop smoking
Cigarette smoking is irritating to the bladder muscle. Repeated coughing spasms due to smoker's cough can cause urine leakage.
Drink plenty of nonirritating fluids
People with bladder symptoms often drink fewer liquids so they don't have to urinate as often. You should regularly drink about 3 to 4 glasses of liquids per day. Try to spread them out as evenly as possible throughout the day. Drinking fewer fluids causes you to produce more concentrated (dark yellow, strong-smelling) urine.
Highly concentrated urine is irritating to the bladder and may actually cause more frequent urination. Limit your intake starting 2 or 3 hours before going to bed.
Decrease or eliminate beverages that may worsen bladder symptoms. These include tea, coffee, alcohol, caffeinated soft drinks, citrus juices, and drinks that contain artificial sweeteners.
Bladder retraining
When you have overactive bladder, over time your bladder muscles become conditioned to react in a certain way. By retraining these muscles, you can hold urine better. Bladder retraining involves working with a healthcare professional to learn how to resist or inhibit the feeling of urgency; postpone voiding; and urinate according to a timetable (rather than in response to a feeling of urgency). Bladder retraining involves learning to:
- Gradually increase the time between bathroom visits. If you normally go every hour, try to increase it to 1 hour and 15 minutes between visits.
- When you can maintain your new schedule without accident for 1 to 2 weeks, try increasing the time between bathroom visits by an additional 15 minutes until you reach an interval you feel comfortable with. The goal is to reach an interval of 2 to 4 hours between bathroom visits.
- Stick to the schedule as much as possible, whether you have to go or not.
Controlling the Urge
The key to bladder retraining is developing the ability to control urinary urges. When you experience a sudden urge, the following strategies may help:
- Stop what you are doing and stay put. Sit down when possible, or stand quietly. Remain very still. When you are still, it is easier to control your urge.
- Squeeze your pelvic floor muscles quickly several times. Do not relax fully in between.
- Relax the rest of your body. Take a few deep breaths to help you relax and let go of your tension.
- Concentrate on suppressing the urge feeling.
- Wait until the urge subsides.
- Walk to the bathroom at a normal pace. Continue squeezing your pelvic floor muscles quickly while you walk.
Be patient. An entire bladder retraining program usually takes at least 6 to 8 weeks to produce results.
Talk to your doctor about the best way to manage the symptoms of overactive bladder.
What are other options for treating overactive bladder
if behavioral modification does not work?
He or she may recommend a combination of overactive bladder medication and bladder retraining to help you achieve the best outcome. If this does not work, there are surgical options that can be pursued for treating medical refractory overactive bladder.
