Overactive Bladder

Going to the Bathroom All the Time?

Overactive BladderHow often do you think about your bladder or the frequency with which you urinate daily? Most people don’t think about it unless they are experiencing a problem like overactive bladder (OAB). One of the most noticeable symptoms of OAB is leaking urine or urinary incontinence.

Overactive bladder isn’t just an annoyance because you need to always be close to, or know where the closest bathroom is, but could be a symptom of a more serious medical condition. Not only is this an issue but an additional challenge is most people are embarrassed by the condition and will suffer in silence rather than speak up to their doctor.

If you’re experiencing bladder control issues, know you’re not alone as this is a condition impacts more than 30 million Americans.

What are the symptoms of overactive bladder?

Keep in mind that if it’s summer and if you are drinking more water than you usually do, you will urinate more frequently. Make note of frequency and how much water you’re ingesting before you worry that your frequent bathroom trips are because of OAB or because you’re drinking more water. Incontinence can also be a sign that you’re drinking too many caffeinated beverages daily. However, there are times when the underlying cause of OAB is a sign of something more medically serious.

When you have been diagnosed with OAB, your doctor will have noticed that there are sudden contractions of the muscles in the bladder and when you have overactive bladder syndrome, the muscles that control bladder function act involuntarily. These involuntary contractions lead to loss of bladder control or incontinence.

OAB sufferers can experience urine leakage of as little as several drops or as much as several ounces. Forty to 70% of urinary incontinence sufferers have overactive bladder.

How do you decide “how much is too much”?

Certainly, if you lose control of the ability to hold in urine at any time that can be an issue or if you are waking up frequently at night but also if you urinate more than eight times per day.

The types of overactive bladder

There are two types of OAB:

1. “Dry” overactive bladder. This is when you have an urgent and sudden need to urinate frequently

2. “Wet”overactive bladder. This is a condition when you have both the urgent need to urinate and bladder leakage.

Either of these conditions can occur without any other health condition being present. Studies show that 60% of OAB patients have “dry” OAB and 40% have “we” symptoms.

Individuals who have an overactive bladder suffer life disruptions from waking up frequently at night and from constantly having to go to the bathroom. Not knowing when you will need a bathroom and knowing you may lead urine, leads many sufferers to live in an almost constant state of stress because of it.

What are the causes and risk factors of OAB?

Overactive bladder can impact both men and women and it can occur in any stage of life. It is more common in older adults; the occurrence of OAB in individuals younger than 5-years-old is fewer than 10%.

Some of the risk factors include:

1. Nerve damage. If there is no nerve damage, a functioning bladder will hold urine until it is full and will prompt the individual to urinate when full. When there is nerve damage to the muscles surrounding the urethra, the area is “loose” and urine leakage can occur. Reasons for nerve damage to the urethra can be caused by: Multiple sclerosis, diabetes, back or pelvis surgery, a herniated disc, radiation, stroke and others.

2. Weak pelvic muscles. When a woman gives birth it can impact the strength of her pelvic muscles and lead to urinary incontinence. When the pelvic floor muscles are compromised, it can lead to the bladder sagging and to the stretching of the urethra and that can lead to urinary leakage.

3. Diuretic medications. Water pills, aka diuretics, are commonly prescribed for those with high blood pressure. This medication causes your body to get rid of salt and water more quickly through urine and this can lead to more frequent bathroom trips.

4. Menopause. When a woman goes through menopause, her body loses estrogen and that is what makes up the bladder tissue. Overactive bladder is more likely then, whether due to aging or loss of estrogen or a combination.

5. Additional weight. Being overweight can lead to overactive bladder and bladder leaking. Excess weight puts additional pressure on the bladder making OAB a possibility.

6. Other issues. There are other underlying symptoms that can include: urinary tract infection, benign prostatic enlargement, bladder tumors or bladder stones. Sometimes, though there is no apparent underlying cause; when this occurs it is called idiopathic overactive bladder.

Treatment options

Conventional treatment for OAB includes prescription medications to calm the bladder. There are side effects to many of the regularly prescribed medications including:
1. Constipation
2. Dry mouth
3. Drowsiness
4. Dizziness
5. Blurred vision
6. BOTOX injections – this is considered an extreme treatment method and is not without its potentially harmful side effects

It’s hoped that even the most conventional physician will offer suggestions on lifestyle modifications before he or she turns to medications.

What are natural ways to treat overactive bladder?

We always advocate for natural treatments and “cures” whenever possible. Here are a few ways in which you can naturally treat an overactive bladder.

1. Dietary changes. Now that you know that foods and drinks can contribute to overactive bladder symptoms, making lifestyle changes to eliminate or cut back on the amount you eat or drink of these foods and drinks can alleviate symptoms. Cut back on: caffeinated foods and drinks, alcohol, carbonated beverages, artificial sweeteners, spicy foods, high sugar foods, milk and cranberry juice. Chances are you have heard that cranberry juice is good for bladder health – and it is – as long as you don’t have OAB. You’ll notice that these dietary changes are those we also advocate for overall healthful living.

In my experience as a physician, a frequent cause of overactive bladder is a food sensitivity or intolerance. Allergy testing for these foods an removing them from your diet can have powerful effects. We have also seen people see improving in symptoms after elimination diets or fasting mimic diets. Common on allergens are wheat, dairy, corn, eggs, peanuts and soy. Removing these 100% from your diet for 2 to 3 weeks may be all that is needed to see significant improvement in bladder spasticity.

2. Pelvic floor exercises aka kegels. These exercises can help strengthen the pelvic floor. A kegel can be done anytime anywhere and are a benefit for men and women. When you perform a kegel you are triggering a reflex mechanism that relaxes the bladder. When you feel an urge to urinate, perform a kegel to help settle the bladder.

3. Limit fluid intake. This may seem a mixed message as you need to drink enough water to avoid dehydration, but you need to limit your fluids if you’re experiencing OAB. If you drink prior to bedtime you will be woken during the night to eliminate urine. If you have OAB, you should avoid liquids after 6 pm.

4. Double void before bedtime. If you normally urinate before bedtime, try to urinate twice. Use the toilet, then brush your teeth, walk the dog, or perform your usual bedtime routine – then urinate again.

5. Retrain your bladder. When you schedule bathroom visits and delay urination as long as possible you are “retraining” your bladder. Start by keeping a journal of how many times you have the urge to urinate and how many trips you take to the bathroom. Begin scheduling your bathroom trips; try to add on fifteen minutes from the time you feel the urge, until you actually eliminate. Over time, increase the amount of time between when you feel the urge and when you urinate.

6. Acuptuncture. A study on twenty patients who received acupuncture once a week for ten weeks showed a 77% “cure” rate on those with idiopathic detrusor instability (IDI). There is a strong correlation between IDI and OAB.

7. Stop smoking. There are myriad health reasons to stop smoking, but another is that tobacco irritates the bladder and can increase the risk of bladder cancer. Smoking leads to coughing and that can lead to “stress incontinence.” If you’re dealing with OAB, this is another reason to stop smoking.

The importance of a proper diagnosis

It is important that you receive a proper diagnosis and for your doctor to rule out other health conditions like bladder cancer, enlarged prostate or urinary tract infections (UTI). Keep in mind that the frequent and sudden urge to urinate are both symptoms of OAB and a UTI; with a UTI you may see blood in the urine and experience pain and discomfort while urinating. OAB symptoms are continual and UTI symptoms occur suddenly and will clear up with treatment.

OAB bottom line

Don’t suffer in silence with urinary incontinence or with frequent urges to urinate or with bladder leakage. Talk with your physician.

And while most people seem to be happier to take a pill than they are to make lifestyle and dietary changes, but we advocate living a healthier life through good, clean living! Not only will you spend less time in the bathroom but your overall health will improve.