Living With Overactive Bladder

Always feel like you need a trip to the bathroom? It could be overactive bladder.

From the WebMD Archives

You're sitting in a meeting when you have the sudden urge to pee. Immediately. Or you can't sleep because your bladder wakes you up. Maybe you've canceled plans because you don't always make it to the bathroom on time. And you're embarrassed to talk about it.

No need to feel shame, says Maude Carmel, MD, assistant professor of urology at The University of Texas Southwestern Medical Center. "OAB [overactive bladder] is very common, and there are solutions." It affects nearly 4 in 10 women, according to the Urology Care Foundation.

OAB is not a disease but a treatable condition, distinguished by peeing often (more than eight times in 24 hours and more than one time at night), sudden urges to empty the bladder, and, for some women, incontinence. When you have OAB, your bladder contracts at the wrong time, sending signals to the brain telling it to empty before it's really full, Carmel explains.

Certain medications, neurological diseases, and aging can raise your risk of OAB. Here's what you can do:

Rethink your drink. "Anyone with OAB should probably limit herself to one or maybe two caffeinated drinks per day," Carmel says. Caffeine -- in coffee, green or black tea, chocolate, and sodas -- irritates the bladder and is a diuretic, "so it really just makes everything worse."

Limit alcohol (another diuretic) and artificial sweeteners, which also irritate the bladder, increasing how often you pee and feelings of urgency to do it.

Write it out. Keep a bladder diary—a log of what you drink, when you pee, and how much. It's a great tool for looking at how much you're drinking and when your OAB symptoms are worse, Carmel says.

Do kegels. When done right, these pelvic floor exercises strengthen the muscles that hold the bladder and help reduce OAB symptoms in women, says Carmel. "But you need to do them properly." Try stopping your urine mid-stream to learn the proper muscles. Then do 10 contractions two to three times a day, holding each contraction for 5 to 10 seconds.

Pee on a schedule. "Bladder retraining is very important," Carmel says. "It helps your bladder hold more urine before sending a signal to your muscles that it's time to go."

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Start by peeing every 2 hours, for example. If the urge comes before then, postpone peeing by doing kegels, Carmel says. If you can't make it to your scheduled time, do kegels and try postponing urination for 5 minutes.

Gradually increase the time between pee breaks, which will help retrain your bladder muscles.

Shed pounds. Studies show that losing weight helps against OAB symptoms. "The extra weight on the bladder can make it oversensitive," Carmel says.

One study showed that if you're overweight, losing 8% of your body weight -- about 17 pounds for women in the study -- reduced incontinence episodes by nearly half.

Fiber up. "You need to treat constipation if you have OAB," she says, "because if the rectum is full it will make the bladder feel full, causing it to contract abnormally." Eat more fiber-rich foods, such as fruits and vegetables, or try an OTC fiber product, she says.

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WebMD Magazine - Feature Reviewed by Brunilda Nazario, MD on June 23, 2014

Sources

SOURCES:

AUA Foundation: "Overactive Bladder." Urology Care Foundation. 

Carmel, Maude, MD.

Robinson, D. Maturitas. February 2012.

Cleveland Clinic: "Overactive Bladder." 

National Association for Continence: "Overactive Bladder," "Urge Incontinence. Overactive Bladder," "Diet and Daily Habits. Can this affect your bowel or bladder control?" "Bladder Retraining." 

NIDDK: "Urinary Incontinence in Women."

UptoDate: "Treatment and Prevention of Urinary Incontinence in Women." 

 Subak, L. New England Journal of Medicine, 2009.

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