Overactive Bladder Explained
Video Transcript
Have you ever had the sudden urge to go to the bathroom and your bladder just will not wait?
I'm Joy Behar. And talking with an expert about what you can do about that,
what is going on in your body.
Dr. Schiff, let me ask you something.
What exactly does it mean, OAB? What is that?
Jonathan Schiff, MD:OAB stands for overactive bladder. And the most basic way to think about it is you just need to go to the bathroom more frequently and more urgently than you'd like to. And in reality, this problem affects millions of people. Somewhere between 15 and 20 million people are affected by overactive bladder and/or incontinence. And it's probably even more than that because there are still a lot of people who won't mention it to their doctor. By the way, I have this issue.
Joy Behar: But you're saying this many people just in this country. Imagine what it's doing in India and China. Billions of people are leaking.
Jonathan Schiff, MDThat's correct.
Joy Behar: Well, that happens to a lot of women in a certain age bracket. So are those the people who are most affected by it?
Jonathan Schiff, MD: So women at all ages really are affected by it. It tends to increase in frequency and prevalence as women get a little bit older. But men are also affected by it too.
Joy Behar: They are?
Jonathan Schiff, MD: Certainly. It happens to most men once they hit their 40s and 50s where their prostate start to enlarge. But I have a lot of young men that I take care with this problem as well.
Joy Behar: It's funny because most of the men I know are like camels. And they can go on long trips. They never have to stop. And the women are constantly-- there's a McDonald's. There's a Chuck E Cheese, you know? And also in the middle of the night. That's when it really happens to me.
Jonathan Schiff, MD: Well, so a lot of people have that problem-- men and women in the middle of the night for a couple of reasons-- one of which is your body tends to produce a little bit more urine overnight and also that you have less to distract you at night. So you're sleeping. You wake up. The first thing you'll sort of feel is that your bladder will be a little bit full. And that will create this urge to then rush to the bathroom.
Joy Behar: I think that with me, I feel like I have to pee badly. And that wakes me up. That's really an urgent feeling. I'm like I've got to go to the bathroom now
Jonathan Schiff, MD: Well, if it's something that bothers you on a consistent basis, I advise most of my patients to limit their fluid intake after dinner and really cut it off about three hours before bed to give your body a chance to process that liquid. Where it becomes OAB is when it becomes a problem that affects your life on a consistent basis.
Joy Behar: So is there such a thing as retraining? Is there a way to stop it? Without medication?
Jonathan Schiff, MD: Absolutely. So what I always start with in the clinical setting is I always start with the easy, noninvasive stuff. And I tell people, look, if you recognize that there are certain things that trigger these urges, let's try to avoid them. For some people, it's a lot of coffee. For some people, it's alcohol. For some people, it's chocolate. Like all the good things in life. But if you do them in moderation, they don't generally have a problem. The second step is to say, look, if you have to rush to the bathroom every two hours, let's try to make it two hours and 15 minutes and go almost on like a schedule almost like when we were kids learning how to go to the bathroom.
Joy Behar: You mean control it for an extra 15 minutes. To sort of train yourself.
Jonathan Schiff, MD: Right, like exercise.
Jonathan Schiff, MD: And then above that we have Kegel exercises.
Joy Behar: Oh, yeah, the old Kegels.
Jonathan Schiff, MD: Yeah, they work. They really do work. They help with not just leakage, but they also help with this urgent feeling.
Joy Behar: And you can do them while you're having breakfast?
Jonathan Schiff, MD: You could do them right now if you wanted to.
Joy Behar: I am doing them right now.
Joy Behar: So doctor, tell me, what's the difference between overactive bladder and incontinence? Which is a more serious thing, isn't it?
Jonathan Schiff, MD: Yeah, I think that's a great question because they often get confused. OAB, or overactive bladder, is really just the sensation of urgency-- of feeling like you need to rush to the bathroom and a frequency. Incontinence is where you really begin to leak urine. And the incontinence can be in of two broad categories. One is the classic stress which is coughing, sneezing, standing up.
Joy Behar: OK, let me get this straight now. So you're having a dinner. You sneeze. And you leak a little. That's considered incontinence?
Jonathan Schiff, MD: That's considered incontinence. That's stress incontinence. Urge incontinence is you'll have an urge to get to the bathroom. And you just can't suppress the urge and some urine will leak out. It could be a small amount. It could be a large amount.
Joy Behar: This is a difficult topic for people to talk about. But it's really not that-- it's not that difficult.
Jonathan Schiff, MD: No. An overactive bladder doesn't have to slow you down. A little understanding can go a long way. Talk to your doctor about what you can do. Tell your doctor what's going on. And get the help you need.
Jonathan Schiff, MD:OAB stands for overactive bladder. And the most basic way to think about it is you just need to go to the bathroom more frequently and more urgently than you'd like to. And in reality, this problem affects millions of people. Somewhere between 15 and 20 million people are affected by overactive bladder and/or incontinence. And it's probably even more than that because there are still a lot of people who won't mention it to their doctor. By the way, I have this issue.
Joy Behar: But you're saying this many people just in this country. Imagine what it's doing in India and China. Billions of people are leaking.
Jonathan Schiff, MDThat's correct.
Joy Behar: Well, that happens to a lot of women in a certain age bracket. So are those the people who are most affected by it?
Jonathan Schiff, MD: So women at all ages really are affected by it. It tends to increase in frequency and prevalence as women get a little bit older. But men are also affected by it too.
Joy Behar: They are?
Jonathan Schiff, MD: Certainly. It happens to most men once they hit their 40s and 50s where their prostate start to enlarge. But I have a lot of young men that I take care with this problem as well.
Joy Behar: It's funny because most of the men I know are like camels. And they can go on long trips. They never have to stop. And the women are constantly-- there's a McDonald's. There's a Chuck E Cheese, you know? And also in the middle of the night. That's when it really happens to me.
Jonathan Schiff, MD: Well, so a lot of people have that problem-- men and women in the middle of the night for a couple of reasons-- one of which is your body tends to produce a little bit more urine overnight and also that you have less to distract you at night. So you're sleeping. You wake up. The first thing you'll sort of feel is that your bladder will be a little bit full. And that will create this urge to then rush to the bathroom.
Joy Behar: I think that with me, I feel like I have to pee badly. And that wakes me up. That's really an urgent feeling. I'm like I've got to go to the bathroom now
Jonathan Schiff, MD: Well, if it's something that bothers you on a consistent basis, I advise most of my patients to limit their fluid intake after dinner and really cut it off about three hours before bed to give your body a chance to process that liquid. Where it becomes OAB is when it becomes a problem that affects your life on a consistent basis.
Joy Behar: So is there such a thing as retraining? Is there a way to stop it? Without medication?
Jonathan Schiff, MD: Absolutely. So what I always start with in the clinical setting is I always start with the easy, noninvasive stuff. And I tell people, look, if you recognize that there are certain things that trigger these urges, let's try to avoid them. For some people, it's a lot of coffee. For some people, it's alcohol. For some people, it's chocolate. Like all the good things in life. But if you do them in moderation, they don't generally have a problem. The second step is to say, look, if you have to rush to the bathroom every two hours, let's try to make it two hours and 15 minutes and go almost on like a schedule almost like when we were kids learning how to go to the bathroom.
Joy Behar: You mean control it for an extra 15 minutes. To sort of train yourself.
Jonathan Schiff, MD: Right, like exercise.
Jonathan Schiff, MD: And then above that we have Kegel exercises.
Joy Behar: Oh, yeah, the old Kegels.
Jonathan Schiff, MD: Yeah, they work. They really do work. They help with not just leakage, but they also help with this urgent feeling.
Joy Behar: And you can do them while you're having breakfast?
Jonathan Schiff, MD: You could do them right now if you wanted to.
Joy Behar: I am doing them right now.
Joy Behar: So doctor, tell me, what's the difference between overactive bladder and incontinence? Which is a more serious thing, isn't it?
Jonathan Schiff, MD: Yeah, I think that's a great question because they often get confused. OAB, or overactive bladder, is really just the sensation of urgency-- of feeling like you need to rush to the bathroom and a frequency. Incontinence is where you really begin to leak urine. And the incontinence can be in of two broad categories. One is the classic stress which is coughing, sneezing, standing up.
Joy Behar: OK, let me get this straight now. So you're having a dinner. You sneeze. And you leak a little. That's considered incontinence?
Jonathan Schiff, MD: That's considered incontinence. That's stress incontinence. Urge incontinence is you'll have an urge to get to the bathroom. And you just can't suppress the urge and some urine will leak out. It could be a small amount. It could be a large amount.
Joy Behar: This is a difficult topic for people to talk about. But it's really not that-- it's not that difficult.
Jonathan Schiff, MD: No. An overactive bladder doesn't have to slow you down. A little understanding can go a long way. Talk to your doctor about what you can do. Tell your doctor what's going on. And get the help you need.