An overactive bladder occurs when the muscles of the bladder start to contract involuntarily, even when the amount of urine in the bladder is low. This leads to frequent and sudden urges to urinate.
An overactive bladder (OAB) can cause considerable disruption to everyday life. People with an OAB may experience urinary incontinence and wake up multiple times during the night (nocturia).
There are several possible underlying reasons for an OAB. These include:
- Neurological disorders that affect the nervous system, such as multiple sclerosis or Parkinson's disease.
- Diabetes. One of the main symptoms of both type 1 and type 2 diabetes is the frequent passing of large amounts of urine, known as polyuria.
- Urinary tract infections.
- Diuretic medications, commonly referred to as water pills. People with cardiac conditions often take diuretics to lower blood pressure, but these drugs also increase urination.
- Older age and cognitive decline.
- Excessive intake of caffeine or alcohol.
Making alterations to diet and lifestyle can have an impact on an overactive bladder. The recommended dietary changes include:
For people with an OAB, there is a fine line between drinking too much and not drinking enough.
People should try to stick to the recommended 6 to 8 glasses of fluid each day. The body can regulate liquid in the body, excreting unwanted fluid via the urine. Therefore, exceeding the recommended amounts is likely to lead to more time in the bathroom.
However, it is important not to get dehydrated as this will result in more concentrated urine, which may further irritate the bladder lining. It is possible to monitor hydration levels by checking the color of the urine. Dark yellow urine could be a sign of dehydration.
It is best not to drink a lot at any one time, but to spread drinks across the course of the day. It is a good idea to stop drinking a couple of hours before bedtime to minimize the likelihood of getting up in the night.
Caffeinated drinks include tea, coffee, and carbonated drinks such as cola. Caffeine is a diuretic, which encourages the release of water in the urine. This can make the symptoms of an OAB worse.
The evidence suggesting that people with OAB should avoid caffeine is varied and mainly anecdotal. However, some people may find it helpful to avoid or limit caffeinated drinks and opt for water, diluted juice, and herbal teas instead. This may improve symptoms of urgency and frequency but not incontinence.
Alcohol acts as a diuretic and increases urine production, so it is likely to make symptoms worse for people with an OAB. It may be a good idea to cut back on alcohol or avoid it completely for a while to see if symptoms improve.
Certain foods, including spicy ones, might irritate the bladder. For some people with an OAB, it is best to avoid them.
Citrus fruits are also believed to irritate the bladder, which might cause painful urination.
High fiber foods
Studies have shown an association between constipation and an OAB. Adults with urge incontinence who also suffer from constipation should seek dietary advice on how to encourage regular bowel movements. Foods high in soluble fiber, which include oats, bran, vegetables, and legumes, may help with constipation.
Those with an OAB may have recognizable symptoms, but each person responds differently to treatment. Other suggestions that may help reduce symptoms include:
Strengthening the pelvic floor muscles
The pelvic floor muscles are located next to the bladder and provide support and strength to the bladder.
Regular physical activity may strengthen the pelvic floor muscles and help decrease the risk of developing urge incontinence. However, it is also possible that heavy physical exercise may aggravate symptoms, so people should be careful not to overexert themselves.
Smoking can irritate the bladder and is a risk factor for bladder cancer.
Alongside the pelvic floor muscle exercises, bladder training aims to make the bladder muscles stronger so it can hold urine for longer periods of time.
Reaching and maintaining a healthful weight
Being overweight or obese has been identified as a risk factor for urinary incontinence.
Adults who are overweight are encouraged to lose weight and maintain weight loss by exercising regularly. They should also eat more fruits and vegetables, choose wholegrain carbohydrates, and include lean proteins, such as fish, lentils, and beans, in their diet.
Doctors frequently prescribe drugs called antimuscarinics for an OAB. These work on the muscles surrounding the bladder to help control the random contractions that cause frequent urination. However, they have some unfavorable side effects such as constipation and dry mouth.
It is possible that nerve stimulation or Botox injections may be a way of controlling the signals between the brain and bladder.
In rare cases, people may need surgery to correct bladder abnormalities and reduce the symptoms of OAB.
Using of absorbent pads or undergarments
In cases where surgery or medications could be risky, for example when advancing age is the cause of the OAB, it may be preferable to consider management techniques to absorb urine.
An OAB can disrupt daily life. Making healthier choices, including following a balanced diet, can help maintain a healthy bladder. Keeping a food diary can be a helpful way to notice any correlation between diet and symptoms.
It is recommended to seek the advice of a medical professional to talk through treatment options.
These may include medication, exercises to train and strengthen the bladder, and behavioral and lifestyle changes. A combination of OAB treatments is likely to have the best effect in the long-term.