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This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Even the smallest distance to the toilet is a problem for people with OAB. With urge incontinence, you may also need to urinate often. The need to urinate may even wake you up several times a night.
Some people with urge incontinence have a strong desire to urinate when they hear water running, as the psychological effect starts the chemical reaction in the body causing the messages to the brain signal to empty the bladder. Urge incontinence may be aggravated by a urinary tract infection or by anything that irritates the bladder. It can also be caused by bowel problems or damage to the nervous system associated with multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, stroke or injury.
Lets look at the mechanics and how a normal functioning bladder works differs from how an overactive bladder works.
Mechanism of a normal bladder
A healthy adult bladder is capable of holding around 500ml of urine. When the bladder starts to fill, the detrusor muscle inside the bladder stretches and receptors send a message to the brain via the spinal cord, the brain then sends a message back down the spinal column to the involuntary muscles in the pelvic area and urethra to automatically close and tighten keeping the urine inside the bladder until you command the brain to relax the muscles to urinate. Upon normal urination, the detrusor muscle would contract and as you relax the voluntary muscles the bladder is able void.
It’s a little bit more complex that, but this is a general overview for people who don’t understand the mechanics of the urinary system.
Mechanism of an overactive bladder
As the bladder starts to fill or even the sound of running water triggers off a premature contraction of the detrusor muscle. This contraction is signalled by the brain and hence the ‘urge’ to pass water is imminent. The bladder doesn’t need to be full at this stage, it could have as little as 150mls of urine inside before the detrusor muscle contracts. This contraction tells the brain the bladder is full when in fact it isn’t.
How many of you have ‘forced’ your child to go to the bathroom before they go out or to bed, ‘just in case’? All of us have I am sure. But this ‘forcing just in case’ can lead to destabilizing the bladder and what you are doing is training the detrusor muscle to prematurely contract.
There isn’t enough clinical evidence to support the notion that childhood toilet trips when not necessary leads to over active bladder in later years, but it is one theory.
Certain abnormalities affecting the nervous system can cause OAB such as Diabetic neuropath, Parkinson’s disease, Alzheimer’s, Stroke, Multiple Sclerosis (MS), Spinal cord injury.
But don’t think for a minute that if you develop OAB you have any of the above, urinary tract infection can play a role in causing OAB, if you have stress incontinence and have got into the habit of forcing yourself to go to the toilet and destabilizing the bladder can cause OAB, sometimes the onset of OAB just happens for no apparent reason.
It is important to balance your fluid intake with an overactive bladder. Too much water can lead to frequent trips to the bathroom and too little water and lead to bladder infections.
Even though onions are a known cleansing agent, they can aggravate the bladder, if you have to eat them, try cooking them in water to dispense some of the agents which aggravate the bladder.
Chutneys and sauces
There is a lot of acidity in chutneys and sauces which can affect the bladder, try to stay away from heavy spiced ones and mustard.
Alcohol will not only stimulate the bladder, but it will dehydrate the body and relax the muscles responsible for controlling incontinence, lending a hand to uncontrollable incontinence.
Non Alcoholic drinks
Tea, coffee, energy drinks, soda, diet drinks are stimulants and diuretics.
Acidic fruits, tomatoes (including sauces made from tomatoes and acidic fruits) can aggravate the lining of the bladder, reacting in the bladder trying to evacuate anything that aggravates it.
Melons are diuretics.
Some spices can irritate the lining of the bladder. Stay away from chilies.
Any food which irritates the bladder should be avoided. It is a good idea to make a daily diary and note which days you are worse and look at the food system.
What can I do about reducing the amount of visits to the bathroom during the night?
Some women have benefited from the medical device IncoStress. It is always advisable to seek medical assistance.
Take the easy 6 question – print – or email directly to your healthcare professional.
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