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Question

I am a 48 year old woman who has had two children. Some of my friends have problems with leaking from the bladder when they exercise or cough. I don’t have that problem. But in the last few years I have noticed that I am going to the bathroom much more frequently and sometimes I don’t get any warning. Sometimes I can’t get to the bathroom before I leak. This is inconvenient, embarrassing and uncomfortable. Is there anything I can do for myself about this problem?

Answer

The condition you describe is often referred to as “overactive” bladder. In most cases it does not mean that you have a serious condition such as cancer. The most common causes of this problem are bladder infection and lifestyle. First, you should see your doctor to have a urine test done to see if you have an infection. If you do have an infection, your doctor can give you antibiotics to get rid of the infection. This may also get rid of the overactive bladder symptoms. If you don’t have an infection, or if you treat an infection but you still have the same bladder problem, then you should next try to modify your life style. Below are some guidelines to help you make changes to what you drink, what you eat and how you live.

Treatments
Self-Help Tips You can help your bladder by: avoiding fluids which irritate the bladder (e.g., caffeinated beverages) keeping your bowels regular losing weight keeping yourself fit and mobile avoiding repeated exposure to high impact physical activities stopping smoking asking your doctor whether any of your medications have a negative affect on the bladder - tell her/him about your urine leakage

Bladder Control Tips

1. Do not severely reduce the fluids you drink to avoid going to the bathroom.
Reducing the amount of fluid you drink to cope with your urinary problem may actually
make your condition worse. Your body needs a certain amount of fluid to work properly
(minimum 5-6 cups per day). If you are not drinking this amount, your body will conserve fluid by producing less urine. The urine you do produce may become very concentrated and irritating to the bladder. It will have a dark colour and a strong odour. In addition, a fluid intake that is too low may lead to problems with constipation. This may make your bladder problems worse.

2.Empty your bladder before going to sleep.
Have nothing to drink for the 2-3 hours before going to bed. This should help you to
avoid frequent trips to the bathroom during the night. This may also help if getting to
the bathroom on time in the morning is a problem for you.

3. Always empty your bladder completely.
Always be sure that you have emptied your bladder completely. At the end of voiding,
wait and give an extra push to be sure that all the urine is out.

4. Empty your bladder before and after intercourse.

5. Reduce your caffeine intake.
It is best to avoid drinks such as coffee, tea, colas, and cocoa that contain caffeine.
Caffeine has a diuretic effect (causes the kidneys to increase the production of urine
so that your bladder fills more quickly and you have to urinate more frequently).
Caffeine may also irritate the bladder causing more contractions (tightenings), urgency
(the feeling of having to rush to get to the bathroom on time) or frequency (a frequent
need to urinate). Try drinking decaffeinated beverages. If you must drink beverages
with caffeine, then it would be best to reduce the intake to no more than 2 cups a day.
Avoid caffeinated beverages in the evening.

6. Drink only moderate volumes of fluid.
It is recommended that you drink moderate
amounts (5-6 cups) of non-caffeinated, non
carbonated liquids every day. You should cut back on fluids after 6 p.m. if you are
waking more than once in the night to urinate. It is best to spread the intake of fluids
throughout the day. Taking large amounts (over 8-10 ounces) of fluid at any single
time can overwhelm the bladder and make it more difficult to hold the urine.

7. Drink "bladder-friendly" fluids.
The fluids that are most friendly to your bladder are water, apple juice and grape juice.
Cranberry juice may be effective for people who have repeated bladder infections. One
to two glasses per day are recommended. It will not cure an infection but it may help
prevent one. Pure cranberry juice with no added sugar is recommended, not
cranberry drinks which have very little cranberry content. However, if you experience
urgency, cranberry juice may worsen your problem and it should be avoided.

8. Modify what you drink.
Alcohol (for example, beer, wine, or hard liquor) can interfere with bladder control. It
should be used moderately (one drink per day) or not at all. For some people,
avoiding citrus juices or fruits and tomato products may also be helpful.