national continence week...

over-active bladder (oab)

​Over-active bladders and or sensitive bladders are very common. If you have been diagnosed with an over-active bladder it means that you have a bladder behavioural problem. The bladder twitches  or spasms as it fills with urine. The spasms can cause pain or a sudden urge to void. Commonly a sudden urge to void occurs when the bladder is relatively empty, which in turn is characterised by frequent trips to the toilet (frequency) and having to get up during the night to void (nocturia). You may feel desperate to pee, then get to the toilet and only void a very small amount. Occasionally it may cause you to leak at night (nocturnal enuresis) or leak with movement. Different people will have varying degrees of symptoms and it will depend upon what you chose to drink, and how much. 
Because OAB is a bladder behavioural issue, it cannot be cured with surgery. In fact, surgery can often make the symptoms worse. Constipation and or Irritable Bowel Syndrome (IBS) can also affect symptoms, so keeping your bowel movements regular and avoiding food and emotional stress that can affect your bowel will then have a positive effect on your bladder.
So how do you know if you have an over-active or sensitive bladder? If you think that you suffer with frequency, urgency or nocturia it is worth keeping a three-day bladder diary. Record everything that you drink for three days and nights. Also measure each void of urine using a measuring jug and record it. If you regularly void less than 200mls, void very frequently or are waking more than twice at night then it is likely that you have an OAB.
What can be done to help? Most over-active bladders will improve if you reduce or preferably cut out the following:

• Caffeine (tea, coffee, green tea, cola, chocolate)
• Fizzy drinks
• Juices that contain citric acid (orange, lemon, grapefruit)
• Blackcurrant juice

Ensure that you are drinking between 1.5 and 2.5 litres of fluid per day. It doesn’t have to be water. Milk, diluted squash, cranberry juice etc are all less likely to irritate the bladder if you don’t like water. Drinking plenty will dilute the urine, making it less concentrated and therefore less likely to irritate the bladder. Drinking too much can also cause the bladder to be unhappy, so vary the amount to suit you. You will need to drink more if the weather is very warm or if you are exercising.
If you are cutting down on caffeine make sure you reduce it slowly to minimise headaches and feeling unwell (caffeine is pretty addictive).
It is also common for people to fall into the habit of emptying their bladder too often. Voiding before leaving the house, before a car journey or exercising can become a habit. Try to think sensibly about whether you really need to void. If you can wait a bit then do. Try curling your toes firmly or distracting yourself with something to see if you can hold off for a bit longer. You should void when your bladder is full, if possible. It is possible to re-train the bladder, but it can take a little while, so keep trying.
If you have tried all of the above for a few weeks and are still complaining of symptoms then visit your G.P., continence advisor or specialist physiotherapist. Look out for the other blogs this week as they will be full of useful hints, tips, websites and gadgets that can help to improve continence issues.