overactive bladder (OAB): controlling symptoms

by Diane K. Newman, RNC, MSN, CRNP, FAAN

Common overactive bladder (OAB) symptoms include:

urinary urgency - sudden and strong sensation to urinate immediately
frequency – urinating often, usually more than 8 times in a day
nocturia – getting up more than twice at night to urinate
urinary incontinence – accidental leakage of urine

Many people find that specific diet, lifestyle changes and exercises may help reduce overactive bladder symptoms and other bladder control problems.

Pelvic floor muscle exercises can help control over- active bladder symptoms

Bladder control depends on muscles working together when the bladder is filling: the bladder muscle should be relaxed and the muscles around the urethra (the tube that urine passes through) called the pelvic floor muscle should be tight. Exercises that strengthen the pelvic floor muscles can help hold urine inside the bladder, preventing leakage. These are commonly called “Kegel” or pelvic floor muscle exercises, named after the doctor who developed them.

To perform a pelvic floor muscle exercise, imagine that you are trying to control the passing of gas or pinching off a stool. Or imagine you are in an elevator full of people and you feel the urge to pass gas. What do you do? You tighten or pull in the ring of muscle around your rectum - your pelvic floor muscle. Women will feel a lifting sensation in the area around the vagina or pulling in of the rectum. Men may see their penis lift or a pulling in of the rectum. One exercise consist of both “tightening and relaxing” the muscle. Start by tightening the muscle for 5 seconds and build till you can hold the tightening or 10 seconds. Be sure to relax completely between each muscle tightening. (See Figures below).

Bladder retraining can help control overactive bladder (OAB) symptoms

Bladder control can be improved by scheduling bathroom trips. The schedule is changed over a period of weeks or months to gradually increase the time between trips. For example, a person who normally goes to the bathroom every hour could plan to go every hour and 15 minutes. After maintaining the new schedule for a few days, the time could be increased to every hour and 30 minutes. The goal is to void no more than every 3 to 4 hours. If you get the urge to void and it is not yet your scheduled voiding time; stop all activity and sit down if possible. Then try one of these techniques to help you lessen the urge, which will cause the bladder to relax, and give you more time to get to the bathroom:

Take some slow, deep breaths through your mouth, concentrating on your breathing; or concentrate on an activity, such as taking a vacation, visiting a friend, counting backwards from 100, or reciting the words of a favorite song or nursery rhyme.
Tighten your pelvic floor muscle quickly several times in a row.

Monitor your diet and medications to improve bladder control

Certain food and beverages can irritate the bladder and make overactive bladder symptoms worse. These include alcoholic beverages, caffeinated foods and/or carbonated beverages, (soft drinks, coffee or tea, chocolate), tomato-based products, citrus fruits and juices, spicy foods, and artificial sweeteners (e.g. Equal). Also some over-the-counter medications and prescription drugs can worsen bladder control problems such as Excedrin, Midol, Anacin, Dristan and Sinarest. Do not stop taking prescription drugs without talking to your healthcare provider first.

Maintain bowel regularity to lessen overactive bladder (OAB) symptoms

Keeping healthy bowel habits may lessen bladder control symptoms. Some suggestions include: 1) increase fiber-rich foods in your diet such as beans, pasta, oatmeal, bran cereal, whole wheat bread, fresh fruits and vegetables; 2) exercise to maintain regular bowel movements; 3) drink plenty of nonirritating fluids (water); 4) see your doctor if you have bowel problems.

Maintain a healthy weight to improve bladder control

Being overweight can put pressure on your bladder, which may cause leakage of urine when you laugh or cough. If you are overweight, weight loss can reduce pressure on your bladder.

Stop smoking to lessen overactive bladder (OAB) symptoms

Cigarette smoking is irritating to the bladder muscle. It can also lead to coughing spasms which can cause urinary leakage and loss of bladder control.

References:

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Posted December 2003
Updated August 2009

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