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controlling incontinence symptoms

controlling incontinence symptoms

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

Table 1: Controlling incontinence and overactive bladder symptoms



Adequate Fluid Intake – Individuals with urinary symptoms often limit fluids so that they will not have to urinate as often. Individuals with overactive bladder and who have a high fluid intake (>3,000 ccs/day) may show a reduction in incontinent episodes and voiding frequency by lowering their fluid intake. Incontinent persons with low fluid intakes (<1,500 ccs/day) may benefit from increasing their fluid intake. Reducing fluid intake after 6 pm (or 2- 3 hours before bedtime), and concentrating fluid intake during morning and afternoon hours may decrease nighttime incontinence episodes.

Adequate Fluid Intake – Individuals with urinary symptoms often limit fluids so that they will not have to urinate as often. Individuals with overactive bladder and who have a high fluid intake (>3,000 ccs/day) may show a reduction in incontinent episodes and voiding frequency by lowering their fluid intake. Incontinent persons with low fluid intakes (<1,500 ccs/day) may benefit from increasing their fluid intake. Reducing fluid intake after 6 pm (or 2- 3 hours before bedtime), and concentrating fluid intake during morning and afternoon hours may decrease nighttime incontinence episodes.

Stop Smoking – Nicotine is irritating to the detrusor muscle causing bladder contractions and urgency. A smoker’s repeated and chronic coughing may cause urinary leakage. Smoking cessation may help to decrease urine leakage.

Dietary Modification – Individuals with incontinence and overactive bladder may benefit from caffeine reduction. Significant rise in detrusor pressure with bladder filling has been demonstrated with caffeine. Taper caffeine intake slowly to avoid migraine-type headache. The effect of other foods and beverages on the bladder is not understood but elimination of one or all of the items listed below may improve bladder control. It is recommended that eliminating these foods on a one-by-one trial basis may help reduce UI in some individuals. They are:

Alcoholic beverage Citrus juices & fruits
Beer, wine Highly spiced foods
Carbonated beverages Sugar, honey
Milk/milk products Corn syrup
Soft drinks with caffeine, tea, coffee
even decaffeinated		 Artificial sweetener (aspartame)

Maintaining Optimal Weight - Weight reduction programs for moderately and morbidly obese women may help reduce urinary symptoms such as urgency, frequency incontinence because of less pressure on the bladder.

Maintaining Bowel Regularity – Constipation and difficulty with defecation (straining during bowel movements) causes increased pressure on the bladder leading to overactive bladder. Individuals should keep regularity through increased fiber, exercise and fluid. A successful way to adequately increase fiber is by using a “special bran recipe”. Mix together: 1 cup applesauce, 1cup coarse unprocessed wheat bran and ¾ cup prune juice. Refrigerate mixture and take 2 tablespoons of the mixture every day. Take the mixture in the evening for a morning bowel movement. Increase the bran mixture by two tablespoons each week until bowel movements are regular. Always drink one large glass of water with the mixture.

[Adapted with permission from Newman, DK. (2002) Managing and Treating Urinary Incontinence, Baltimore: Health Professions Press]

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Posted October 2006


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