Your day-to-day habits play a big role in treating incontinence.
Overactive bladder (OAB) isn’t simply “part of getting older,” and you don’t have to suffer with it. The symptoms of OAB—such as a frequent and urgent need to pee—can be frustrating, embarrassing, and highly anxiety provoking, and they can hold you back from doing things you love.
But treatment is available—and effective. Many people with OAB are able to reduce the urgency and frequency of their bathroom breaks, and that doesn’t always mean medications. “A substantive portion of treatment for overactive bladder is lifestyle modification,” says Lauri Romanzi, MD, urogynecologist in New York City.
Behavioral therapy for OAB alone may not cure your condition, especially if it’s moderate to severe, but it may help reduce your symptoms and live a higher quality of life. Here are important lifestyle tweaks that can help treat OAB.
Keep a bladder diary. Log how often you go, how much you urinated, and how urgently you had to go. This can reveal trends to you and your doctor, and help you set goals. Your bladder diary can also help you track progress and allow your doctor to evaluate whether treatment approaches are effective for you, according to American Urological Association. Get started with this bladder diary by the National Association for Continence (NAFC).
Drink the right amount of fluid. If you drink large amounts of fluids, you may find that cutting back on fluids helps your symptoms. On the other hand, you might be drinking too little, which can actually make your OAB symptoms worse. Treating OAB might start with helping you find the right level of hydration.
Avoid bladder irritants. Certain foods and drinks may irritate OAB and make symptoms worse. These include coffee, tea, caffeinated sodas, chocolate, berries, and spicy foods, according to Dr. Romanzi. Learn other foods that can worsen OAB symptoms here.
Lose weight if you need to. “There were a couple of studies that showed that just normalizing weight without any other therapy … significantly reduced incontinence problems,” says Dr. Romanzi. A 2012 study also found that patients with OAB who had a body mass index above 30 experienced higher frequencies of leaking and pad use, compared to patients with a BMI below 30.
Keep a bathroom schedule. “Timed voiding” is a strategy to train your body into going at regular intervals. Gradually increase the amount of time between voiding; the goal is to be able to go every three to four hours, according to NAFC. Over time, this should help minimize urges and help you go longer stretches of time without needing the bathroom. (Learn more about bladder training for OAB here.) This goes hand-in-hand with strategic hydration, which may include drinking small amounts of liquid at regular intervals instead of a large amount all at once.
Make Kegels a habit. Yes, Kegels work—as long as you’re doing them correctly. (This is a common Kegel mistake women make.)Your pelvic floor muscles wrap around your urethra sphincter like a doughnut, according to Dr. Romanzi. “Every time you’re squeezing the [pelvic floor] muscles, you’re also exercising the muscles in the sphincter,” says Dr. Romanzi. “This can make the urinary sphincter stronger and better able to control urine flow—including preventing incontinence.” Here’s the right way to do a Kegel.
If your OAB isn’t getting better after a few months of these lifestyle modifications, see your doctor. “The earlier you come in for evaluation for overactive bladder symptoms, the better you are in terms of keeping your entire body healthy,” says Dr. Romanzi, “and the better off you are in terms of getting a response to non-medical therapies.”
Dr. Romanzi is a urogynecologist and reconstructive pelvic surgeon based in New York City.
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-: A substantive portion of treatment
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for overactive bladder is lifestyle modification.
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The treatment for overactive bladder starts
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with an evaluation method, and that is the bladder diary.
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Typically you're recording when you urinate
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and measuring how much you urinate, writing that down,
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and rating each void against the degree
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of pre-urination urgency you were experiencing
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before you went to the toilet,
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usually on a scale of one to 10.
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The first thing you learn is
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how much is that patient drinking every day?
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And right away you can gauge is this person dehydrated,
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is this person in the habit of over-hydrating,
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or is this more or less a good amount
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of fluid intake for 24 hours?
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If they're dehydrated or over-hydrating,
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you need to start there.
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And then you can begin to look at
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how much bladder irritant beverages
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are they taking in every day?
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Some of the foods and drinks that are more irritating
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to patients with overactive bladder, they're coffee, tea,
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sodas that have a lot of caffeine in them, chocolate.
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For some patients,
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sensitive to certain types of berries,
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01:17.800 --> 01:20.210
There were a couple of studies that showed
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that just normalizing weight
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without any other therapy alone
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significantly reduced incontinence problems.
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One of the behavior modifications that's very common,
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that would be timed voiding and also strategic hydration.
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This is particularly helpful for patients
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where frequent nighttime voiding is a big problem.
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You want them to get to bed
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with a minimum amount of fluid still in their system
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and a minimum amount of bladder irritants coming in
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to their system in the afternoon and early evening.
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There is some data showing
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that women can help restore continence and bladder control
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for all types of incontinence with Kegel exercises.
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The way Kegel exercises work for bladder control,
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the Kegel muscles contribute muscle fibers
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to the urethral sphincter that wrap around like a doughnut.
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So every time you're squeezing the muscles,
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you're also exercising the muscles in the sphincter.
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This can make the urinary sphincter stronger
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and better able to control urine flow,
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including preventing incontinence.
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This is crucial
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because overactive bladder is a chronic condition.
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It's not going to go away.
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It will always have to be managed.
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The earlier you come in for evaluation
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for overactive bladder symptoms, the better you are
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in terms of keeping your entire body healthy,
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and the better off you are
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in terms of getting a response to non-medical therapies
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like pelvic floor physical therapy
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and behavior modification without any medications.
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Al-Shaiji TF, Radomski SB. Relationship between body mass index and overactive bladder in women and correlations with urodynamic evaluation. Int Neurourol J. 2012 Sep;16(3):126-31.Diagnosis and treatment of non-neurogenic overactive bladder (OAB) in adults: AUA/SUFU guideline. Linthicum Heights, MD. American Urological Association. (Accessed on April 12, 2021 at http://www.auanet.org/guidelines/overactive-bladder-(oab)-(aua/sufu-guideline-2012-amended-2014)#x3763.) Find an immediate way to manage your condition. Charleston, SC. National Association for Continence. (Accessed on April 12, 2021 at https://www.nafc.org/triage-1.) Lifestyle changes. Linthicum, MD: Urology Care Foundation. (Accessed on April 12, 2021 at https://www.urologyhealth.org/urologic-conditions/overactive-bladder-(oab)/treatment/lifestyle-changes.)