Are you always looking around for the nearest restroom? Do you feel like you have to pee much more often than others around you? Do you ever run to the bathroom only to have a small amount of urine come out when you were expecting more? When the urge strikes, do you feel like you have to rush to make it to the bathroom to avoid an accident?
These are all classic signs of OAB or Overactive Bladder. It can be annoying, embarrassing, and even prevent you from participating fully in activities, but the good news is it’s treatable!
Overactive bladder occurs when there is bad communication between the bladder and the brain. In a healthy bladder, the bladder sends a signal to the brain when it first starts to feel a bit full. That signal will get stronger and stronger as the bladder fills up more, and it will finally send an “emergency” signal when it reaches maximum capacity, so that you avoid overstretching the bladder.
With OAB, the bladder starts sending “emergency” signals even when the bladder is only partially filled, sending you running for the toilet long before there’s a need to empty the bladder. So what can cause this problem?
Top Causes:
Bladder irritation:
Certain foods and drinks can irritate the bladder lining, making it more sensitive to being filled, and send stronger signals to the brain. Caffeine, carbonated beverages, spicy or sour foods, alcohol, and artificial sweeteners/colors are common culprits, but there are many other possible irritants depending on the person. Also, if you are dehydrated, your urine will be more concentrated which is more likely to irritate the bladder lining.
Pregnancy/Postpartum:
As the uterus presses on the bladder, it’s normal to have to pee more often. However, after pregnancy, as the uterus shrinks back to a smaller size, many people still experience the bladder frequency they had before. This is because the bladder has adjusted to the “new normal” of sending a signal when it has a smaller volume of urine in it.
Overactive Pelvic Floor Muscles:
In an ideal world, the bladder and pelvic floor muscles take turns contracting, so that as the bladder empties, the pelvic floor relaxes so that the pee can easily get out. When the pelvic floor has a tough time relaxing and letting go (which can be because of pain, stress, or any number of other factors), the bladder has to squeeze extra hard to push the urine out. This is often called “power peeing” where the person is squeezing extra hard and the urine is coming out with a lot of force. Because of the extra pushing of the bladder, this can cause it to send stronger urgency signals to the brain as well.
So what do you do to treat these issues? Luckily, there are many options available:
Adjustments to food and drink.
Look at the times of day you notice the most urgency and see if you can pick up a pattern. Is it always after your morning coffee? Your afternoon diet coke? Your evening glass of wine? Try making some adjustments to your routine and see if that makes a difference. And if you are consuming something irritating to your bladder, try drinking some extra water right before or after, to help dilute your urine and make it less irritating to the bladder.
Urge Suppression.
Start paying attention to when you are going to the bathroom unnecessarily. Do you go before you leave the house out of habit, even if you don’t have the urge to? Do you pee three times in the half-hour before a big meeting, just out of nerves? Instead of going straight to the bathroom at the first urge, try sitting down, performing a couple of Kegels (pelvic floor contractions) and distracting yourself with a different task to see if you can prevent yourself from going straight to the bathroom.
Pelvic Physical Therapy.
In addition to helping you with the two treatment tactics listed above, pelvic PTs can assess the tone of your pelvic floor, check your fluid intake and outtake to see if you are within normal ranges, and utilize other treatment techniques such as massage techniques around the abdomen and TENS electrical stimulation to the bladder nerves to help decrease your levels of urgency.
Medication.
There are some medications that may help with urinary urgency if it is not responding to the techniques listed above. Talk to your doctor about what treatment tactics might be best for you!