Overactive Bladder (OAB) What is it and how to treat it?

What is an overactive bladder?

An overactive bladder, or OAB, is characterized by a frequent and unexpected urge to urinate, which may be hard to suppress. This condition might make you feel as if you need to urinate multiple times throughout the day and night, and you could also experience involuntary urine leakage, known as urgency incontinence.

Living with an overactive bladder might lead to feelings of embarrassment, causing you to isolate yourself or restrict your professional and social activities. However, it’s encouraging to know that a simple evaluation can help identify any specific reasons for your overactive bladder symptoms.

Effective management of overactive bladder symptoms can often be achieved through straightforward behavioral modifications such as changes to your diet, scheduled urination, and exercises for your pelvic floor muscles aimed at enhancing bladder control. If these initial measures aren’t sufficiently alleviating your overactive bladder symptoms, there are further treatment options available.

Overactive Bladder symptoms

Having an overactive bladder might result in:

Overactive bladder treatment

Before using Surgery and medication treatment for OAB typically starts with lifestyle changes and behavior therapies, which may include:

  1. Dietary Changes: Avoiding foods and drinks that irritate the bladder, such as caffeine and alcohol.
  2. Bladder Training: This involves gradually increasing the interval time between trips to the bathroom, helping to stretch the bladder so that it can hold more urine.
  3. Pelvic Floor Muscle Exercises: Exercises such as Kegel exercises can help to strengthen the muscles that control urination and improve symptoms of urgency and frequency.
  4. Healthy weight. If you’re overweight, losing weight may ease symptoms. Weight loss may help if you also have stress urinary incontinence.

If these initial efforts aren’t enough to control symptoms, there are several medications available that can help relax the bladder muscle and increase bladder storage capacity. In more severe cases, procedures such as nerve stimulation or Botox injections into the bladder muscle may be used.

Over active Bladder, bladder diary test

A bladder diary, also known as a voiding diary or urolog, is a valuable tool in diagnosing and managing conditions such as overactive bladder (OAB). It’s essentially a record of your fluid intake and output, and it can provide significant insights to both you and your healthcare provider about your bladder health.

The role of a bladder diary includes:

  1. Understanding Patterns: A bladder diary can help identify patterns in your urinary habits. For instance, it can reveal whether you urinate more frequently at certain times of the day or night, or after consuming particular foods or drinks.
  2. Assessing Fluid Intake: By documenting what and how much you drink, a bladder diary can determine if you’re consuming fluids that irritate the bladder (such as caffeine or alcohol) or if you’re drinking excessive amounts of any fluid, both of which can contribute to symptoms of OAB.
  3. Identifying Incontinence Episodes: The diary can also track episodes of urinary incontinence, providing information about how often these occur and in what circumstances, which can help in formulating a treatment plan.
  4. Evaluating Treatment Effectiveness: Once a treatment plan is underway, continuing to maintain the bladder diary can help assess the effectiveness of the treatment by tracking any changes in symptoms or urinary habits.

Recently Minze Health developed an automated bladder diary to enhance diagnostic analysis. This can help you or your healthcare provider in more accurately diagnosing and treating overactive bladder (OAB).

Modern Bladder diary example. Minze Bladder diary report from the Diary Pod. The bladder diary results viewer Inclusive lifestyle suggestions and bladder training tips for Nocturia and OAB.

Overactive bladder natural treatment

Overactive bladder (OAB) can often be managed with lifestyle changes and natural treatments, and medication isn’t always necessary. Here are some non-pharmacological approaches that can help manage OAB symptoms:

  1. Behavioral Techniques: Techniques such as bladder training, timed voiding, and double voiding can help control your bladder. Bladder training involves gradually increasing the time between your trips to the bathroom, training your bladder to hold more urine. Timed voiding means urinating at regular, planned intervals—whether you feel the urge or not—to prevent urgency. Double voiding involves urinating, waiting a few moments, and then trying again to ensure your bladder is empty.
  2. Pelvic Floor Exercises: Exercises such as Kegels can strengthen your pelvic floor muscles and urinary sphincter, improving bladder control.
  3. Dietary Changes: Avoiding bladder irritants (such as caffeine, alcohol, spicy foods, and acidic foods) and monitoring your fluid intake can help manage symptoms.
  4. Healthy Weight: If you’re overweight, losing weight can help reduce pressure on your bladder and pelvic floor muscles, improving urinary urgency and incontinence.
  5. Quit Smoking: Smoking can irritate the bladder muscle and cause coughing, which often leads to episodes of incontinence.
  6. Biofeedback: Under the guidance of a healthcare provider, biofeedback can help make you more aware of signals from your body. This could help you gain control over your pelvic floor muscles.
  7. Absorbent Pads and Protective Garments: If you’re dealing with leakage, these can offer a safety net and make OAB easier to manage day-to-day.

Best sleeping position for overactive bladder (OAB)

There’s not currently much specific research into what’s the best sleeping position for OAB. A general rule of thumb is to select one that’s both comfortable to you, leads to restful sleep, and doesn’t contribute to pain upon waking.

For some people, elevating the legs and lower body slightly higher than the rest of the body might help. This can be achieved by placing a pillow under your legs or using a special bed wedge. This position can reduce fluid accumulation in the lower body, which could potentially minimize nocturia, the need to urinate during the night.

Sleeping on your side may also be helpful for some, as this can relieve pressure on the bladder.

Alongside these positional considerations, other lifestyle changes such as limiting evening fluid intake (particularly caffeine and alcohol), maintaining a healthy weight, and practicing good sleep hygiene can also play a significant role in managing overactive bladder symptoms during the night.

Botox treatment for overactive bladder (OAB)

Botox, also known as OnabotulinumtoxinA, is a treatment option for overactive bladder (OAB) when other methods such as lifestyle changes, pelvic floor exercises, and medications haven’t worked effectively.

Botox works by blocking the nerve signals that cause bladder muscles to contract excessively. When Botox is injected into the bladder muscle, it relaxes the bladder, increasing its storage capacity and reducing episodes of urinary incontinence.

The procedure usually involves a cystoscope, a thin tube with a tiny camera, which is passed through the urethra into the bladder. Through this tube, the Botox is injected into several areas of the bladder muscle. The procedure is usually performed under local or general anesthesia.

The effects of Botox on the bladder typically last for about six months. Therefore, you may need to repeat the treatment two times a year for sustained results.

As with any medical procedure, there are potential side effects. These can include urinary tract infections and difficulty completely emptying the bladder, known as urinary retention. For some people, if urinary retention occurs, they may need to use a catheter temporarily to empty their bladder.

Overactive bladder kegel exercise

Kegel exercises, also known as pelvic floor muscle exercises, can be very helpful in managing overactive bladder (OAB). These exercises strengthen the pelvic floor muscles, which support the bladder and regulate urine flow. Strengthening these muscles can improve bladder control and reduce symptoms of OAB.

Here’s how you can do Kegel exercises:

  1. Identify the Right Muscles: The first step in doing Kegel exercises is to identify your pelvic floor muscles. These are the muscles you would use to stop urinating midstream or to hold in gas. It’s important to ensure you’re targeting the right muscles and not tightening your abdominal, buttock, or thigh muscles during the exercise.
  2. Contract and Relax: Once you’ve identified the right muscles, tighten (contract) them for 5 seconds, then relax for 5 seconds. Try to do this exercise 10 to 15 times in a row. This will constitute one set.
  3. Repeat: Aim to complete three sets of these exercises every day. You can do these exercises at any time and in any place, whether you’re sitting at your desk, watching TV, or lying in bed.
  4. Breathe Normally: During these exercises, try to maintain normal breathing. Don’t hold your breath or strain other muscles.

While it might seem simple, doing Kegel exercises correctly can be challenging. If you’re not sure you’re doing the exercises right, or if you’re not noticing any improvement in your symptoms after a few weeks, don’t hesitate to seek help. A healthcare provider or physical therapist specialized in pelvic floor therapy can offer guidance and monitor your progress.

Remember, it can take time to see improvements, so be patient and consistent with your practice. These exercises are most effective when done regularly.

Natural remedies for overactive bladder at night

Overactive bladder (OAB) symptoms can be particularly troublesome at night, disrupting sleep and impacting overall quality of life. Several natural remedies can help manage nocturnal symptoms:

  1. Limit Evening Fluid Intake: Try to reduce your fluid intake in the hours leading up to bedtime. Be cautious with beverages that can irritate the bladder like coffee, tea, alcohol, and acidic drinks.
  2. Double Voiding: Before bed, try to empty your bladder twice. This can ensure your bladder is as empty as possible before you go to sleep.
  3. Elevated Legs: Consider using a pillow or a wedge to elevate your legs while sleeping. This could reduce fluid accumulation in the lower body and potentially minimize the need to urinate during the night.
  4. Bladder Training: This involves gradually increasing the time between your trips to the bathroom. You can apply this technique during the day to help increase your bladder’s holding capacity at night.
  5. Pelvic Floor Exercises (Kegels): Regularly practicing these exercises can strengthen the muscles that control urination, improving bladder control.
  6. Maintain a Healthy Weight: Excess weight can put additional pressure on your bladder and increase symptoms of OAB.
  7. Avoiding Bladder Irritants: Certain foods and drinks like spicy foods, acidic fruits, chocolate, and caffeinated drinks can irritate the bladder. Avoiding these close to bedtime may help reduce nighttime symptoms.

Keep in mind that what works for one person might not work for another. It might take some time and experimentation to find out what natural remedies work best for you. Always consult with a healthcare provider for advice tailored to your specific symptoms and health history.

Overactive bladder diet and what foods to avoid with overactive bladder?

Diet can play a significant role in managing overactive bladder (OAB) symptoms. Certain foods and beverages can irritate the bladder and exacerbate symptoms, while others can help maintain a healthy urinary system. Here are some tips for an OAB-friendly diet:

  1. Hydration: While it’s important to stay hydrated, try to distribute your fluid intake evenly throughout the day to avoid filling your bladder too quickly. Also, consider reducing fluid intake in the evening to limit nighttime bathroom visits.
  2. Limit Caffeine and Alcohol: Both caffeine and alcohol can stimulate the bladder and increase the urgency and frequency of urination. Try to reduce or eliminate these substances, especially if you notice that your symptoms worsen after consuming them.
  3. Avoid Spicy and Acidic Foods: Spicy foods and acidic fruits can irritate the bladder, increasing OAB symptoms in some people. Consider limiting your intake of foods such as tomatoes, citrus fruits, vinegar, and spices if you notice they aggravate your symptoms.
  4. Reduce Artificial Sweeteners: Some people find that artificial sweeteners like aspartame and saccharin can worsen OAB symptoms. You might want to consider reducing or eliminating these from your diet.
  5. High-Fiber Diet: A diet high in fiber can prevent constipation, which can put pressure on the bladder and worsen OAB symptoms. Whole grains, fresh fruits, vegetables, and legumes are all excellent sources of fiber.
  6. Monitor Fluid Intake: Some people find that simply reducing their total fluid intake can help manage OAB symptoms. However, it’s important not to restrict fluids too much, as this can lead to dehydration and concentrated urine, which can also irritate the bladder.
  7. Food Diary: Keeping a food and drink diary can help you identify any triggers that worsen your OAB symptoms. Note what you consume and when, along with any changes in your symptoms.

Remember, everyone is different and what works for one person might not work for another. It’s worth experimenting to see which dietary changes help manage your OAB symptoms. Always consult with a healthcare provider for advice tailored to your specific symptoms and health history.

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