“I got to go!”: How to take back control from your bladder
Who’s in charge of your daily routine? You or your bladder?
Do you ever feel like you are at the mercy of your bladder? Constantly needing to rush to the loo upon returning home from running errands? Planning your social events around proximity to the toilet? Being that person on a road trip that seemingly needs to stop ever. single. rest area? Keep reading to learn about urinary urgency (also referred to as overactive bladder) and how to help yourself improve these habits.
According to the NIH, approximately 17% of the United States deals with overactive bladder symptoms with or without urinary incontinence. Frankly, I would question the accuracy of this as I bet this is under reported for many.
To understand what “overactive” is, one must first understand what is typical voiding (peeing) habits. On average, the adult bladder should be emptied every 2-4 hours during the wake cycle and 0-2 times per night. As we age and hormones change, the overnight voids can become closer to the 2x per night.
If you are going 10, 12, 16, 20 times per day (or at least it feels like this), you probably don’t have to live like this! Urinary urgency/overactive bladder is when you have strong urge to pee that can seemingly come out of nowhere and come frequently.
High frequency of bathroom usage to void can be caused by behaviors, dietary consumption, and ironically poor fluid intake. Let’s break these down.
Behaviors.
You probably don’t remember when you were potty trained in your youth but if you have your own kids or have ever babysat children, we commonly encourage them to go to the bathroom “just in case”.
Oh, little Johnny, we are going to go to the park, why don’t you try to go to the bathroom just in case? Sally, let’s just try to pee.
This is great at teaching kids how to potty train since it is all new to them to make the neuro connections as to what an urge feels like. Well, as an adult, we can get caught in this pattern even though we should be well aware of what an urge feels like.
How often do you find yourself about to leave your house to run errands and head to the bathroom even though you just peed about a half hour ago? Or, have you found yourself immediately upon returning home having an urge come out of nowhere that forces you to rush to the bathroom even though you voided an hour ago? I have actually seen in a medical record “key in the door syndrome” alluding to the strong urge to pee upon coming home and putting your key in the door of your house.
Other triggers besides leaving/returning home that can be associated with urinary urgency can also include: walking past the bathroom, running water/in the shower, washing dishes and more. Over time, we have reinforced with our brain that when what ever trigger is present, we should empty our bladder.
If you find yourself being triggered by something in the environment, identifying the trigger is the first step to resolving your issue. Once the trigger is identified, the fun begins, you get to mess with your own brain to take back control!
For example, if washing the dishes always makes you have strong urges to void, maybe you go to the bathroom and then immediately head to the kitchen to do some dishes. If the urge arises, you know you just emptied your bladder and can try some of the ideas below. Or if you always rush immediately to the bathroom upon return home, challenge yourself to do at least 1 task (could be something small like giving your dog some pets) before going to the bathroom.
Dietary Consumption/Fluid Intake
What you consume can impact your bladder’s urge to frequently empty as well. Certain foods such as those that are tomato based, spicy, citrusy (lemons/oranges) or even chocolate consumed in high quantities can irritate your bladder to the point that the bladder will let you know!
Besides food, certain beverages such as alcohol, caffeine, and most carbonated drinks can also cause irritation to the tissues of the bladder and the bladder will notify you the need to empty. It doesn’t care you just peed 45mins ago, it wants you to empty again.
Often times, people think, well, I am constantly going to the bathroom, I’ll just limit how much water I drink. This might have the reverse effect on your voiding frequency. If you drink less water, that means the urine in your bladder can be even more concentrated and thus causes even more irritation to the lining of the bladder and pulling you towards the bathroom.
What can I do about this?
Luckily, if you are experiencing any overactive bladder habits, there’s hope for you! Some ideas to help decrease symptoms:
As mentioned above, if you are triggered by something in the environment, identify the trigger and mess with your behaviors around said trigger to break the pattern
Stay hydrated and drink mostly water (goal for everyday, not overly active people is half their body weight in ounces daily; if you are someone who sweats a lot, workouts frequently, or does high level activity, you likely need even more than this)
Decrease (or even better eliminate) bladder irritants from your diet
Now for those that laughed at that last one.... when you know you are going to consume a bladder irritant, drink water first. Example, get in a full glass of water before your morning cup of coffee
When the urge arises, try to calm the urge first and then walk without rushing to the bathroom
If standing, stagger your feet with your left foot back (if sitting, shift left hip back), weight shift onto the left foot (sit bone if sitting) and take x4 slow deep breaths
Distract yourself.... if you constantly think “I have to pee, I have to pee, I have to pee” you’re going to have to pee
Put pressure on the perineum (tissue between your upper thighs) by crossing your legs
Ultimate goal: calm the urge, delay the walk to the bathroom and slowly, you will find you get control back from your bladder. If still struggling or not sure how to incorporate these, reach out! Would love to chat more!