Do you never leave anywhere without going to the loo ‘just in case’?
Do you suffer from painful urinary tract infections or incontinence? If so, you’re not alone.
An estimated 25 million Americans and 14 million people in the UK suffer from bladder problems – and many suffer needlessly in silence.
Not only is this painfully unjust, as there are often many steps you can take to help improve the situation, but it’s also incredibly isolating.
Take incontinence – something that affects millions of people around the world.
Fear of having an accident in public means that some people with bladder symptoms stay home.
Over time, isolation itself causes both severe mental health problems, such as depression, and has also been linked to physical health conditions such as heart disease and stroke – to the same extent as smoking.
In our new book, What’s Up With Your Bladder, we discuss various problems and what you can do about them.
We also reveal how to prevent yourself from getting a bladder problem in the future – by not going to the loo too often, for example.
For the 25 million Americans and 14 million Brits who suffer from bladder problems, here are some tips that could alleviate or even prevent symptoms from coming on so strong
TOP TIPS FOR A HEALTHY BLADDER
1. DON’T PEE ‘JUST IN CASE’
Many of us go to the toilet ‘just in case’, especially people with bladder problems. However, there is an elegant mechanism – known as the micturition reflex – that exists between the brain and bladder to let us know when it’s time to find a toilet.
By emptying the bladder when it’s not necessary, we can disrupt this process.
When the bladder is about half full, stretch receptors in the bladder wall tell the brain it might be a good idea to think about where a toilet is.
But if there isn’t one nearby, we can hold on for quite some time. In fact, even when the bladder is over half full, we can usually manage for many hours.
Problems can start if we go to the toilet many times in the day for fear of being ‘caught out’.
Over time, our bodies start to think we must go to the toilet when there is very little pee to empty – meaning you really will need to go a lot more often but there will only be a small amount of urine – or at least feel like you need to go.
Fortunately, just as going too often can mess up our bodies’ understanding of when we need to urinate, we can retrain the bladder and brain back into a healthy pattern.
By gradually lengthening the time between trips to the toilet or scheduling when you visit the lavatory, it’s possible to once again only go when we need to.
2. DON’T AVOID FLUIDS, DRINK THEM! – EVEN IF YOU KEEP NEEDING TO GO
It sounds counterintuitive, but staying hydrated is really important for people with bladder conditions.
There can be a strong temptation to limit the amount you drink in an effort to avoid leaks and accidents.
This, however, is often counterproductive as concentrated urine, which is produced when we don’t drink enough, can irritate the bladder lining – meaning you really will need to go a lot more often but there will only be a small amount of urine – or at least feel like you need to go.
But, on the other hand, drinking far too much liquid can disrupt the balance of minerals in our bodies such as sodium and potassium that are important for bodily function.
The key, therefore, is to hydrate slowly throughout the day.
For men, this should be around 2½ litres a day (10 glasses) and for women 2 litres (8 glasses), preferably of water.
But rather than downing 4 glasses in the morning than another 4 later in the day, sip continually throughout the day.
If nocturia (needing to get up to go to the toilet in the night) is a problem for you, it’s ok to kerb fluid intake later in the day but do check that your urine isn’t becoming too strong.
3. STUDY YOUR PEE
You can check the strength of your urine by examining the colour of it. There is natural variation between us all but a pale yellow colour is a sign of good hydration.
Darker, strong smelling pee can be a sign of dehydration whereas very clear urine that looks like water may mean you’re drinking too much, too quickly.
4. AVOID TRIGGERS LIKE CHEESE AND TOMATOES
Certain foods and drink can trigger bladder irritation – which manifests itself as pain and a feeling of needing and/or actually having to go to the loo urgently – so it’s useful to know which ones affect you.
As different things affect different people, note down everything you eat and drink in a bladder diary.
You’ll also need to write down the amount of times you needed go to the toilet and how urgently this desire was, including any leaks
Foods that many people find troublesome include:
- Processed meats
- Some dairy products including string cheese, cheesecakes and flavoured yogurts
- Tomatoes, vegetables (including beans) cooked in tomato sauces
- Some fruit (kiwi, lemon, pineapple, preserved prunes)
- Spices (chili powder, yeast extract, paprika)
- Chocolate
- Soy products, Worcester sauce, Vinegars
- Aspartame, NutraSweet, or sugar-free sweets
- Alcohol
- Citrus/acidic juice (e.g. orange, cranberry, grapefruit
- All caffeinated and decaffeinated drinks, drinking chocolate
- Carbonated water
5. REMEMBER YOU’RE NOT ALONE
Because bladder conditions are embarrassing and can threaten our sense of dignity, symptoms such as incontinence can be incredibly hard to talk about.
But bladder illness is very common indeed – someone you know will have had bladder trouble at some point in their lives. We are all so good at hiding health problems that you may not even know a close friend has experienced urgency, pain or laughter leaks.
Talking about health issues is an essential part of coping with any illness.
Other people are not merely a shoulder to cry on – those who experienced the same sorts of symptoms as us, can make the world of difference either emotionally, practically or in terms of useful information sharing.
If you feel you can’t talk to friends or loved ones, there are many support groups for all kinds of conditions. A good one is Bladder Health UK http://bladderhealthuk.org
6. DON’T BE ASHAMED TO USE PRODUCTS THAT CAN HELP
This doesn’t just include pads and pants, although these are often a lot better than most of us think.
For light leaks, there are many options of incontinence pants that look just like regular underwear and also have odour control panels.
Taking these or an extra pair of knickers or briefs with you when you’re out, along with wet wipes, in a discrete toiletry bag (or a pencil case if you’d prefer) can sometimes act as a comfort mechanism – you have them just in case.
Also knowing where toilets are can help rest the mind and limit panicky feelings – there are numerous toilet locator apps and you can use a Can’t Wait Card to ensure you don’t have to stand in lengthy queues.
The important point of all these products and apps is to make sure you don’t become isolated – bladder conditions are upsetting, and, for some, effective management can take time. On this journey towards recovery, use everything at your disposal to continue living your life.
7. GET SQUEEZING – NO EXCUSES!
We hear it time and again, but if you have bladder problems, it really is crucial to keep your pelvic floor in shape.
Research trials looking at how pelvic floor muscles can help tackle incontinence consistently show that these exercises are key to taking back control of overactive bladders.
Because this set of muscles isn’t something we can see, it can be hard to first know if we’re doing the exercises correctly, and secondly to know if they are becoming toned.
But these simple contractions can mean that people with bladder issues can avoid medications and surgery – both of which come with risks and side effects.
The exercises are very easy to do – next time you go to the toilet try to slow or stop the flow of urine and you’ll be able to feel them working (but don’t do this too often as disturbing your flow can eventually damage the bladder).
Then (when not on the toilet) practice squeezing these muscles on a regular basis.
As this exercise can be done literally anywhere, give yourself a trigger to remind you to do it; something you do many times a day such as driving or walking.
Put a little note in your car or by your shoes to prompt you and after a time you’ll automatically remember to practice the pelvic floor squeezing.
8. DOSE UP ON GOOD BUGS TO BATTLE CYSTITIS
Urinary tract infections are a very common bacterial infection, especially in women, with approximately 50 percent of women experiencing one episode during their lives. As anyone who has suffered one knows, they are agonizing.
In a bid to try and prevent further episodes, support your microbiota.
We are now beginning to understand how important the many millions of microorganisms in our guts are for our health.
The microbiota has a vital role to play in our immune systems, so taking care of these friendly companions will help not only to keep the bladder working well, but also support overall health.
You can do this by taking both pre- and probiotics as a supplement and eating foods that have pre-and probiotic properties,
such as milk, yogurt, kefir (a traditional Middle Eastern beverage which can be milk or water based); kimchi (a Korean vegetable dish) and sauerkraut. For people who suffer from recurrent and chronic urinary tract infections (cystitis) this is an approach worth trying.
Other ways to take care of our microbiota include cutting our artificial sweeteners, cutting back on the booze, eating enough fibre and managing stress.
- What’s Up With Your Bladder is published by Hammersmith Books in paperback, £14.99 and e-book, £5.99