Bladder Control Through Lifestyle Strategies

​If you have been struggling with bladder control problems, you may be looking for ways to improve them.  There are simple strategies you can employ called lifestyle modifications or behavior therapies. You can try the following techniques before trying other types of treatment, such as medications or surgery.

Bladder Control Through Lifestyle Strategies
By Pierre Mouchette | Bits-n-Pieces

If you have been struggling with the embarrassment and discomfort of a bladder control problem, you may be looking for ways to improve it.  Fortunately, there are simple strategies you can try.  Doctors often call these strategies lifestyle modifications or behavior therapies. They are safe, easy, effective, and inexpensive.  You can try these techniques before trying other types of treatment, such as medications or surgery, or in combination with them.
 
Focus on fluids and food
How much fluid you drink can influence your bladder habits, and so might certain foods you eat.

1. Too much fluid:  Drinking too much liquid makes you urinate more often.  Drinking too much too quickly can overwhelm your bladder, creating a strong sense of urgency.  Even if you need to drink more because you exercise or work outdoors, you do not have to drink all the fluids simultaneously.  Drink smaller amounts throughout the day, such as 16 ounces at each meal and 8 ounces between meals.
   
   

If you are getting up numerous times at night to urinate:

• Drink most fluids in the morning and afternoon rather than at night
• Skip alcohol and beverages with caffeine, such as coffee, tea, and cola, which increase urine production
• Remember, fluids come not only from beverages but also from foods

 

1. Too little fluid:  Drinking too little liquid can lead to a buildup of body waste products in your urine.  Highly concentrated urine is dark yellow and has a strong smell.  It can irritate your bladder, increasing the urge and frequency you need to go.
   
   

Certain foods and beverages might irritate your bladder, including:

• Alcohol
• Carbonated drinks
• Certain acidic fruits (oranges, grapefruits, lemons, and limes) and fruit juices
• Chocolate
• Coffee, tea, and carbonated drinks, even without caffeine
• Spicy foods
• Tomato-based products

Avoid these possible bladder irritants for about a week to see if your symptoms improve.  Then gradually, every one to two days, add one back into your diet, noting any changes in urinary urgency, frequency, or incontinence.  You might not have to eliminate your favorite foods and drinks.  Simply cutting down on the amount might help, too.
 
Lifestyle strategies

1. Bladder training:  When you have an overactive bladder, you can get used to urinating frequently or at the slightest urge.  Sometimes, you might visit the toilet when you do not have the desire because you want to avoid an accident.  After a while, your bladder begins sending full messages to your brain even when it is not full, and you feel like you must urinate. 

 
Urinary training, or retraining, involves adjusting your habits.  You go to the toilet at set times, even without the urge to urinate, slowly increasing the time between urination.  It allows the bladder to fill and gives greater control over urination urgency.


A bladder-training program typically follows fundamental actions:

• Identify your pattern - keep a diary that you note every time you urinate.  Your doctor can use this diary to help you schedule your bladder training.
• Extend your urination intervals - using your bladder diary, determine the amount of time between urinating.  Then extend that by 15 minutes.  If you usually go every hour, try to extend that to an hour and 15 minutes.  Gradually lengthen the time between trips to the toilet until you reach intervals of two to four hours.  Be sure to increase your time limit slowly to give yourself the best chance for success.
• Stick to your schedule - Once you have established a schedule, do your best to stick to it.  Urinate after you wake up in the morning.  If an urge arises, but it is not time for you to go, try to wait it out.  Distract yourself or use relaxation techniques, such as deep breathing.  If you feel you will have an accident, go to the toilet but then return to your schedule.

Do not be discouraged if you do not succeed the first few times.  Keep practicing, and your ability to maintain control is likely to increase.
 

1. Strengthen your pelvic floor:  Your pelvic floor muscles and urinary sphincter help control urination.  You can strengthen these muscles by regularly doing pelvic floor exercises, commonly called Kegels.

The pelvic floor muscles open and close the tube that carries urine from the bladder to outside your body (urethra).  These muscles also support the bladder during everyday activities such as walking, standing, lifting, and sneezing.

• Practice Kegel exercises - to perform, squeeze your pelvic floor muscles as if you are trying to stop your stream of urine for three seconds.  Relax for a count of three and repeat several times.  Your doctor might recommend doing these exercises three or four times daily: lying, sitting and standing.

To be sure you are doing them correctly, ask your doctor or nurse to help you or refer you to a physical therapist knowledgeable about pelvic floor exercises.

• Biofeedback - can help train pelvic floor muscles.  Sensors placed near the muscles transmit exertion levels to a computer, which displays the levels on the screen.  This immediate feedback may help you master Kegel exercises more quickly because you can see whether you use the correct muscles.  Biofeedback is attained with a professional or a home device.
• Vaginal weights - cone-shaped weights are another option to help with Kegel exercises.  You insert a weight into the vagina and contract the pelvic floor muscles to keep it from falling out.  Cones come in different weights, allowing you to employ heavier weights as your pelvic floor muscles strengthen.

 

1. Controlling contributing factors:  certain medications, excess weight, smoking, and physical inactivity contribute to bladder control problems.  In addressing these factors, bladder-specific techniques such as avoiding bladder irritants and training might be more successful.

 

• Manage your medications - drugs that might contribute to bladder control problems include high blood pressure, heart medications, diuretics, muscle relaxants, antihistamines, sedatives, and antidepressants.  Talk to your doctor if you develop incontinence or difficulty urinating while taking these drugs.
• Maintain a healthy weight - being overweight will contribute to bladder control problems, particularly stress incontinence.  Excess weight puts pressure on your abdomen and bladder, sometimes resulting in leakage.  Weight loss can help with this problem.
• Stop smoking - smokers are more likely to have bladder control problems and more severe indicators.  Additionally, heavy smokers tend to develop a chronic cough, which places added pressure on the bladder and aggravates urinary incontinence.
• Be active - studies indicate that regular physical activity helps to improve bladder control.  Try at least 30 minutes of low-impact moderate exercise, such as walking briskly, biking, or swimming.
• Minimize constipation - straining during bowel movements can damage the pelvic floor.  Unfortunately, some medications used to treat bladder control problems can worsen constipation.  Exercising, drinking enough water, and eating high-fiber foods like lentils, beans, fresh vegetables, and fruit might help improve constipation.

Manage chronic cough - your cough could be making your bladder problem worse.  See your doctor about treatment options.
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