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Daily Habits and Urinary Incontinence

Many aspects of our daily life influence bladder and bowel function. Sometimes our daily habits may not be in the best interest of the bladder. A number of surprisingly simple strategies can improve bladder and bowel function.

Fluid Intake

Many people with incontinence reduce fluid intake to reduce the severity of incontinence. This practice causes more harm than good. Adequate fluids are vital to normal function of the urinary tract and to the prevention of kidney and bladder stones and urinary tract infection. About 1,500 ml to 2,500 ml (1-1/2 to 2-1/2 quarts) of fluid are need each day, more during hot weather or exercise.

Inadequate fluid intake results in concentrated urine with a strong odor. This urine is very irritating to the bladder and leads to urgency, frequency of urination, and urge incontinence.

Dilute urine will not irritate the bladder, and the bladder will hold larger amounts comfortably.

When you gradually increase fluid intake by several ounces each day, taken between meals, you can help the bladder adjust to increased amounts. It can be helpful to fill a water bottle or pitcher in the morning and refrigerate it so that you can take small amounts from the pitcher throughout the day. The goal is to drink the entire pitcher by late afternoon.

The amount in the pitcher is determined by the amount you usually take at meals, subtracted from the daily amount needed (1,500 to 2,500 ml.) The majority of fluids should be taken before 7 p.m. to avoid nighttime bathroom visits.

Toileting Habits

Good toileting habits are necessary for preventing bladder problems. Chronic holding of urine can be an occupational hazard for truck driver, factory workers, teachers, nurses, and others who repeatedly delay voiding. The chronic holding of urine results in an overstretched bladder that may lose elasticity and tone in the later years. This may predispose you to bladder infections and poor bladder emptying.

On the other hand, emptying your bladder too often may eventually decrease the amount of urine the bladder can comfortably hold. In later years, your bladder may be unable to stretch to hold normal amounts of urine, you become, in effect, a prisoner of the bathroom because frequent voiding is habitual. In many cases, bladder training can help restore a healthy voiding pattern.

Good toileting habits include using the bathroom on a regular basis, every 3 to 6 hours, with the urine volume no greater than 400-600 ml. Most people feel strong urges to void at about 400 ml and should respond to this urge. More frequent voids may be necessary if you increase your fluid intake or take medications such as diuretics (water pills.)

Older persons typically have slightly smaller bladder capacity due to normal aging changes. For this reason, bathroom visits every 2-3 hours are more reasonable.

Bladder Irritants

Certain foods and beverages may irritate the bladder and result in urgency, frequency of urination, and urge incontinence. Some individuals report that eliminating such foods improves bladder symptoms and incontinence.

Potential bladder irritants include milk and milk products, citrus juices and fruits, tomato-based products, highly spiced foods, sugar, honey, corn syrup, and artificial sweetener. Carbonated beverages, even those that are caffeine-free, can increase bladder symptoms.

In addition to being a bladder irritant, alcohol in hard liquor, beer, and wine increases urination and decreases your awareness that you need to urinate until your bladder is full. This increases the risk for incontinence because the strong urge to void can be more intense and unmanageable.

Caffeine

While fluid intake is important, caffeinated drinks can provoke urgency, frequency of urination, nighttime urination, and urge incontinence. Coffee, tea and many soft drinks contain caffeine in varying amounts. Chocolate contains caffeine, as do some medicines that are available for headache or sinus and allergy symptoms. It is important to read labels to note the caffeine content.

For some individuals, reducing or eliminating caffeine resolves urge symptoms and incontinence. If you are a heavy caffeine user, you can avoid caffeine withdrawal symptoms, such as fatigue and headache, by gradually reducing caffeine intake over several weeks. If you are sensitive to the effects of caffeine, you may need to eliminate all coffee and tea completely. Even decaffeinated coffee and tea usually contain small amounts of caffeine (3-7 %.) There are many excellent varieties of herbal teas and grain beverages that may be substituted for coffee.

Smoking

Incontinence is one of the health dangers associated with smoking. One of the consequences of smoking includes an increased risk of damage to the urinary sphincter at the base of the bladder due to chronic coughing. The sphincter controls urination and is necessary for preventing urine leaks. Chronic coughing can weaken and damage the sphincter and result in incontinence.

A second consequence of smoking is irritation to the bladder by the by-products of tobacco. The result is urgency and frequency of urination.

A third consequence is a marked increase in the risk of bladder cancer. A sudden onset of bladder urgency and frequency of urination or blood in the urine should be investigated promptly.

By giving up smoking, you may be more likely to avoid incontinence and can recover more easily from incontinence-related problems.

Chronic Cough

Conditions that are associated with chronic cough, such as lung disease or seasonal allergies, may provoke stress incontinences as a result of recurrent vigorous coughing. Some individuals may become incontinent only during flu season. It is important to protect the pelvic floor muscles by tightening the muscles just before the cough or sneeze. Pelvic muscle exercises on daily basis, especially women, who have a chronic cough. Optimal management and prevention of cough symptoms may improve incontinence and prevent further damage to the pelvic floor muscles.

Obesity

Excessive weight is associated with increased risk for incontinence. The excess weight puts strain on the pelvic floor muscles that support the bladder and the urethra. Weight loss may reduce the severity of incontinence, or even cure it. A sound weight loss program is an important component of a bladder program.