overactive bladder

Peeing Too Often

Do you pee a lot? I mean do you pee more frequently than you think is normal? Or do you pee and then literally feel like you could pee again 10 minutes later? I used to pee about 4-5 times in the morning before I leave for work—this is in the span of four hours or so (I know, TMI). But, I was thinking, “I know this can’t be right.” Or maybe it is and it’s just because I drink of a lot fluids.   But it isn’t, “normal.” So, I’ve changed it. Find out how below.

This is otherwise known as Overactive Bladder Syndrome

 Overactive bladder syndrome could include any of the following:

  • Increased frequency of urination (peeing more than 8 times in a day)

  • Urinary urgency (feeling like you have to pee now!)

  • Leakage if the urge sensation cannot be suppressed

The bladder holds 20-30 ounces of fluid. We should be emptying about half that, ~12-15 ounces each time we urinate. When we pee, there is actually less than 50ml of fluid left in the bladder. So those times when we pee and then feel like we have to pee again 10 minutes later…..what’s that all about? We could not possibly have filled our bladder enough to have to empty it. We really should only be peeing every 2-3 hours.

Now, several things can affect this time schedule. Those with neurological diseases or pathologies such as stroke and Multiple Sclerosis may present with altered patterns, because the neural pathways to the bladder are disrupted. Scheduling will also be different if you have Interstitial Cystitis (or painful bladder syndrome) or diabetes. Or if you drink caffeinated drinks such as coffee or tea, your frequency will be greater, as might the volume that you are peeing.

A good start to seeing what volume, how often and what might be affecting your urination habits is a Bladder Diary—click this link for the diary and this link for the directions. When I did this on myself, I was validated that yes, I was indeed peeing frequently during the day, especially in the morning hours. Now, I provide these to my clients to get a better idea of their habits. It gives a nice glance at ways we can start to retrain the bladder. An integrative PT can help you decipher and make a plan based on the results.

One thing to look at may be what your eating and drinking. It seems obvious, but when I actually looked at the list, I was surprised to find out what foods may irritate the bladder. Foods that decrease pH and make urine more acidic, are likely to increase urinary frequency and urgency by irritating inflamed areas of the bladder and urethra or by sensitizing the nerve fibers associated with pain. The most common irritants are alcohol, carbonated beverages and caffeinated beverages. Foods high in arylalkalamines (tyrosine, tyramine, tryptophan, aspartate, and phenylalanine) may also irritate the bladder. Check out this link to a partial listing of foods that decrease pH and are high in arylalkylamines.

I love lemon in my water, especially in the morning to get my digestion going. But, if you look, it’s on the list, as are many citrus foods. Makes sense, as they are acidic. So, I reluctantly took out my lemon water in the morning, and have completely decreased my AM frequency pattern by half. This isn’t to say that you have to cut these things out completely. I use it just as a guide. If I know I’m going on a plane or a long car ride or going to watch a movie, I avoid the things on the list. This will greatly increase my chance of being able to sit the whole time without having the urge.

You could also take something called Prelief, which is available over the counter.  It’s a supplementary base to help reduce the acidity of foods you ingest so you reduce the irritation to the bladder. This can be taken prior to having those acidic foods to reduce their acidic effects. Of course if you have Painful Bladder Syndrome, you may want to eliminate the irritants all the time (this topic is a whole other article).

And speaking of urge…..do you ever go to the bathroom, “just in case?” Say, I’m leaving the house and going to work, so I’m going to go “just in case” I might have to go on the way there, even though the commute to work is only 30 minutes. And you know you just peed an hour ago, so you really shouldn’t have to pee. But now, you do this every morning (I know, I do it too!). And your bladder, your nervous system and your brain have all been trained now. Urge does not always equal need to pee. So if we know we just peed out ~15 ounces of urine 1 hour ago (you will know because you have tracked on your bladder diary), and you’ve only had 8 ounces of water, then you don’t have to go. Your bladder which fills one drop every 15 seconds, could not possibly be full now.

So what do you do? Re-train your brain. Tell yourself what I just told you. “I just went and my bladder couldn’t possibly be full, so I don’t need to go.” Check this link for Changing Your Brain–this is in terms of pain, but the science is similar.  There are other ways to retrain the brain, such as visualization, meditation and diaphragmatic breathing (click here for a link for a handout on breathing). You can also do a few quick pelvic floor muscle contractions. Check with your integrative practitioner for to help you out with these.

So hopefully now you’ll be able to track your habits, check your diet and start to re-train your brain so you’re not spending half your day peeing or trying to find a bathroom. Or a more dangerous option: decreasing fluids because you don’t want to worry about it. Keep hydrated! Drinking half your body weight in ounces per day is the recommended amount.

Now, all this talk about peeing has got me to the point of having to go. Or do I? I’ll tell myself that my bladder can’t be full, do a few quick squeezes of the pelvic floor, take ~5 deep/slow breaths and I’m good for another 30 minutes!

Reference: Built on information from Herman & Wallace workshop manual

I welcome your feedback and if you find this information helpful, please share with your colleagues and your friends. Contact Tianna to see how she can help you with pelvic floor and continence issues–to help you spend more time out of the bathroom and more time doing the things you love!

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