Conditions

Overactive Bladder, Meaning, Causes, Symptoms, Treatment & Remedies

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Overactive bladder is a condition marked by a sudden urge to urinate. This urge may be difficult to stop, thus at times, it may lead to involuntary loss of urine or urge incontinence.  OAB is a syndrome meaning it is a set of symptoms.

In this article, we offer an insight into:

  • What an overactive bladder is
  • Common symptoms of OAB
  • List of possible causes of OAB
  • Treatment and natural remedies to help relieve the symptoms and
  • What foods to avoid with an overactive bladder

Overactive bladder ICD-10

ICD-10 is the 10th revision of the international statistical classification of diseases and related health problems. It is a medical classification list by the world health organization.

According to this classification, synonyms of an OAB may include:

  • Bladder dysfunction
  • Detrusor hyperreflexia and
  • Detrusor hyperreflexia of the bladder

Symptoms of an overactive detrusor are muscle of the urinary bladder that contracts with abnormally high frequency and urgency.

The condition is characterized by the frequent need to urinate both during the day and at night. Urinary incontinence may or may not be present.

What causes an overactive bladder?

The actual cause of an OAB is unknown, there are however multiple conditions often associated with the overactivity of the detrusor urinae muscle, one of these is the normal bladder function.

Normal bladder function

The kidney produces urine that drains into the bladder. When urinating, urine passes from your bladder through the urethra.

As your bladder fills, nerve signals sent to the brain triggers the need to urinate.

When urinating, nerve signals coordinate the relaxation of the pelvic floor muscles and the urinary sphincter muscle (muscles of the urethra). The bladder muscles contract pushing the urine out.

Involuntary bladder contractions

In other cases, an overactive bladder may result from an involuntary muscles contraction. The contraction may even occur when the volume of urine in your bladder is low, creating an urgent need to urinate.

According to Mayo Clinic, the following conditions may contribute to signs and symptoms of OAB:

  • Acute urinary tract infections
  • Neurological disorders such as stroke and multiple sclerosis
  • Declining cognitive function common in old people
  • Overconsumption of alcohol, coffee, and other diuretics
  • Medication that causes rapid increase in urine production
  • Bladder abnormalities such as tumor and bladder stones
  • Enlarged prostate, constipation and other conditions that obstruct bladder flow
  • Spinal cord injury
  • Diabetic neuropathy

NOTE: the risk of developing this condition increases with age. You are also at risk of developing diseases and disorders such as enlarged prostate and diabetes that can contribute to other problems.

Symptoms of an overactive bladder

OAB is a condition that can be both annoying and embarrassing. Johns Hopkins Medicine reports that around 33 million Americans have an overactive bladder (2011). The symptoms come in many forms which include:

  • Sudden and frequent urination
  • The inability to postpone urination also called urinary urgency
  • Leakage or urine or urge incontinence
  • Nocturia characterized by too many night-time trips to the bathroom
  • Involuntary contraction of the muscle in the walls of the urinary bladder
  • Frequent urinary tract infections
  • Accidents during the day

Overactive bladder in children

Like in adult overactive bladder in children is a specific type of urinary incontinence. It is often characterized by a sudden and uncontrollable urge to urinate often leading to accidents during the day. OBA is often misdiagnosed as bed-wetting or nocturnal enuresis.

Wetting the bed in children under 3 years is common. However, most children are able to control the bladder after they turn 3. An overactive bladder is only able to be diagnosed in children between 5 to 6 years.

The symptoms of OAB can interfere with a child’s normal day to day activities. This can negatively impact the social and emotional development of the child.

In children physical complications of an overactive bladder will include the following:

  • Problems completely emptying the bladder
  • Kidney damage
  • Urinary tract infections

OAB in children may be caused by any of the following:

  • Anxiety and emotional upset
  • Nerve damage
  • Underlying sleep apnea
  • Drinking lots of fizzy drinks
  • Constipation
  • Urinary tract infections

Overactive bladder at night

Unless you drunk a lot of alcohol before bed, frequent urination at night may be a sign of nocturia. It is not the same as an overactive bladder. It is, however, possible to have nocturia along and overactive bladder.

Though more common in old people, anybody can develop nocturia. Statistics show that 1 in 3 people over the age of 30 need to make at least 2 trips to the toilet at night.

Nocturia is not the same as bedwetting. While it is possible for most people to sleep six or eight hours without having to get up, with nocturia, one may need to wake up more than 3 times at night. This can disrupt your normal sleep cycle and cause sleep loss among other complications.

There are four types of this condition:

a) Nocturnal polyuria where one produces excessive amount of urine during the night

b) Global polyuria where one produce excessive amount of urine during the day and at night

g) Low nocturnal bladder capacity in which your bladder is unable to hold as much fluid during the night

d) Mixed nocturia which is a combination of the above types

Lifestyle changes are often the first-line treatment option for hypertonicity of bladder at night. Your healthcare provider may recommend that you restrict your fluid intake before bed, but you need to ensure you get enough fluids during the day to compensate for this.

Overactive bladder treatment, medication

As mentioned, OAB syndrome can have an array of symptoms. Treating an overactive bladder will, therefore, vary depending on the symptoms and what the underlying causes is. Common treatment option will include the following:

1. Surgery

In severe cases of overactive bladder syndrome, surgery may be prescribed. With surgery, most common procedures used are:

  • Urinary diversion: in this procedure, the ureters are routed directly to the outside of your body. The urine does not flow into the bladder. This procedure is only used when other treatment options have failed.
  • Augmentation cytoplast: a small piece of tissue from the intestine is added to the walls of the bladder to increase its size.

2. pelvic-muscle strengthening

When the OAB syndrome is accompanied by stress incontinence, then pelvic floor exercises are the most effective treatment option.

Pelvic-muscle strengthening involves exercises to strengthen the muscles that wrap underneath the bladder, rectum and the uterus.

NHS recommends you do the following:

  • Sit comfortably and squeeze the pelvic muscles 10 to 15 times in a row
  • Avoid holding your breath or tightening your stomach, buttock, or thigh muscle
  • With time, continue to add more squeezes but be careful not to overdo it
  • Continue doing the exercise even when you notice them start to work

Apart from managing the symptoms of OAB, these exercises can increase sensitivity during sex and enhance strong orgasms for women. In men, it can help reduce the symptoms of erectile dysfunction.

3. Biofeedback

This is a technique where one learns how to control body functions that are not normally under conscious control. This may include skin temperature, heart rate, and blood pressure among others.

With OAB, your healthcare provider will teach you bladder-sphincter biofeedback method together with pelvic floor exercises.

During the process, bladder, rectal sphincter, abdominal pressure and electrical activities are recorded and displayed for you. From this information, you learn how to relax your bladder, belly muscles and the pelvic floor muscles.

In women, a weighted cone inserted into the vagina may act as a biofeedback during pelvic floor muscle training. This process needs to be practiced in a lab with the guidance of a trained therapist.

4. Medications

In some cases, your healthcare provider may need to prescribe some medication especially when the symptoms persist or physical exercises seem not to work.

Your doctor is likely to prescribe antimuscarinics that work by blocking certain nerve impulse in the bladder, this relaxes the bladder muscle and increase its capacity.

The rate of improvement may vary with different medicine and from person to person.  Some people may also end up develop side-effects that are often minor and tolerable.

Common such side effect a dry mouth, dry eyes, constipation and blurred vision all of which will clear with time. See your doctor when this is not the case.

5. Neuromodulation

Neuromodulation is physiological by which a given neuron uses one or more chemicals to regulate diverse population of neurons. This process works via afferent nerve modulation and offers a minimally invasive and reversible treatment option for those with OAB syndrome.

It is important to know that treatment of OAB should progress from the least to most invasive modality. Neuromodulation provides an attractive option owing to its minimally invasive approach, tolerability, reversibility and positive outcome.

6. Botox injection

Injection of botulinum toxin into the bladder is considered a third-line therapy for the treatment of OAB. This option is used in individuals who have tried and failed or cannot tolerate the side effects of medical therapy.

The effects of the toxins are to prevent the release of chemicals from the nerves that supply the bladder. This prevents the stimulation of bladder muscle. The treatment does not cause permanent changes thus periodic retreatment may be required.

Natural remedies for overactive bladder

Managing an overactive bladder often begins with behavioral strategies that will include fluid schedules, timed voiding and bladder-holding techniques using your pelvic floor.

One way to relieve the symptoms of an overactive bladder is to cut your consumption of fluids. Cut down on to much water and diuretic fluids that can irritate the bladder thus worsen the symptoms especially during the night.

The other natural way to ease the symptoms is bladder training also called bladder drill. The aim of these remedies is to slowly stretch the bladder to hold larger volumes of urine. With this process, the bladder becomes less overactive leaving you in control.

Bladder drill involves holding the urge to urinate for as long as you can. This can be hard at first but with time, it becomes possible to hold urine and reduce the number of trips you make to the toilet.  To help you can try to:

  • Counting backward from 100
  • Sitting straight on a hard surface
  • Doing some pelvic floor exercises

 Foods to avoid if you have an overactive bladder

One of the most annoying symptoms of an overactive bladder is the sudden, urgent and frequent need to urinate especially during the night. There are some foods and drinks that can irritate the bladder, thus worsening the symptoms.

In such cases, your bladder is often very sensitive. Avoiding the following foods can go a long way towards cutting down the urgent and frequent trips to the bathroom.

1. Coffee

With hypertonicity of bladder, too much bladder can not only make you jittery but also make your overactive bladder jumpy. Coffee is both a diuretic and a bladder irritant, it makes your bladder make more urine and very sensitive.

If you have to take tea or coffee, stick to at most a cup a day until the condition is fully fixed.

2. Alcoholic drinks

Just like with coffee, alcoholic drinks are also diuretic and bladder irritant. Taking alcohol increases the rate at which your kidneys are gathering water.

Cut down on your alcohol consumption to help manage the frequent urination especially at night.

3. Carbonated beverages

Carbonated beverages or bubbly drinks can also trickle your bladder. Most of these drinks contain caffeine, sugar, or artificial sweeteners all which can trigger an overactive bladder.

4. Acidic juice

Acidic food and drinks are also a NO when it comes to an overactive bladder. Some of these include blueberries, pears, citrus, orange juice, and apple juice or fruits.

5. Artificial sweetener

Sugary drinks and artificial sweeteners can also worsen the symptoms of an overactive bladder. You also need to cut them down to ease the symptoms and speed up the healing process.

6. Spicy foods

Avoid hot pepper sauce. Just as these foods can burn your mouth, they can also irritate your bladder lining worsening the symptoms. Harvey Winkler, co-chief Urogynecologist in New York says that instead of spices use herbs.

Sources:

  1. Causes, symptoms, diagnosis & treatment of overactive bladder: https://www.mayoclinic.org/diseases-conditions/overactive-bladder/symptoms-causes/syc-20355715
  2. The truth about overactive bladder OAB: https://urologyhealth.org/urologic-conditions/overactive-bladder-(oab)
  3. Best treatment for an overactive bladder: https://www.healthline.com/health/overactive-bladder/best-treatments
  4. WebMD, What is an overactive bladder: https://www.webmd.com/urinary-incontinence-oab/causes-overative-bladder#1
  5. Causes, diagnosis, and management of overactive bladder: https://en.wikipedia.org/wiki/Overactive_bladder
  6. 10 foods to avoid if you have an overactive bladder: http://www.health.com/health/gallery/0,,20540820,00.html

 

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