Do you often have that sudden “gotta go” feeling that makes
you nervous you will leak urine if you don’t get to a bathroom right
away? If so, you may have Overactive Bladder (OAB).
OAB is not a disease. It’s the name given to a group of troubling
urinary symptoms. The most common is a sudden and unexpected urge to urinate
that you can’t control. In some people, this “gotta go”
feeling may result in urine leakage (incontinence). But in others, it
may not. Other OAB symptoms include frequent urination during the day
and night. The number of times someone goes to the bathroom may be different
from person to person. But many experts agree going to the bathroom more
than 8 times in 24 hours is “frequent urination.”
“Because many people living with overactive bladders don’t
ask for help, they don’t know there are treatment options,”
says Brian Bechtol, PA-C. “But there are plenty of things we can
do to help. If you are having difficulty with OAB symptoms, it’s
important to talk to your health care provider. You may be asked to describe
your symptoms, you may be referred to a specialist, such as a urologist
and you’ll be asked about your medical history and how symptoms
are affecting your life. Your provider will also ask about past and current
medical problems and about your diet-including what liquids you drink
and how much you drink.”
You will be given a physical exam to check for problems that may be causing
OAB symptoms. Your provider may ask you to keep a “Bladder Diary,”
where you write down how often you go to the bathroom and any time you
leak urine. You may also have tests, such as a urine test, to look for
infection or blood. Your doctor may do an ultrasound to see how much urine
is still in your bladder after you go to the bathroom.
The risk for OAB increases as you get older. Men who have had prostate
issues are also at higher risk. Conditions affecting the brain or spinal
cord, such as multiple sclerosis or stroke, also raise your risk for OAB.
Food and drinks, such as caffeine, artificial sweeteners, alcohol and
very spicy foods, can bother your bladder and make symptoms worse.
There are many treatment options for OAB. Your doctor may use just one
treatment, or several at the same time including lifestyle changes, medications
and other therapies.
Examples of lifestyle changes that may help control an overactive bladder:
- Limiting food and drinks that irritate your bladder. This includes coffee,
tea, artificial sweeteners, caffeine, alcohol, soda, other fizzy drinks,
citrus fruit, food made with tomatoes, chocolate (but not white chocolate)
and spicy foods.
- Emptying your bladder twice. This is helpful for people who have trouble
emptying their bladders completely. After you go to the bathroom, wait
a few seconds and then try to urinate again.
- Keeping a bladder diary. Writing down when you make trips to the bathroom
for a few days can help you and your doctor understand your symptoms better.
A diary may also show you some things like certain foods that make your
symptoms worse, for example.
- Teaching yourself to put off going to the bathroom, even when you feel
an urge to go. Start by waiting a few minutes. Then gradually build up
to 2-3 hours. Only do this if your doctor tells you to.
- Following a set, daily bathroom schedule during the day, usually every
2-4 hours.
- Doing exercises to relax your bladder muscle. Quickly squeeze and release
the muscles in your pelvis a number of times when you feel the urge to go.
Prescription drugs are sometimes used to relax the bladder muscle. They
can help stop your bladder from contracting when it is not full. Some
are taken by mouth. Others are delivered through a gel or patch on the
skin. For example, with neuromodulation therapy (also known as a bladder
pacemaker) electrical pulses are delivered to the nerves to change how
they work. Botulinum toxin (Botox®) injections are also a possible
treatment option to keep the bladder muscle from contracting too often.
Brian Bechtol, PA-C, a family medicine provider with medical staff privileges
at CVMC, also serves on the advanced panel of wound healing providers at the
CVMC Center for Wound Healing and Hyperbarics. Bechtol is licensed to practice by the state of North Carolina and is
certified by the National Commission on Certification of Physician Assistants.
He is a Navy veteran and holds his Physician Assistant degree from Alderson-Broaddus
College. Bechtol is also a member of the Urgent Care Association of America
and the North Carolina Academy of Physician Assistants.