Overactive Bladder Disorder

Overactive bladder (OAB) is a condition in which the bladder cannot hold urine normally. One of the most common symptoms of this health problem is urinary incontinence or leaking urine. Many people suffer in silence, but if you are currently experiencing a bladder-related difficulty you are truly not alone. It’s estimated that at least 33 million Americans have overactive bladder. (1)

Under Construction

Sometimes a person experiencing overactive bladder doesn’t have any underlying health problem. Other times, an overactive bladder can be the result of medications or other more serious health issues, such as diabetes, kidney disease, multiple sclerosis (MS) or Parkinson’s disease. (2) OAB can also occur after surgery or childbirth. How much is too much when it comes to urination? People with OAB typically have to urinate more than 8 times per day or more than once at night. (3)

It’s crucial to address overactive bladder symptoms right away. Early treatment can reduce, or even completely get rid of, the highly unwanted symptoms. (4) With some time and effort, there are several very doable and natural ways you can overcome an overactive bladder.

What Is an Overactive Bladder? Symptoms to Look For

Overactive bladder is a syndrome, or a set of symptoms, that is believed to be due to sudden contractions of the muscles in the wall of the bladder. (5) When you have overactive bladder syndrome, the muscles controlling bladder function start acting involuntarily. This often leads to urinary incontinence or loss of bladder control. The urine leakage experienced by someone with OAB can be as little as several drops to up to several ounces. Sometimes, incontinence can be a sign of something simple like drinking way too many caffeinated beverages on a daily basis. Other times the underlying cause can be something more serious.

An overactive bladder is said to account for 40 to 70 percent of incontinence. (6) What is incontinence? Incontinence is a lack of voluntary control over urination or defecation. When you have overactive bladder, you can experience urinary incontinence or loss of control over urination.

There are actually two different types of overactive bladder. “Dry” is when you have a sudden, urgent need to urinate many times during the day. “Wet” means you have the sudden, urgent need to urinate and you experience bladder leakage, which is also referred to as urge incontinence. Both “dry” and “wet” can occur without any underlying health condition. (7) An estimated 60 percent of OAB patients have dry OAB (no leakage) while 40 percent have wet OAB (urine leakage). (8)

OAB symptoms can differ on an individual case basis. Common symptoms of an overactive bladder include: (9)  an urgent need to urinate  urine leakage frequent trips to the bathroom

These symptoms can be serious life disruptors during the waking and sleeping hours of a person’s life. Having to constantly go to the bathroom, and not knowing when you might have urine leakage, can cause a lot of stress. If you already have overactive bladder, then you know how important it is to be near a bathroom at all times.

You’re probably wondering just how many trips to the bathroom per day is considered normal. An OAB sufferer typically feels the need to urinate eight or more times in a full day or 24 hour period. This urgent need to relieve oneself might even exist when fluid intake is low. (10)

Causes and Risk Factors

Aging

OAB occurs in both men and women. It’s possible to have overactive bladder at any point in your life. But, it’s especially common in older adults. The prevalence of OAB in people younger than 50 years of age is less than 10 percent. After the age of 60, the prevalence increases to 20 to 30 percent.  (11)

The following are some of the other most common underlying causes and risk factors associated with OAB symptoms: (12)

Nerve Damage

A healthy, normal functioning bladder holds urine until it gets full and is prompted to empty by nerve signals. However, when nerve damage occurs in the body, the muscles surrounding the urethra (the tube that takes urine out of your bladder) can be too loose. This undesirable looseness can cause someone to become incontinent. What can cause nerve damage that can then lead to bladder leakage? Some possibilities include:

  • Back or pelvis surgery
  • Diabetes
  • Herniated disc
  • Multiple sclerosis
  • Parkinson’s disease
  • Radiation
  • Stroke

Weak pelvic muscles

When a man or woman’s pelvic floor muscles are weak, bladder control issues can happen. The pelvic floor muscles are like a sling that holds up the uterus and bladder. For women, a pregnancy and childbirth can often lead to a stretching and weakening of the vital pelvic floor muscles.  When pelvic floor muscles are compromised for this reason or another, the bladder can then sag out of place. The opening of the urethra also stretches and urine easily leaks out.

Menopause

For women, the bladder often changes after the body goes throughmenopause and makes OAB more likely. One theory is that there is a loss of estrogen that makes up bladder tissue. Or, it’s just due to aging or a combination of both.

Extra weight or obesity

Need another reason to aim for a healthy waistline? Carrying around extra pounds is linked to OAB and urine leaks. This makes a lot of sense since excess weight puts more pressure on the bladder.

Diuretic medications

Diuretics or water pills are very commonly prescribed for high blood pressure. These medications cause your body to get rid of water and salt faster through the urine. As a result, this can cause the bladder to fill up faster and possibly leak.

Other causes behind some OAB symptoms include bladder stones, urinary tract infection (UTI), urethral strictures, benign prostatic enlargement (BPH) or bladder tumors. Often, no apparent cause of overactive bladder can be determined. This is called idiopathic overactive bladder. (13)

Overactive Bladder vs. Urinary Incontinence

Overactive Bladder

  • Condition in which the bladder can no longer hold urine normally.
  • Often feel a sudden urge to urinate or experience an accident.
  • Defining symptom is urgency, or the inability to postpone urination.
  • OAB is typically a chronic problem
  • Often requires strengthening of pelvic floor muscles to get rid of symptoms like urinary incontinence.
  • Symptoms including urinary incontinence are ongoing.
  • Bladder muscle problems at the root of it.
  • Can result from regularly consuming alcohol and caffeine in large quantities.
  • Serious health conditions can lead to OAB including a stroke, diabetes, kidney disease, multiple sclerosis (MS), or Parkinson’s disease.

Urinary Incontinence

  • Is when you lose control of your bladder.
  • Isn’t a condition; it’s a symptom.
  • Is a symptom of OAB.
  • Can be caused by a loss or weakening of control over the urinary sphincter.
  • Can be a sign of something simple like a singular occasion of too much fluid consumption, a temporary problem.
  • Is a common symptom of a UTI along with a burning sensation during urination and/or blood in the urine.

Conventional Treatment

Conventional treatment typically involves prescription medications, specifically antimuscarinic drugs, that aim to calm the bladder.  The seven common drugs for overactive bladder include: darifenacin (Enablex); fesoterodine (Toviaz); mirabegron (Myrbetriq); oxybutynin (Ditropan XL, a skin patch called Oxytrol, a topical gel called Gelnique, and generic); solifenacin (Vesicare); tolterodine (Detrol and generic, Detrol LA) and trospium (Sanctura, Sanctura XR and generic).

An analysis of these drugs demonstrated that none of these medications are obviously better than the others. What difference did they find? In addition to cost variations, there were also different side effects including constipation, dry mouth, drowsiness, blurry vision and dizziness. Even most conventional doctors will hopefully tell you to try lifestyle modifications before turning to medications. (14)

In more serious cases, a doctor may inject botulinum toxin (BOTOX®) to calm the bladder muscles. Again, this treatment is not without possible and often serious side effects including urinary tract infection, urinary retention (not being able to empty the bladder completely), hematuria (blood in the urine), fatigue and insomnia. (15)

 

 

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