By Jovie Murtha, Women’s Health Physical Therapist
Ok, we have all heard the commercial, “Gotta go, gotta go, gotta go right now!” Ever feel that way? Frequent urination is a real problem for millions of Americans. It can interfere with so many aspects of life, like school, travel, shopping, work, and sleep! Urinary frequency can have many causes, and the good news is, it is often easy to remedy. Oftentimes the culprit is something as easy as looking at what is in your glass or on your plate!
Let’s take a look at “normal” urination and bladder function. Typically, a person with a normal voiding pattern will urinate between four to eight times per day, and zero to one time at night (one to two times at night, if you are over 65). That means that a normal-sized bladder will be able to hold urine for two to five hours and should be able to hold about 20 ounces of fluid. Your bladder fills about 15 drops per minute during the day. It will fill more quickly in the presence of caffeine, alcohol, certain medications, and carbonation. It fills more slowly at night.
If you feel the constant need to run to the bathroom, it is important to find the cause. Problems can be medical, physical, or behavioral. Let’s look at a few medical issues. First and foremost, if you have a fever, confusion, blood in your urine, pain with urination, or difficulty voiding, it’s time to visit your doctor to rule out infection or stones. Patients that complain of thirst and report urinating large amounts of fluid could be demonstrating signs of diabetes. Interstitial cystitis, chronic constipation, neurological dysfunction, radiation therapy, and use of blood pressure medications are also culprits.
Physically, prostate issues can slow or interrupt the stream of urine, which can lead to incomplete bladder emptying and therefore frequent urination. Tight pelvic floor muscles can also cause urinary hesitancy, intermittent urine stream, and difficulty passing urine. This is easily treated by a Men’s or Women’s Health Physical Therapist. Obesity also can create undue pressure on the bladder. Of course, pregnant mommies can attest to frequent trips to the bathroom due to hormonal changes, as well as the weight of that little babe on the bladder.
Many times, the cause of urinary frequency is behavioral and can be remedied. This is where a physical therapist can really help. By keeping a simple bladder diary for a couple of days, we can assess what foods and/or drinks may be triggering your bladder. A good way to remember these triggers is to think of the three “A’s” and the four “C’s”. Artificial sweeteners, alcohol, and acidic foods (tomatoes, lemons, oranges, and vinegar) are bladder irritants for many. The four “C’s” include citrus, cranberry, carbonation, and caffeine (including coffee, soda, tea, and sadly, chocolate … sorry). When your bladder is irritated, it wants to rid itself of the irritant so it will begin to contract. By keeping track of the foods and drinks you consume can help identify what may be an issue for your bladder. Some other interesting triggers include onions, spicy foods, aged cheeses, gluten, processed foods, and MSG. Everyone is different.
Urinary frequency can also have a behavioral cause. For example, if you run to the bathroom every time you get a little twinge of an urge, your bladder gets used to being emptied when it really is not full. Remember, a normal bladder should be able to hold urine for about two hours. So, if you are voiding every hour, your bladder is not full. Your brain and bladder start to think that every hour is “normal,” so you will be triggered to go before it is actually time. This is easily remedied for most people by bladder re-training, as instructed by your PT. Please note, there are a few exceptions to this rule for those with other serious medical problems.
Urinary urgency can be caused by non-dietary triggers. Some people have to dart to the restroom as soon as they get home, even if they just went not very long ago. Others have to go if they hear or touch water. Other patients tell me that every time they go to a certain store they are triggered to go. This is called urinary urgency and can also be re-trained with your PT.
Interestingly, many people believe that drinking less fluid will alleviate those frequent trips to see John. However, the bladder is sensitive and does not like concentrated urine. It likes diluted urine. If your urine is yellow and concentrated, the bladder will want to expel it because it is irritating. Your bladder is much more willing to tolerate and hold urine that is diluted. Drink plenty of water and keep the urinary tract healthy and flushed.
With a little investigating, you may be able to easily remedy urinary frequency. You may want to start drafting your “Dear John” letter, because you may be seeing a lot less of him in the near future.
Physical Therapist Jovie Murtha is relentless in her mission to help women conquer pain and discomfort so they can be more active. For more information contact jovie.murtha@acceleratedrehab.com or please call 309-683-6900.
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