What Lifestyle and Diet Changes We Can Make To Control Leaky Bladder?

1. Manage the timing and/or the total volume of fluid intake throughout the day - To achieve better bladder control, for some people it is helpful to manage the timing and/or the total volume of fluid intake throughout the day but especially right before bedtime (perhaps cutting out beverage consumption completely after 6:00 P. M.).  In this circumstance fluid schedules and bladder training with expansion in scheduled/timed voiding intervals can sometimes help to improve overall management of OAB. 

Research has shown that up to 75% of women with stress and urge incontinence who followed a bladder retraining program significantly reduced both trips to the bathroom and urinary leakage.  Despite the initial intuitive reaction that drastically reducing fluid intake ought to result in fewer trips to the bathroom, the fact is that cutting back too much on water drinking can have just the opposite rebound effect.  In such cases the more concentrated urine which results from too great a reduction in fluid consumption could actually increase bladder irritation and cause a more frequent need to void.  Unless a health care provider advises otherwise, it is generally a good goal to aim at drinking at least four to six cups of water -- but perhaps not more than eight cups -- each day.  Helpful guidelines: if daily urine output is much higher than 48 ounces, you may be drinking too much fluid. 

While this isn't necessarily an unhealthy practice, it does force your bladder to process and void more urine volume, which consequently may invite or aggravate incontinence.  On the other hand, if output is much lower than 30 to 40 ounces daily, it can increase the risk for urinary tract infection and also, for some people, create a more frequent urge to urinate because the concentrated urine might irritate the bladder lining.  Additional recommendations: don't drink more than eight ounces at a time and don't guzzle. The faster your bladder fills, the more likely you are to feel subsequent urgency.  As a guideline, generally you can tell you’re drinking enough when your urine is light yellow (about the color of lemonade) in color.

2. Performing pelvic contractions (Kegel exercises, also called “quick flicks“) may strengthen pelvic floor muscles, which have a powerful role in retaining urine in the bladder to prevent leakage. Check with your health care professional for instructions on the proper way to perform these bladder control exercises if you are unfamiliar with them.

3.  Identify and limit your intake of specific foods that trigger excessive bladder activity.  Avoiding onions (try substituting shallots instead), prunes, spicy, citrus and pineapple- or tomato-based foods along with certain beverages such as cranberry juice and carbonated (alcoholic and nonalcoholic) drinks may be advisable because those items are known to irritate the bladder for a significant number of adults. 

Better substitute choices could be pure water and non-citrus juices or fruits such as peaches, blueberries, melons, pears and coconut.  Cooking with extracts and mild herbs instead of pungent spices and fiery condiments like hot pepper sauce, vinegar, wasabi, MSG, mustard, mayonnaise and soy sauce might also help some people to manage their OAB.  Substituting imitation sour cream and processed, non-aged cheese for creamy, rich sour cream and sharp/zesty, aged cheese may also be beneficial to minimize symptoms.  Finally it could be advisable to limit the total intake of processed foods made with artificial flavors, preservatives or additives (read package labels carefully).  Go “fresh and all-natural” whenever possible to optimize the nutrients, vitamins and minerals in food as well. 

4. Use as little as possible of added sugars, artificial sweeteners -- and even honey -- if such items, as is often the case, cause an increase in symptoms.  Sugar may encourage bacterial growth, and bacteria can cause urinary tract and bladder infections, which in turn intensify overactive bladder symptoms.

5. Reduce consumption of salty foods like potato chips, salted nuts and other high-sodium snacks, which can cause the body to retain too much water that eventually has to go  to the bladder for elimination.  Salty items also often increase thirst and therefore lead an individual to drink more liquids than the body can handle conveniently.  An effective solution might be to switch to low- or no-salt replacement snacks.

6. Some people with an overactive bladder may find that milk and dairy products make their symptoms worse.  This caution doesn't mean that everyone with bladder problems will necessarily have a bad reaction to dairy.  If you keep a careful food intake diary, you can use that record to figure out which foods do bother you, and then you can minimize or eliminate those items from your own daily diet.

7. Consuming the right amount of dietary fiber can ward off constipation, which is not only uncomfortable in itself but which also can increase the likelihood of both OAB and incontinence symptoms. Because the bladder and the bowel are in such close proximity, being constipated puts unremitting pressure on the bladder.  Severe constipation (having less than one bowel movement in a week) can even damage the neurological function of the pelvic floor muscles making it much more difficult to get bladder symptoms under control.

Fortunately research has shown the reverse to be true as well: alleviating constipation may significantly improve control of urinary frequency and urgency.  To maximize the effect of fiber intake, combine both soluble fiber (which absorbs water and slows digestion) and insoluble fiber (which helps maintain regularity) on a daily basis.  Good sources of fiber include whole-grain breads and cereals, barley, brown rice, oatmeal, beans, peas, apples, cabbage and carrots.  For snacking, try fresh or dried fruit, raw veggies, unsalted popcorn, whole-grain crackers or a handful of unsalted nuts.

8. Limiting caffeine intake from beverages like coffee, tea (experiment with substituting herbal teas instead of “regular“ or even decaffeinated coffee or tea), energy drinks and some sodas such as cola and a few other flavors (again, read the label carefully) or from chocolate candy, some mints and chewing gum as well as hot or cold beverages, ice cream, frozen yogurt, puddings and other desserts flavored with coffee and/or chocolate may lessen the feeling of urgency to urinate. 

9. Beware also of some over-the-counter diet pills, stimulants, pain relievers and cold/allergy medications which contain high amounts of caffeine.  In fact it is recommended to read all product labels carefully because unexpected sources like a few brands of beef jerky, instant oatmeal and even “energized” sunflower seeds surprisingly can include almost as much caffeine as the better-known, usual suspects identified above.

10. Avoid excessive alcohol intake.  If you drink alcoholic beverages at all, stick to no more than a single glass of wine or liquor per day.  Note: it may be especially helpful in managing OAB to minimize or eliminate beer consumption.

11. Certain prescription medications have been documented to affect bladder control.  For example some blood pressure control drugs, diuretics and muscle relaxants may worsen urinary incontinence.  It might be helpful to ask the prescribing physician whether a bladder problem could, at least in part, be the side effect of a prescribed drug regimen. 

 
12. Both improved posture and stress reduction techniques are also sometimes helpful in managing OAB.  Tense situations can make some people feel as if they need to empty the bladder with haste.  For these individuals deep breathing and other relaxation exercises may provide tools that can better ease tension instead.  In addition it is important to maintain good posture when urinating.  Sit back on the toilet and relax; don’t lean forward because such an angle can place unwanted physical stress on the urethra and/or the bladder.

13. Cigarette smoking might cause a loss of bladder control - Bladder control problems, including urge incontinence, are three times more common among people who smoke compared to those who have never used tobacco products.   Results from a recent study of 2000 subjects showed a dose-response relationship that explains the effect of smoking on bladder control: the more people smoke, the more frequent and stronger is their need to urinate.  These results underscore the importance of smoking cessation as part of an effective treatment plan for urge incontinence or OAB. 

Exactly why cigarette smoking causes a loss of bladder control is not yet well understood; however, some explanations have been proposed such as nicotine-induced contractility and the production of other toxins that can function as bladder irritants.  Chronic coughing among smokers can also exacerbate urinary incontinence issues by putting extra pressure on the bladder, and -- even worse -- smoking cigarettes is a significant risk factor for developing bladder cancer.

Until improved bladder control is established, wearing an absorbent protective/sanitary or incontinence pad can give temporary help to hide any accidental leakage that might occur.