Multiple Sclerosis Foundation - 5 Questions to Ask about Your Overactive Bladder

Among the many challenges of living with MS, an overactive bladder is one symptom people with MS are most eager to control. You probably already know to avoid caffeine and alcohol and reduce liquid intake a few hours before bedtime. But other lesser-known factors might be contributing to your OAB as well. To uncover hidden irritants, ask yourself:

Are my bowels healthy? Constipation can affect bladder functioning. Because the bladder and colon are in close proximity, being constipated puts constant pressure on the bladder. Severe constipation (having less than one bowel movement a week) can even damage the neurological function of the pelvic floor muscles. Constipation is generally described as having fewer than three bowel movements a week, according to the Mayo Clinic.

If you’re often constipated, talk with your doctor about relief without using addictive laxatives. Learn how to add more fiber to your diet. Be sure to include both soluble fiber, which absorbs water and slows digestion, and insoluble fiber, which helps maintain regularity. Most foods contain both insoluble and soluble fiber but are usually richer in one type than the other. Good sources of fiber include whole-grain bread and cereals, barley, brown rice, oatmeal, beans, peas, apples, cabbage and carrots. For snacking, try fresh or dried fruit, raw veggies, popcorn, whole-grain crackers or a handful of nuts.

Do I smoke? The chronic cough that comes from smoking increases intra-abdominal pressure, which causes bladder issues. Some researchers exploring the link between loss of bladder control and smoking suspect smoking causes nicotine-induced bladder contractility and introduces other toxins that can be bladder irritants, says urogynecologist Sharon Knight, M.D., an associate professor of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco. Your healthcare practitioner can help determine which smoking cessation program is right for you.

3) Am I overweight? Obesity creates increased intra-abdominal and pelvic floor pressure, contributing to OAB. Losing weight may help relieve those symptoms. Set yourself up for success by finding:

A way of eating you can sustain. Diets involve restrictions, and while we can usually handle a certain amount of restriction for the short-term, in the long-term, we rebel. Move away from the dieting mentality and more towards a mindset focused on healthy eating.
An exercise program you can live with long term. Find a way to get moving that appeals to you. Start with something simple, such as a walking program, or whatever sounds doable to you.
Forgiveness. Sometimes you'll mess up. You'll quit, skip your workouts, eat too much – it happens. Forgive yourself and then get right back to it.

Always check with your doctor before beginning a new exercise program or diet.

4. Do I drink enough water? Cutting back on liquids to keep from going to the bathroom often may do more harm than good. Drinking less causes you to produce more concentrated (dark yellow, strong-smelling) urine. Highly concentrated urine is irritating to the bladder and can cause more frequent urination. It can also lead to a urinary tract infection.

How much is enough? Doctors traditionally recommend consuming about eight 8-ounce glasses of water daily. However, that recommendation may not be best for everyone because activity levels and diets vary. You also get water in the foods and other liquids, such as juice, you consume. Monitoring the color of your urine is one way to know if your intake is on target. A light yellow tint is ideal. No color means you’re overhydrated, while dark urine indicates you need to drink up.

5. Am I eating foods that irritate my bladder? Keeping a daily food diary of everything you eat, along with your voiding frequency, can help you correlate certain foods with increased frequency. The following foods are common OAB irritants:

Spices: Spicy foods have been found to irritate the lining of your bladder and worsen OAB. While spices may be out of the question, that doesn’t mean you’re limited bland meals. To add flavor to your dishes try using herbs that don’t bother your bladder.
Acidic foods: Cranberry juice, orange juice, and even tomatoes can worsen OAB, as the acidity in these foods and drinks irritates the bladder’s lining. Try to avoid citrus fruits and juices, and instead opt for fruits or juices made from produce like apples or pears.
Added sugars and artificial sweeteners: For some, refined sugar and/or artificial sweeteners may worsen OAB, so steer clear of foods and drinks that contain either of these. Diet sodas can be especially irritating to the bladder because they may contain caffeine, artificial sweeteners, and carbonation – all of which can aggravate symptoms and irritate the lining of the bladder.