Understanding Overactive Bladder
Overactive bladder (OAB) is the name given to a group of urinary problems, including stress incontinence, frequent urination or waking more than once in the night to urinate. OAB usually results in a strong, sudden need to urinate that can't be controlled or predicted, and many people with overactive bladder experience anxiety about getting to the bathroom on time.
Overactive bladder is a relatively common condition affecting millions of people in the United States. An estimated 33 million people live with OAB, with women being more likely than men to have the condition. Experts believe the number of people living with OAB is much higher than reported, since many people with overactive bladder never report their symptoms, whether due to embarrassment or lack of information.
Overactive Bladder Causes and Risk Factors
Overactive bladder can have several causes. Sometimes, OAB occurs when the signals between the bladder and the brain miscommunicate, causing an urgency to urinate even when the bladder isn't full. Overactive bladder can also be caused by overactive bladder muscles, which contract and create a strong, sudden urge to urinate. Other causes of OAB may include structural abnormalities, certain medications and neurological disorders, such as multiple sclerosis, strokes or Parkinson's disease.
The risk of developing overactive bladder increases with age, though urinary incontinence is not considered a normal part of the aging process. Women who have gone through menopause have a higher risk of overactive bladder, as do men who have a history of prostate problems. Certain foods and medications may also increase the risk of overactive bladder and urinary incontinence. Avoiding bladder irritating foods like coffee, alcohol and spicy foods can decrease the risk.
Symptoms of Overactive Bladder
Symptoms of overactive bladder may include a strong, sudden urge to urinate, frequent urination, leaking urine or an inability to get to the bathroom on time. Waking multiple times per night is another common symptom of overactive bladder. Symptoms may also include an involuntary release of urine, and in some cases, emptying of the entire bladder with little or no warning. Many people with overactive bladder report that controlling the flow of urine or holding urine in until getting to a bathroom is very difficult.
If you experience other symptoms, such as fever, nausea, vomiting, fatigue, painful urination, foul smelling urine or notice blood or mucus in the urine, contact your doctor right away, as these may be signs of a more serious health condition. Some symptoms of overactive bladder may also be symptoms of another condition, so talking to your doctor about all of your symptoms is important. Your doctor may want to run tests to determine the cause of your overactive bladder symptoms to rule out other possible health conditions and determine the best course of treatment for your symptoms.
How is Overactive Bladder Diagnosed?
When you talk to your doctor about overactive bladder symptoms, you'll be asked questions related to your past and current health problems, your current symptoms, how long you've been experiencing symptoms and whether or not you're taking any medications. Your doctor may want to perform a physical exam and other tests to help determine the cause of your symptoms. An exam of the abdomen, pelvis, rectum and prostate (in men) will alert your doctor to any possible structural abnormalities that may be causing your symptoms.
A urinalysis or urine culture may also be done to look for blood or mucus in the urine, which may indicate a bladder infection, and ultrasound may be used if structural abnormalities are suspected. If no other causes of your symptoms are found, your doctor may ask you to keep a journal detailing urinary frequency and urgency, as well as foods and beverages you consume throughout the day, to determine the severity of overactive bladder and whether food or drink may be exacerbating the problem.
Treatment for Overactive Bladder
There are several treatments available for overactive bladder, and the treatment that's right for you will depend on the underlying cause of your OAB. The most common treatment option is behavioral therapy and lifestyle changes, which may involve giving up caffeine, alcohol and other trigger foods, while keeping a journal of overactive bladder symptoms. Your doctor may also ask you to perform daily bladder exercises, such as Kegel exercises, starting and stopping the stream of urine during urination and waiting a set amount of time before going to the bathroom.
Other treatment options include medications that relax the bladder muscles to stop them from contracting, neuromodulation therapy, which delivers electrical impulses to the nerves in order to change how the nerves work, and Botox injections into the bladder. Your doctor can help you decide which treatment option is best for you, based on your health history, lifestyle and severity of overactive bladder.