Overactive Bladder

Overactive Bladder

Overactive bladder syndrome, known as OAB, is a condition in which the muscles of the bladder contract suddenly and unexpectedly. This spasm can cause the urgent feeling of needing to urinate and can also force urine into the urethra from where it can spill or leak out of the body, with intensely embarrassing consequences for the sufferer.

The kidneys are constantly making urine, a slow trickle constantly filling the bladder, the amount produced is dependent on how much the person is drinking, sweating or eating. The bladder has a decent storage capacity under normal circumstances and the urge to go to the toilet is only triggered when it is almost full. When a person urinates the bladder muscles squeeze and the urethra and pelvic floor muscles relax to enable the urine to flow. With overactive bladder disorder the bladder muscles contract before there is enough urine to warrant a trip to the toilet.

Approximately one in six people suffer from an overactive bladder, with one in three of those admitting to having instances of urge incontinence, when urine leaks out involuntarily.

The causes of OAB are not well understood. Normally, as the bladder fills up the bladder muscle, called the detrusor, gradually relaxes. Our feeling of needing to go to the toilet comes from the muscle being stretched by the volume of fluid, and most people can control the urge to go until it is convenient. With OAB the messages, sent between the brain and the muscle, are muddled and the detrusor can contract suddenly, without warning, sending the small volume of urine into the urethra involuntarily.

Signs and symptoms of OAB include feeling that the bladder is full, even immediately after emptying it, needing to urinate often, getting up at night to go the bathroom – several times a night in some cases – and extreme urgency in the need to go, that is to say the sufferer cannot wait a moment or two, they need to rush to the toilet straight away.

While OAB presents mainly in older patients, becoming more prevalent as ages rise, children can suffer from OBA too. This is generally as a result of an urinary infection or a condition known as pollakiuria in which children (usually between the ages of 3 and 8) need to urinate very frequently, as often as every five or ten minutes! Men can suffer from OAB too, although it is more often women who will seek out treatment for involuntary incontinence as there is more awareness of stress incontinence caused by childbirth and pregnancy.

Coping with an overactive bladder

While the causes of OAB may not be well understood, there are a variety of lifestyle changes that be implemented to lessen the impact of the disorder. These include reducing the intake of caffeine and alcohol, reducing fluids before beds, and implementing urination training. This consists of urinating on a schedule, starting at every two hours, for example, and employing good urination practice, ensuring that the bladder is properly emptied. Pelvic floor exercises can help to increase muscle control, while other exercises try to 'stretch' the bladder muscle to improve its storage. There is no specific cure for OAB, rather it is an all-round approach.

Patients often have various herbs and supplements urged on them as relief for their condition, but little is known about the effects, good or bad, of any herbs or natural remedies for OAB.

In summary:
  • The best overactive bladder treatments involve a proactive approach on the part of the patient, taking control of the disorder and making the necessary lifestyle and diet changes to reduce the impact on their daily lives
  • Botox has recently been added to the regimen of possible treatments, enabling sufferers to unchain themselves from the burden navigating through life from loo to loo
  • There is no real understanding of what causes OAB