Ways to a better bladder

If you have a problem with your internal plumbing, chances are you’re experiencing bladder weakness, an overactive bladder or a urinary tract infection

If you thought only older people have bladder problems, you’re wrong. Bladder problems can affect men, women, the young and the old. In fact, according to the Bladder And Bowel Foundation, there are around 14 million people in the UK with some form of bladder problem. That means there are more people with bladder problems than asthma, diabetes and epilepsy put together.

Some of the most common bladder problems include bladder weakness, overactive bladder and urinary tract infections. Here’s our quick guide to all three.

Problem: Bladder weakness

Also called stress incontinence – one of the two main types of urinary incontinence – bladder weakness can make you leak urine unintentionally when you cough or laugh (when your bladder is under pressure).

The other main type of urinary incontinence is urge incontinence (associated with overactive bladder – see below). Combined, stress and urge incontinence are thought to affect nine out of 10 of all cases of urinary incontinence, which according to the NHS affects between three and six million people in this country. And unlike bladder problems in general, urinary incontinence is thought to affect about twice as many women as men, and becomes more common with age.

Stress incontinence is called bladder weakness because it happens when your pelvic floor muscles and the urethral sphincter are too weak to stop you leaking urine. So when your bladder fills with urine, the pressure on the muscles increases. And when you laugh, sneeze or cough – or do anything to put extra pressure on your bladder – the result is a leak.

There are several things that may cause the damage to your pelvic floor muscles or urethral sphincter, making them weak. These include nerve damage during childbirth, being pregnant or overweight, a lack of the hormone oestrogen in women (such as after the menopause) and some medications.

What can you do?

Non-medical treatments may include lifestyle changes – such as drinking less caffeine and more water, or losing weight if you need to – and pelvic floor muscle training (see Work those muscles, below).

There are prescription medicines that can be used to relive stress incontinence if your condition doesn’t improve after making lifestyle changes and training your pelvic floor muscles. You can find out more about these treatments – as well as information about surgical treatment for more complex cases – from your GP.

Your pharmacist also stocks incontinence products such as discreet incontinence pads and pants, which are more effective than sanitary pads.

Other products are available for more serious leakage, including pull-ups, appliances and washable bed pads. Ask your pharmacist for more details.

Problem: Overactive bladder

According to the Cystitis & Overactive Bladder Foundation, overactive bladder is a common medical condition where the bladder muscle contracts too often or spontaneously and involuntary, making you want to pass urine more frequently and/or urgently than is necessary.

The COB Foundation suggests as many as one in six adults may have some symptoms of an overactive bladder, about one in three of whom may also have episodes of urge incontinence (urge incontinence is what happens when urine leaks whenever you feel an intense urge to go to the loo, or soon afterwards).

There are many possible causes of overactive bladder, including a urinary tract infection (see below), benign prostatic obstructions in men, neurological conditions such as Parkinson’s disease, multiple sclerosis or stroke, and certain medicines. Meanwhile, according to the NHS, urge incontinence is usually the result of overactivity of the muscles that control the bladder (the detrusor muscles).

What can you do?

Again there are some lifestyle changes you could make if you have the symptoms of an overactive bladder. Drink plenty of water – around 2-2.5 litres a day, recommends the COB Foundation, since not drinking enough could cause bladder irritability. Nicotine can also irritate the bladder muscles, so ask your pharmacist about help with quitting smoking if you need support.

Some foods are also thought to irritate or trigger overactive bladder, including:

  • Highly spiced foods
  • Fruit and fruit juices,
  • Fizzy drinks
  • Anything containing caffeine (chocolate, tea and coffee).

Increasing your fibre intake could help too, as constipation can also add pressure to your bladder.

Being overweight can put pressure on your bladder too, so it’s a good idea to adopt a healthy diet and do more exercise – both of which could help you lose those excess pounds.

Bladder training is also one of the first treatments you may be offered if you have urge incontinence. This involves learning techniques that could help you go for longer without feeling the need to urinate. Ask your GP for more details, as well as information on prescription medicines that may help if bladder training isn’t effective.

Problem: Urinary tract infections

Urinary tract infections (UTIs) can cause pain or a burning sensation when you urinate as well as a need to go to the loo often and pain in the lower abdomen. But while they may be painful and uncomfortable, UTIs usually run their course within a few days and, if necessary, can be easily treated.

According to the NHS, UTIs are more common in women than men, with around half of all women in the UK thought to have a UTI at least once in their lifetime (whereas every year one in 2,000 healthy men will get one). Even children can get UTIs, though it’s not as common as in adults.

Most UTIs are caused by bacteria that spread to the urethra via the anus, causing an infection such as urethritis (infection of the urethra) or cystitis (infection of the bladder). This may explain why more women are likely to have an UTI, since the female urethra is closer to the anus than the male, which means it’s easier for bacteria to reach the bladder.

What can you do?

UTIs can usually be easily treated by taking a course of antibiotics. Your pharmacist can also recommend an over-the-counter painkiller if you need one, and you should drink plenty of fluids to prevent dehydration and also flush bacteria out of your body.

Other tips on preventing UTIs include going to the toilet whenever you need to, instead of holding it in, and practising good hygiene by washing your genitals every day and before having sex, and emptying your bladder after having sex. Also get into the habit of wiping from front to back after going to the toilet, to reduce the risk of bacteria being spread, and avoid constipation or treat it quickly.

  • For more information on over-the-counter treatments for UTIs, have a chat with your local pharmacist.

Work those muscles

Strengthening your pelvic floor muscles could help relieve the symptoms of stress incontinence. And anyone can do them, any time. Here’s a quick example:

  • While sitting, squeeze your pelvic floor muscles 10-15 times in a row (imagine you’re trying to stop the flow of urine when you go to the loo).
  • When you get better at squeezing, try holding each squeeze for a few seconds. You could also do more squeezes as you get used to the exercise.
  • Do your pelvic floor exercises when you’re at work, when you’re watching TV or when you’re on the bus or train – nobody will know.