Overactive Bladder (Cleveland Clinic)

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What is an overactive bladder?
Overactive bladder represents a collection of symptoms that include:

  • urinary urgency -- failure to be able to postpone the need to urinate
  • frequency of urination -- the need to urinate at least eight times per day
  • urge incontinence -- leakage of urine when one gets the urge to urinate
  • nocturia -- the need to get up and urinate at least two times per night

What causes an overactive bladder?
Urine leakage and bladder control problems can have many possible causes. These include:

  • Weak pelvic muscles -- muscles that have become stretched and weak due to pregnancy and childbirth, which in turn have let the bladder sag out of position and have stretched the opening of the urethra causing urine leakage.
  • Nerve damage -- sending signals to the brain and bladder to empty at the wrong time. Diseases that can cause nerve damage include diabetes, Parkinson’s, multiple sclerosis, and stroke. Trauma that can cause nerve damage includes pelvic or back surgery, herniated disc, and radiation.
  • Medications, alcohol, caffeine -- these products can dull the nerves, affecting the signal to the brain, resulting in bladder overflow. Diuretics and caffeine can cause rapid bladder filling and may cause bladder leakage.
  • Infection -- a urinary tract infection can irritate bladder nerves and cause the bladder to squeeze without warning.
  • Excess weight -- being overweight puts pressure on the bladder and contributes to urge incontinence.
  • Estrogen deficiency after menopause -- may contribute to loss of urine due to urgency. Ask your doctor if vaginal-only estrogen therapy is right for you. This is different from "systemic" hormone therapy, which is absorbed throughout the body.

How is overactive bladder treated?
Bladder over activity is a very common condition. It is very treatable, but requires assistance from both the doctor and the patient. Treatment can range from behavioral modification techniques to drugs to neuromodulation.

Behavioral modification techniques to help your overactive bladder
Keep a log
During a typical day, write down your fluid intake, the number of times that you urinate, the number of accidents and when they occur (after coughing, sneezing, laughing, because you were not able to reach the bathroom in time, etc.).

Monitor your diet
Eliminate or decrease foods or beverages that may worsen bladder symptoms. These include:

  • Tea
  • Coffee
  • Alcohol
  • Chocolate
  • Caffeinated soft drinks (even decaffeinated coffee and tea contain some caffeine)
  • Citrus juices and fruits
  • Tomatoes and tomato-based products
  • Spicy and acidic foods and drinks
  • Foods and drinks containing artificial sweeteners
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Last Updated: 11/4/2010

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