What Is Fluid Management For Oab
It is important not to severely restrict fluids for overactive bladder as this could lead to dehydration. However, most people need roughly 4 to 8 eight ounce glasses of fluid per day more may be required with exercise, hot weather, or excessive perspiration.
It’s true that cutting back on fluids may help with leakage and embarrassing moments. However, if you do not drink enough liquids, your urine may become dark and concentrated and dehydration may occur.
One option is to drink small amounts at regular intervals throughout the day, instead of a large glass all at once. If you awaken frequently at night to urinate, avoid fluids right before bed, and cut back on alcohol and caffeine.
If you take a diuretic for high blood pressure, take it in the morning rather than at night, to help prevent nighttime trips to the bathroom.
Other Treatments To Try
In rare cases when all OAB treatment fails and overactive bladder is severe, doctors may recommend one of several types of surgery.
A procedure called bladder augmentation uses part of the bowel to increase bladder capacity. Or, urinary diversion, an alternate route for bladder drainage for severe, complicated OAB patients.
Sacral nerve stimulation. Another procedure implants a small device, similar to a pacemaker, under the skin. The device is connected to a wire, which sends small electrical pulses to nerves around the pelvic floor that control the bladder and muscles surrounding it. This helps build bladder control. Itâs often called a bladder pacemaker. The main limitation with this treatment is that it keeps you from having a spinal MRI.
Percutaneous tibial nerve stimulation. The doctor places a needle on nerves near your ankle that affect bladder control. Youâll have one session a week for 12 weeks and then maintenance treatments as needed. This procedure is done in the office.
An overactive bladder doesnât have to get in the way of your daily life. With a little time, patience, and the right treatment, you can regain control — and peace of mind. Whatever treatment for overactive bladder you and your doctor decide upon, it’s important that you stick with it. If you do, chances are your condition will improve in time.
Cholinergic Drugs For Bladder Problems
This class of drugs includes bethanechol . Cholinergic refers to nerve cells or fibers that use a certain type of chemical to send signals within the body. Cholinergic drugs are used when the bladder is not emptied completely following urination. This problem is known as residual urine in the bladder.
- How cholinergic drugs work: These drugs contract the bladder, thus allowing complete emptying.
- Who should not use these medications: Individuals with the following conditions should not use cholinergic drugs:
- Parkinson’s disease
- Bladder or bowel obstruction
Beta Agonists For Bladder Problems
This class of medication, mirabegron , works by relaxing the bladder muscle during the storage phase, thus increasing the capacity of bladder to hold more urine. They can be used for the treatment of overactive bladder . Mirabegron is the first drug in this category.
- How beta-agonist drugs work: They work by relaxing the bladder muscles and reducing bladder overactivity.
- Who should not use this medication: Individuals with the following conditions should not use mirabegron or a similar class of drugs:
- Allergy to this drug
- Advanced kidney disease
Medical Treatments For Nocturia
Your doctor may prescribe medications when preventive measures and lifestyle changes fail to reduce the frequency of your nighttime urination. Doctors prescribe a class of drugs called anticholinergics to treat symptoms of OAB, if thats the cause of your nocturia. They reduce bladder spasms that create the urge to go.
Your doctor may suggest you take a diuretic for regular urine production. A diuretic can itself cause nocturia. But if you take it early enough in the day, it may help you get rid of excess fluid while youre awake. This should decrease your urine production at night.
Other drugs that may help are:
- desmopression in cases of diabetes insipidus to cause the kidneys to produce less urine
- tamsulosin , finasteride , or dutasteride to treat prostate enlargement
- antibiotics if you have a urinary tract infection
Your doctor may also adjust your diabetic medications to lower your blood sugar if theyre causing nocturia.
Making Too Much Urine
Your childs kidneys may make too much urine overnight, leading to an overfull bladder. If your child doesnt wake up in time, a wet bed is likely. Often this excess urine at night is due to low levels of a natural substance called antidiuretic hormone . ADH tells the kidneys to release less water at night.
Coping Methods And Quality Of Life Issues
Most women visit their physicians without hesita-tion forsuch conditions as urinary tract infections , vaginal fungalinfections, and birth control. However, for some inexplicable reason, alarge number of those suffering from OAB postpone a medical appointment,many for as long as 6 or 7 years.4 During this time, theyemploy a variety of coping mechanisms of dubious efficacy andquestionable safety. For instance, the use of absorbent pads ispartially effective, but increases the risk of a UTI.4 Somewomen also take great pains to ascertain the location of all bathroomsin advance of an attack of OAB, a behavior known as toilet mapping.4
Women with symptoms of OAB may reduce the extent ofactivities they once found pleasurable, such as movies, walks, tennis,golf, or visiting with friends. They may voluntarily reduce fluidintake, which can lead to dehydration. They may feel forced to wearclothing that would conceal a urine leak, and only sit on furniture thatwould not be permanently stained if a leak were to occur. It becomesapparent that OAB can cause constant concern due to fear of an accidentand also the perception that odor from underclothing or absorbent padsmight be detected by others. If a patient feels forced to lead a moresedentary lifestyle, she may experience greater medical andpsychological problems.
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Prevalence And Epidemiology Of Oab
As many as 17% to 40% of adult women in the United States have OAB.4,7This is approximately 20 million OAB patients. However, the true numberis likely to be far higher, as many patients do not enter the healthcare system. There are three major reasons for this reluctance to do so.4First, many patients view OAB as an inevitable part of aging and chooseto take various self-care measures rather than visit a physician foradvice. Second, as many as 61% of OAB sufferers do not realize that thecondition can be successfully treated with medication and therefore donot seek help. Finally, OAB can induce shame and embarrassment inpatients, and the resultant negative social stigma may cause them toavoid any mention to health care providers.
Although OAB occurs in women of all ages, it exhibits a strong age association.3,8 The median age is 52 years, and the most common age range is 45 to 60 years.4
How Can Diet Affect Overactive Bladder
Some foods and drinks irritate the bladder, possiblycontributing to the problem. You should strive to eliminate caffeinefrom your diet by halting use of coffee, tea, and all caffeinated softdrinks. Alcohol should be eliminated entirely, as it is another bladderirritant. Spices such as pepper add flavor to foods, but they also cancause severe irritation to the bowels and bladder. It may be helpful tokeep a diary of your intake of these foods and drinks to see if theyactually do produce a worsening of symptoms.
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Lifestyle Fluids And Diet
A few small changes to your lifestyle could help to alleviate your nocturia symptoms. Avoid caffeine, alcohol and fizzy drinks, especially late at night as these can have a diuretic effect and increase urine output at night. Avoid constipation as this can put pressure on a small bladder by eating a healthy, balanced diet with enough fibre. More advice on Lifestyle, Fluids and Diet.
Nonsurgical Treatments And Implantable Devices
If your overactive bladder isnt well controlled using lifestyle changes and prescription drugs, your doctor may refer you to a specialist if you arent seeing one already.
A specialist, usually a urologist, will be able to offer certain nonsurgical procedures and implantable devices to help ease your symptoms.
Botox injectionsBotox is a paralytic agent with a number of medical uses. To treat overactive bladder, its injected into your bladder muscle.
Botox treatment can help prevent your bladder from contracting too easily or often. But it may also relax your bladder so much that it doesnt fully empty, especially during the period shortly after you receive the treatment.
Urinary retention affects about 9 percent of people who receive Botox treatment for overactive bladder, according to the Mayo Clinic.
If this happens to you, you may need to use a catheter intermittently to fully empty your bladder until its able to do so on its own.
The effects of Botox treatment eventually wear off. For overactive bladder, treatments tend to be effective for about five months or longer.
Neuromodulation therapy Also known as nerve stimulation, this type of treatment uses electrical impulses to change how nerves in certain areas of your body work.
There are two main types of neuromodulation therapy for overactive bladder:
- Sacral neuromodulation
- Percutaneous tibial nerve stimulation
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A New Nonprescription Product
Women may try the behavioral changes mentioned above, aswell as one of several prescription medications that relax the muscles of the bladder to preventcontractions. Physicians may also attempt such therapies as applicationof electrical impulses or Botox.
A new nonprescription product may be helpful for overactive bladder. It is known as Oxytrol For Women, which is available as a patch that is worn continuously on the skin for 4 days and contains the medication oxybutynin.
This product may be appropriate for you if you have hadtwo or more of the following symptoms for at least 3months: 1) urinary frequency, more than 8 times in 24 hours 2) urinaryurgency and 3) urge incontinence. However, urinary frequency can alsobe caused by urinary tract infections, diabetes, pregnancy , and other more serious conditions. If you think you have anyof these, you should see a physician instead.
The products label will have many additional useprecautions, warnings, and instructions. You should read and heed eachof these. Further, it is wise to Consult Your Pharmacist for additional assistance regarding use of this innovative new approach to overactive bladder.
Remember, if you have questions, Consult Your Pharmacist.
Who Can And Cannot Take Mirabegron
Mirabegron can be taken by adults .
It is not suitable for everyone. To make sure it’s safe for you, tell your doctor or pharmacist before starting mirabegron if you:
- have had an allergic reaction to mirabegron or any other medicines in the past
- have liver or kidney problems
- have high blood pressure
- are not able to pee or empty your bladder completely
- have a blockage in your bladder
- have a heart problem called QT prolongation
- are pregnant, trying to get pregnant or breastfeeding
Try To Avoid Caffeine Carbonated Drinks Sugar Alcohol And Spicy Or Acidic Foods
- Caffeine is a diuretic which makes you need to use the bathroom more often.
- Carbonated drinks and sugar are thought to stimulate the bladder.
- Alcohol switches off the ability of your body to concentrate urine. This means you tend to urinate more dilute, watery urine, which dehydrates you. Since you are dehydrated, you may drink more.
- Acidic or spicy food may aggravate your overactive bladder and worsen your symptoms. Certain acidic fruit and juices like orange, grapefruit, lemon and lime can aggravate your bladder, too.
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Assessment Of Frequent Urination At Night
The assessment of nocturia includes those factors on history and physical examination discussed in the general assessment of urinary incontinence.
History taking in patients with nocturia includes a specific assessment of:
- Fluid intake
- Total fluid intake
- Intake of fluids in the hours before going to bed
- Intake of fluids that can act as bladder irritants and increase nocturnal urine output such as alcohol and caffeine
- Blood sugar levels
- Diabetic control in diabetic patients
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Herbal Natural Remedies For Overactive Bladder At Night
One of the easiest ways to help an overactive bladder is to take herbal remedies. These are some of the best home remedies for overactive bladder because theyre natural and often inexpensive.
Make sure you look at the individual herb instructions because herbal applications vary. You make tea with some herbs while others you take by mouth like food.
Drink Normal Quantities Of Fluids
It may seem sensible to cut back on the amount that you drink so the bladder does not fill so quickly. However, this can make symptoms worse as the urine becomes more concentrated, which may irritate the bladder muscle. Aim to drink normal quantities of fluids each day. This is usually about two litres of fluid per day – about 6-8 cups of fluid, and more in hot climates and hot weather.
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Surgery Is A Last Resort For Restoring Proper Bladder Function
If lifestyle measures, drug treatments, Botox, and neuromodulation therapy are all ineffective at relieving your symptoms, your doctor may consider more drastic surgical treatments for overactive bladder.
These surgical treatments are usually reserved for people with severe symptoms. At this point, two main surgical options are available:
Surgery to Increase Bladder Capacity Surgically increasing the size of your bladder may help relieve pressure and improve its ability to store urine.
In this procedure, your doctor removes pieces of your bowel and uses them to replace a portion of your bladder.
If you have this surgery, you may need to use a catheter intermittently to urinate for the rest of your life.
Bladder Removal As a last resort, your doctor may remove your bladder. A replacement bladder, called a neobladder, may be surgically constructed, or your urine may be routed to the outside of your body through a hole in your skin called a stoma.
If you have a stoma following this surgery, youll wear a bag or pouch on your skin to collect your urine.
How Is Nocturia Diagnosed
To help your healthcare provider diagnose nocturia, you can keep a fluid and voiding diary. This is a two-day record of how much you drink, how often you have to go the bathroom and how much you urinated . You should also record any medications you are taking, any urinary tract infections and any related symptoms. Your healthcare provider will review the diary in order to determine the possible cause of and treatment for the nocturia.
Your provider may ask you the following questions:
- When did this condition start?
- How many times do you need to urinate each night?
- Is there a large or small volume of urine when you void at night?
- Has there been a change in urination output ?
- How much caffeine do you drink each day, if any?
- Does frequent urination during the night keep you from getting enough sleep?
- Do you drink alcoholic beverages? If so, how much each day?
- Has your diet changed recently?
In addition to reviewing your voiding diary, your doctor may order a urinalysis to examine your urine for infection.
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Why Frequent Urination Happens At Night
Waking up night after night, time after time is vexing and tiring. Why does it happen? It helps to understand the mechanics of the disorder.
Overactive bladder involves the nerves and muscles of the bladder. The urge to urinate is caused by uncontrolled spasms of the bladder muscle. Also, people with OAB have small bladder capacity whereas a bladder normally holds up to 600cc of urine.
Coffee, tea, alcohol, and spicy foods are irritants that can make the problem worse.
If you have OAB, you experience whats known as urinary urgency, a sudden, uncontrollable desire to urinate. This can occur when the bladder isnt even full. At times, this urgency makes it challenging to reach a bathroom in time.
When you need to urinate often at night, its due to the uncontrollable nature of OAB. The urge to urinate more frequently is a 24/7 problem.
Now that the New Year has passed, consider these specific, realistic resolutions for people with OAB that can help improve your daily life.
How can you know its OAB and not another urinary problem? You likely have OAB if you:
- Urinate 8 or more times daily without drinking excess fluid.
- Need to urinate several times every night.
- Urine leakage, bed wetting, and accidents.
Many people with OAB suffer from social anxiety because they fear an accident. They may avoid social situations and change their lifestyles to prevent accidents. However, theres no escaping the symptoms of OAB even at home at night.