Summary Interstitial Cystitis Vs Overactive Bladder
Interstitial cystitis and overactive bladder are two chronic medical conditions that are due to problems in the bladder. Interstitial cystitis is characterized by bladder pressure and bladder pain, while the overactive bladder is characterized by urinary urgency. This is the key difference between interstitial cystitis and overactive bladder.
How Do Health Care Professionals Diagnose Overactive Bladder
The diagnosis of overactive bladder is based on the presence of symptoms, while excluding other conditions that may cause similar symptoms. This is based on history, physical examination, and a urine test. Waking up to urinate one or more times at night, urinary frequency , urinary urgency, and urinary incontinence are all important clues in evaluating someone suspected of having overactive bladder.
In addition to a general physical examination, a pelvic exam in women and a prostate examination in men are helpful in excluding other contributing conditions.
Urine analysis to assess for infection, blood cells in the urine, and high levels of glucose in the urine is recommended. Occasionally, urine cytology is sometimes advised in individuals undergoing evaluation of urinary incontinence and overactive bladder, particularly individuals with blood cells in the urine . Bladder ultrasound measurement of the amount of urine left in the bladder after urination may also provide additional information about the cause of urinary incontinence but is not needed in all individuals with OAB symptoms.
What Behavioral Changes Can I Make To Help Fix Overactive Bladder
You can make many changes to your behavior to help fix your overactive bladder. These include:
Keeping a bladder diary
A healthcare provider may ask you to keep a bladder diary for a few days. Noting what happened before you had an accident can help the provider determine the cause of your OAB. Youll use your bladder diary to track:
- What you drink.
- Tomatoes and tomato-based products.
- Spicy and acidic foods and drinks.
- Foods and drinks that contain artificial sweeteners, such as diet soft drinks and some chewing gums.
Maintaining bowel regularity
Constipation can place pressure on your bladder and affect your bladder function. You may be able to avoid constipation and reduce bladder symptoms by keeping healthy bowel habits. The following can help you maintain bowel regularity:
- Increase your fiber intake. Incorporate foods such as beans, pasta, oatmeal, bran cereal, whole wheat bread, fresh fruit and fresh vegetables into your diet.
- Drink two to four extra glasses of water each day.
- Exercise regularly.
Managing your weight
Having overweight can put pressure on your bladder, which may contribute to bladder control problems. Maintaining a weight thats healthy for you can reduce pressure on your bladder.
Stop using tobacco products
Cigarettes and other tobacco products can irritate your bladder muscle. Coughing spasms due to smokers cough can also cause leakage.
Bladder retraining teaches you how:
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How Should This Medicine Be Used
Topical oxybutynin comes as a gel to apply to the skin. It is usually applied once a day. Apply oxybutynin gel at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Apply oxybutynin gel exactly as directed. Do not apply more or less of it or apply it more often than prescribed by your doctor.
Oxybutynin gel may help control your symptoms but will not cure your condition. Continue to use oxybutynin gel even if you feel well. Do not stop using oxybutynin gel without talking to your doctor.
Oxybutynin gel is only for use on the skin. Do not swallow oxybutynin gel and be careful not to get the medication in your eyes. If you get oxybutynin gel in your eyes, wash them with warm, clean water right away. Call your doctor if your eyes become irritated.
You can apply oxybutynin gel anywhere on your shoulders, upper arms, stomach, or thighs. Choose a different area to apply your medication every day, and apply the entire dose to the place you choose. Do not apply oxybutynin gel to your breasts or your genital area. Do not apply the medication to skin that has recently been shaved or that has open sores, rashes, or tattoos.
Keep the area where you applied oxybutynin gel dry for at least 1 hour after you apply the medication. Do not swim, bathe, shower, exercise, or get the area wet during this time. You may apply sunscreen during your treatment with oxybutynin gel.
If You Have Overactive Bladder Drugs May Not Be The Best Solution
The advertising of drugs for what is often called overactive bladder can make it seem as though medication is the key to curbing frequent bathroom breaks and bladder leaks. But is taking a drug the best solution for regaining control of your bladder?
Drug ads may leave out information you need before deciding whether to use a certain therapy, says Michael Hochman, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California. In particular:
Symptoms may be addressed without drugs. About one-third of the time, leaks and strong urges to go resolve in women within a year without treatment. In many cases, simple lifestyle changes, such as cutting back on certain fluids or doing exercises to strengthen muscles supporting the bladder, can greatly improve control.
The drugs often dont work well. According to an analysis by Consumer Reports Best Buy Drugs, most people who take these medications can expect only modest relief. Medication reduces the number of daily bathroom trips from 12 to nine or 10, on average. People who experience bladder leaks can expect one or two fewer episodes per day.
Lifestyle changes that improve your overall health shedding a few pounds if youre overweight and stopping smoking can also reduce incontinence. In addition, get your fiber, because constipation puts pressure on your bladder.
Copyright 2017. Consumers Union of United States Inc.
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What If I Forget To Take It
If you forget to take your medicine, take it as soon as you remember unless the next dose is due in less than 6 hours. In this case skip the missed dose and take your next one at the usual time.
Do not take a double dose to make up for a missed dose.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
How To Talk About Urinary Incontinence
Bringing up the topic of urinary incontinence with your doctor or your spouse is never easy most people are at least a bit embarrassed. But open communication can help you find out about the causes of incontinence and whether your medications may be contributing.
One good opener might be something like this: “I have been having bladder troubles.”
If you will be visiting a new doctor, and have not yet selected them, you might seek out a doctor of the same sex, if you think that would help you feel more comfortable. Or, you might bring up the topic first with your doctor’s nurse.
Preparing for the conversation about urinary incontinence may help you feel more in control. That means being able to answer the questions your doctor is likely to ask, including:
- When did your urinary incontinence symptoms begin?
- Have you had urinary incontinence symptoms before?
- What drugs are you on, and when did you start each of them?
- Do you leak urine with physical activity, coughing or sneezing?
You may find it easier to talk about incontinence if you acknowledge it as a medical condition that needs treatment, just as high blood pressure, arthritis, or high cholesterol does. Treatment options for urinary incontinence are plentiful.
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Overactive Bladder And Botox
Botox may be best known as a great wrinkle reducer for the face. But this injection has actually shown great promise as a treatment for many medical conditions.
Most overactive bladder medications aim to calm muscles and nerves in the urinary tract. If these medicines arent effective, your doctor may consider injecting Botox into your bladder muscles. This can help calm the muscles and reduce symptoms of OAB.
Botox injections for overactive bladder are well-tolerated with few side effects. The injections effects typically last six to eight months. After that time, your doctor may want to use another round of injections to control symptoms.
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When Should I See A Healthcare Provider
See a healthcare provider if you experience any symptoms of an overactive bladder.
Age-related OAB may develop gradually and slowly worsen over time. If your symptoms develop suddenly and you have heavy leakage, your OAB may be a symptom of another condition, such as an infection or a neurological issue. Its best to have a provider check these symptoms sooner rather than later.
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How Do I Control Urges When Resetting My Bladder
Controlling your urges is a key step in resetting your bladder. The following strategies may help:
- Stop what youre doing and stay put. Stand quietly or sit down, if possible. Remain as still as possible. When youre still, its easier to control your urges.
- Squeeze your pelvic floor muscles quickly several times . Dont fully relax in between Kegels.
- Relax the rest of your body. Take several deep breaths to help you let go of any tension.
- Concentrate on suppressing your urge to pee.
- Wait until the urge goes away.
- Walk to the bathroom at a normal pace. Dont rush. Continue squeezing your pelvic floor muscles quickly while you walk.
Patience is important. Retraining your bladder usually takes at least six to eight weeks to see results. Talk to a healthcare provider if you have any questions or arent happy with your progress. They may prescribe medications for you to take while youre resetting your bladder to help you achieve the best outcome.
Pelvic Floor Exercises Can Help Immensely
You cant see your pelvic floor muscles however, just like other muscles in your body they lose their strength if they are not put to use.
Pelvic floor exercises help strengthen the pelvic floor when done consistently at least twice a day. How are they done?
- Imagine you are holding back gas or urine.
- Squeeze and lift the rectal area without tightening your buttocks or belly. Try and hold it for a count of three before relaxing. Repeat this cycle 10 times. Do 10 sets of Kegel exercises, at least 3 times a day.
- Increase your contractions as your doctor recommends.
- Do not hold your breath when you do Kegel exercises. Keep your stomach, back, and leg muscles relaxed.
- Dont use Kegel exercises to start and stop your urine stream which can lead to incomplete emptying of the bladder and an increased risk of a urinary tract infection.
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Medications That Can Cause Urinary Incontinence
Urinary incontinence, or the loss of bladder control, can be caused by various health conditions and physical changes, such as childbirth, changes in diet, infection, prostate issues, menopause, and neurological disorders. But there are also a number of medications can cause urinary incontinence in both men and women in a variety of different ways.
Diuretics such as hydrochlorothiazide , furosemide , bumetanide , triamterene with hydrochlorothiazide
Increase urine production by the kidney
Frequent urination, overactive bladder, stress incontinence
Muscle relaxants and sedatives such as diazepam , chlordiazepoxide , lorazepam
Cause sedation or drowsiness relax the urethra
Frequent urination, stress incontinence, lack of concern or desire to use the toilet
Narcotics such as oxycodone , meperidine , morphine
Cause sedation or drowsiness relax the bladder, causing it to retain urine
Lack of concern or desire to use the toilet, difficulty in starting urinary stream, straining to void, voiding with a weak stream, leaking between urinations, frequency incontinence
Antihistamines such as diphenhydramine and chlorpheniramine
Relax the bladder, causing it to retain urine
Alpha-adrenergic antagonists such as terazosin , doxazosin
Relax the muscle at the outlet of the bladder
Leaking when coughing, sneezing, laughing, exercising, etc.
From Better Bladder and Bowel Control, Harvard Health Publishing
Which Medications Can Cause Oab
Some medications help with an overactive bladder and are used to treat the condition. But in other instances, your medications may be the culprit leading to urinary urgency.There are several classes of medications that may lead to OAB, including the following:
Diuretics are a type of medication that helps stimulate the kidneys to get rid of water and salt from the body in the form of urine. It is prescribed for people who may retain fluid. One of the most common drugs used is Lasix. Because it stimulates the body to make more urine, it often causes OAB.
Three overactive bladder surgery options include Botox injections, bladder augmentation and sacral nerve stimulation. Learn more about each procedure here.
2. Blood Pressure Medications
Alpha-blockers are a type of medication used to reduce blood pressure. They work by dilating the blood vessels in the body, which can increase urinary urgency. Examples of alpha-blockers include prazosin and doxazosin mesylate.
Different antidepressant medications may prevent the bladder from emptying completely. This may cause an increased urgency to use the bathroom. Some antidepressants also decrease a persons awareness that they need to urinate, which can lead to urinary incontinence.
4. Narcotic Pain Medications
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Seven Effective Treatments For Overactive Bladder
Overactive bladder occurs when sudden or frequent urges to urinate become hard to control, and can often lead to leakage .
In order to best treat overactive bladder, a urologist must pinpoint the underlying cause. Treatment will depend on symptom severity and the degree to which they impact someones quality of life. In general, there are three approaches to treatment: medication, behavioral interventions, and surgery.
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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
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What To Expect From Your Doctor
Your doctor may use an overactive bladder questionnaire to make an assessment of your symptoms, asking questions such as:
- How long have you had these symptoms?
- Do you unexpectedly leak urine? How often?
- What do your symptoms keep you from doing that you like to do?
- During daily activities, such as walking or bending over, do you leak urine?
More On Drug Side Effects
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I’m sorry to say, however, that your aunt long ago reached the age where anticholinergic drugs should almost certainly be ruled out as a treatment option. In older patients, anticholinergics like the two your aunt has been prescribed can cause a wide range of adverse effects, including constipation , blurred vision, confusion and short-term memory problems, dizziness, anxiety, depression and hallucinations.
When considering how to treat urinary incontinence it’s important to remember two things. First, while the muscles in the bladder and urethra lose some of their strength as we get older , incontinence isn’t “normal” at any age. Second, urinary incontinence is a symptom, not a disease. Urge incontinence, for example, may be caused by:
I’d recommend that you work closely with your aunt’s physician or other health care provider to determine, if at all possible, what might be causing her incontinence. Smoking or being overweight can be contributing factors, for example.
While it’s not always possible to pinpoint a cause especially with very old patients I find that adjusting a patient’s medications often resolves or, at least, substantially lessens the problem. Some simple behavioral techniques including bladder training and scheduled toilet trips can help, too.
Also of interest:
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In Case Of Emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at . If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
If someone swallows oxybutynin gel, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.