If you’re like many women struggling with overactive bladder, you’ve probably tried restricting your water intake to stop all the annoying bathroom breaks. Let me explain why that strategy might be making things worse…
In my practice as a pelvic health physical therapist (physio), I treat many women who are dealing with the debilitating effects of overactive bladder. The sudden urgency or even the potential of sudden urgency is enough to restrict your ability to go to the store or take a vacation.
Additionally many of the ladies I treat describe anxiety about urgency coming on in the worse of circumstances; the lack of an immediate bathroom. As a result, many of my clients start restricting their activity including exercise.
The distress caused by this urgency is so great that many of my ladies will confide that they are restricting fluids including water to gain control. This is the ‘less in, less out’ strategy of bladder control that many women resort to in desperation.
What’s wrong with this strategy?
When you start restricting fluids your body slowly becomes more dehydrated. The liquid that does make it to the bladder is much less, and while that does mean fewer bathroom breaks it doesn’t mean your bladder is happier.
Your bladder is designed to stretch to accommodate fluid, when it doesn’t get very much, the urine that is created will be concentrated.
The concentrated pee is darker in color and may even have a strong odor. This type of urine is highly acidic and irritates the inner lining of your bladder. This irritation, in turn, leads to more urgency. Yikes!
Even though you have the best of intentions, the restriction of fluids could be the driver behind your bladder urgency. If you suspect your bladder urgency (OAB) is aggravated by not getting enough fluid, don’t worry.
Just follow my tips below to get yourself back on track.
Stay hydrated!
As human beings, we are largely made up of water. As much as 75% of our body consists of water as the main element. We also know that attaining a water balance is an essential element for human health.
But exactly how much water should you be drinking has been debated and studied intensely. In 2005 the National Academies of Medicine published a consensus study report on ‘Adequate Intake’ of water.
This study found that ideally, women should consume 2.7 L/day of total water, which includes fluid and food sources of water. Of the 2.7 Liters, 80% should come from fluids and 20% from food sources. That works out to the following amounts:
Fluids – which include plain water, and liquid beverages
- 2.2 L/day or 74 fluid oz. or 9.25 cups
Food – which include soups, broth, watery fruits
- .5 L/day or 17 fluid oz. or 2 cups
As a bonus, increasing your hydration will decrease the likelihood of developing bladder infections or recurrent UTIs. Regular hydration will also reduce the risk of becoming constipated. Curious about the relationship between constipation and OAB?
Check out my blog on the subject here.
Avoid bladder irritants!
When it comes to fluids, some are better than others. Additives like artificial sweeteners, citric acid, alcohol, and carbonated water are all known bladder irritants and when taken in large quantities or when you’re dehydrated can bring on bladder urges. Cutting back on irritants is key to stopping all those bathroom breaks.
The top ten bladder irritants are:
- Diet soda
- Citrus based herbal tea
- Carbonated flavored water
- Citrus juices
- Cranberry juice
- Coffee/coffee drinks
- Soy milk
- Chocolate milk
- Energy drinks
- Alcohol
Yep, coffee made the list. If you’re like me, coffee is a favorite morning beverage, and giving it up is a hard one. As I tell all of my clients, the key is moderation and hydration. If you get plenty of water during the day and don’t overdo your coffee intake during the day, you will likely be fine.
Want a deeper dive into this subject? Check out my blog on bladder irritants.
Sip water throughout your day!
Sipping water rather than gulping down a large amount in one sitting will prevent the sudden urgency that comes with drinking a large amount of water at once.
Your body needs time to process fluids, so when a large amount goes in at one time the excess will be expelled. This means gulping water at one sitting will likely lead to trips to the bathroom.
If you make it a habit to sip throughout the day, you will stay hydrated and avoid the sudden rush to the toilet.
Drink more in the daytime and less in the evening!
Not only is it important to stay hydrated, but also when you drink your water is important as well. Drinking excessive amounts in the evening can lead to more trips to the bathroom at night.
This is especially true if you have medical conditions like sleep apnea, heart disease, and diabetes which tend to increase urine production. Getting good quality sleep is essential for our body to feel good, and frequent trips to the toilet in the middle of the night are very disruptive.
Simply shifting the time you take in fluids can decrease the likelihood of your bladder waking you up at night for a trip to the bathroom. I generally recommended that you decrease fluid intake after 6 pm or three to four hours before your usual bedtime.
Too much water or fluids is not good either
Like most things in life, too much of anything can have a negative effect, even how much water you drink.
Excessive fluid intake (defined as 16 cups or more) has been linked with increased episodes of urinary frequency and bladder leakage. This is especially problematic for those individuals who have medical conditions that increase urine production.
Experiment with your water and fluid intake.
We will all have slightly different hydration needs based on activity level, underlying medical conditions, and age. Figure out the right amount for you that keeps you hydrated, doesn’t send you running for the toilet, and prevents constipation.
It may take some time, but finding the right balance is key to keeping your bladder healthy and happy. 
What are your hydration strategies? Leave me a comment below!
Happy bladder Wishes,
~ Tami
Tami Lines is a licensed Physical Therapist with certifications in Pelvic Rehabilitation and Women’s Health Coaching. She is the founder of Pelvic-Health-Matters. Tami has over 15 years of experience with expertise in bladder Health, and pelvic floor muscle dysfunction for adolescent and adult women. She is also a mom of two wonderful young adults working their way through college.
References:
Wyman JF, Burgio KL, Newman DK. Practical aspects of lifestyle modifications and behavioral interventions in the treatment of overactive bladder and urgency urinary incontinence. Int J Clin Pract. 2009;63(8):1177-1191. doi:10.1111/j.1742-1241.2009.02078.x
Burgio, K. Impact of behavior and lifestyle on bladder health. International journal of clinical practice Volume: 67 Issue 6 (2013) ISSN: 1368-5031 Online ISSN: 1742-1241