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Overactive Bladder (OAB)

Nocturia: How to treat an overactive bladder at night

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Simply put, at night, nocturia is unnecessary urination. The disorder includes waking up early in the evening to urinate.

This disorder has several different causes which can make it difficult to diagnose.

Nevertheless, there are many therapies available once the causes are identified. There are several ways to help avoid nocturia, as well as suggestions to sleep well with the condition.

Nocturia vs. overactive bladder

Nocturia is often confused with a condition called overactive bladder (OAB).

A ma walking to the toilet at midnight
People with nocturia can produce an average amount of urine overall, but often need to take several night-time trips to the bathroom.

OAB is caused by the bladder muscle’s early and uncontrolled spasms which make a person urinate when their bladder is not actually full. This means routine all day urination, and even during the night.

Although people with OAB can experience frequent urination at night, people with nocturia appear to experience urination only frequently at night.

Many people with nocturia generate a regular amount of urine in general, but they actually produce a lot of urine at night.

Treatment for nocturia

The nocturia treatment depends on its cause, so there may be many different treatments for the work.

For example, if an infection causes nocturia, antibiotics may help clear the symptoms. When a medication triggers it, physicians may consider adjusting the medication of the individual, or simply suggest that they take it earlier that day.

Of example, in some cases where an person with nocturia also has an enlarged prostate, surgery can be required. More intensive care may also be required for nocturia caused by other serious conditions, such as diabetes, cancer or heart failure.

The key thing to remember is that to treat nocturia you need to recognize and treat the underlying condition.

Doctors can also recommend nocturia-treated medications. To reduce the amount of urine produced, antidiuretics such as desmopressin can be used. Other medicinal products that may help are anticholinergic or anti-muscarinic, such as:

  • darifenacin
  • festerodine
  • oxybutynin
  • solifenacin
  • tolterodine
  • trospium

Estrogen creams can also be given to women to treat stress incontinence.

People with nocturia induced by lifestyle choices may find the symptoms go away as they change their behaviors. However, if the symptoms continue, it might be time to see a doctor to ensure that an underlying medical condition is not causing them.

Tips for sleeping well

Most physicians and urologists may advise people to limit the amount of alcohol and caffeine they consume during the day.

Even if these drugs are not the cause of the condition, they are also diuretics and can worsen symptoms. Doctors can also recommend people with nocturia drink less liquids at night and before bedtime.

It is also important to avoid foods that are rich in liquids, and foods that serve as diuretics. Examples may include:

cranberry and citrus juices
Avoiding diuretics such as cranberry and citrus juices may alleviate some symptoms of nocturia.
  • melon
  • cucumber
  • cranberry juice
  • soda
  • soup
  • citrus drinks, such as lemonade, orange juice, and grapefruit juice
  • tomatoes and other acidic foods
  • spicy foods
  • artificial sweeteners
  • chocolate

Maintaining a meal log is an useful tool for many. Writing down what is consumed everyday will help establish a link between symptoms and problem foods.

There are also several individuals who benefit from exercising their bladder to help regain control of their contractions. If the bladder is used to contract every hour to inform the body that it’s time to urinate, the practice will also continue.

Over time, the bladder can be conditioned to move urine every 2-4 hours instead, or kept overnight. It is best done, with a doctor’s supervision.

Causes of nocturia

Since nocturia causes range from simple lifestyle decisions to serious medical conditions, diagnosis can often be difficult. Nocturia is most common in adults over 60 years of age but can occur at any age.

Medical conditions can cause symptoms of nocturia, and people can expect their doctor to ask them about their symptoms to help determine the causes.

Possible nocturia factors and medical conditions include:

There are other more unusual causes, too, such as autonomic dysreflexia and cystic medullary disease. People should always speak to do a complete and thorough diagnosis with their doctor.

Lifestyle choices influencing nocturia include:

  • excessive fluid consumption before bed
  • overhydration throughout the day
  • alcoholic beverages
  • caffeinated beverages

Another thing to remember is that the practice of waking up during the night to urinate may also change the inner clock of the body. Also if someone has stopped drinking liquids before bed, they may still wake up to urinate simply because at that time of night their body is used to doing so.

Diagnosing nocturia

It’s not unusual for people to go to the bathroom at night, especially when they drink extra fluids before bed. Normally, during the night the body produces less urine to help a person get a full night’s sleep. This is also one indication why morning urine is more concentrated.

People who wake up early to urinate over once a night experience nocturia. This may interfere with sleep habits and may be a symptom of a health problem.

For certain cases, the symptoms of nocturia may be identical but the causes may be different. And, to understand their root cause, a doctor may want to ask questions and track the symptoms.

Doctors may ask several questions about the nocturia to people who come to see them, such as:

A man waking up from sleep
A doctor may ask how many times a person wakes up to urinate per night, as well as if they experience any incontinence.
  • How many times do they urinate each day?
  • How many times do they wake up to urinate?
  • Did the symptoms of nocturia come with any other symptoms?
  • Does the body produce less or more urine than before?
  • What makes the symptoms worse? What makes the symptoms better?
  • Is there a personal or family history of bladder problems, kidney diseases, or diabetes?
  • Are there any medications they are taking that may cause these symptoms?
  • Do they experience incontinence or wet the bed during the night?

Doctors may ask patients to undergo regular tests, as well as the questioning, such as:

  • urine culture samples
  • blood sugar tests
  • fluid deprivation tests
  • blood urea tests

If cysts, stones, or an enlarged prostate are believed to be the cause of nocturia, a doctor may want to do an ultrasound as well.

Outlook

People with nocturia in their lives may see it as an annoyance. It could also be found embarrassing.

Luckily, there are several different treatment strategies, such as medications, and the root cause of the symptoms healing. There are also options and behaviors about lifestyle that can help ease the symptoms.

In most cases the underlying cause behind the symptoms can be identified and handled with caution and the advice of a doctor.

Overactive Bladder (OAB)

What are the implications of holding your pee?

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It’s natural for people to fight the urge to urinate from time to time, whether it’s due to a long day at work or a thrilling movie. However, holding urine on a daily basis is not recommended because it can cause issues.

The urinary bladder is a pear-shaped, hollow organ that is a part of the urinary system. The bladder’s job is to store pee until it’s time to go to the restroom.

A healthy adult bladder can hold about 16 ounces of liquid, or 2 cups, while a child’s bladder can hold considerably less. Although the bladder may stretch to retain more, doing so too frequently might be harmful. It is not a good idea to put off going to the restroom on a regular basis.

We’ll look at the consequences of holding in pee for too long or too often in this article.

Introduction

a man using restroom

Holding in pee on occasion will not harm a healthy adult, but if it becomes a habit, it may have negative consequences.

The bladder sends a signal to the brain when it is roughly halfway full of liquid, indicating that it is time to pee. The bladder is told to hold on while the brain develops the urge to urinate.

It is sometimes important to hold urine in. It could be difficult to find a restroom, or a person could be working on bladder retraining exercises.

There are no hard and fast guidelines about when and how to hold in pee. Side effects may be more common in certain people than in others.

Side effects that may occur

1. Discomfort

The following are five possible negative effects of holding in pee:

People who neglect their urge to pee on a regular basis may have pain or discomfort in their bladder or kidneys. Urinating can be painful when a person finally gets to the bathroom.

After the release of urine, the muscles may remain partially contracted, causing pelvic cramps.

2. Urinary tract infection

Holding pee for an extended period of time might cause bacteria to proliferate. It’s possible that this will result in a urinary tract infection (UTI).

Many doctors advise against holding in urine for long periods of time since it can raise the risk of UTIs, especially if you have a history of UTIs.

Because the bladder is not alerting the body to pee frequently enough, people who do not drink enough liquids are more prone to acquire a UTI. This can transmit bacteria throughout the urinary tract, resulting in infections.

A UTI can cause the following symptoms:

  • a burning or stinging feeling during urination
  • pain in the pelvis or lower abdomen
  • a constant urge to empty the bladder
  • strong- or foul-smelling urine
  • cloudy, off-colored urine
  • consistently dark urine
  • bloody urine

3. Bladder stretching

Regularly holding in urine can lead the bladder to stretch in the long run. The bladder may find it difficult or impossible to contract and release pee normally as a result of this.

Extra measures, such as a catheter, may be required if a person’s bladder is strained.

4. Damage to pelvic floor muscles

Retention of urine on a regular basis might cause damage to the pelvic floor muscles.

The urethral sphincter is one of these muscles, and it seals the urethra closed to prevent pee from spilling out. Urinary incontinence could result if this muscle is damaged.

Kegels and other pelvic floor exercises can help strengthen these muscles, heal muscle loss, and prevent leaks.

5. Kidney stones

In people with a history of kidney stones or those who have a high mineral content in their urine, holding in pee can cause kidney stones to form. Minerals like uric acid and calcium oxalate are commonly found in pee.

How much urine can the bladder hold?

The capacity of the human bladder varies slightly from person to person.

A healthy bladder can contain around 1.5–2 cups (300–400 ml) of pee over the day, according to research. The bladder may be able to store more during the night, up to 4 cups (800 ml).

Because their bodies are still developing, children’s bladders are smaller. Using the equation (age + 2) x 30 ml, people may be able to anticipate the size of a child’s bladder.

A 10-year-old child, for example, would have a bladder capacity of around 360 ml based on this formula.

In addition, a healthy bladder may be able to extend and accommodate bigger volumes of urine. Urinating at regular intervals, on the other hand, is recommended.

Will the bladder burst?

Many people assume that if they hold their pee in for too long, their bladder may burst.

While a spontaneous urinary bladder rupture is possible, most ruptures are caused by an underlying reason, such as a blockage that prevents the bladder from voiding. Most of the time, the bladder will simply override the muscles that are holding the urine in, resulting in an accident.

Blows or piercing items, on the other hand, are more likely to cause bladder injuries.

It’s important to remember that a spontaneous urinary bladder rupture can lead to serious problems if left untreated.

Other conditions’ effects

Urinary retention can be caused by a variety of medical disorders. This is usually unintentional and goes unnoticed, but it might result in comparable difficulties.

Urinary blockage or retention can be caused by an enlarged prostate, weaker bladder muscles, or nerve injury in the urinary system.

It’s also a good idea for people with kidney problems to avoid holding in pee to avoid difficulties.

Training the body to pee less often

Doctors may advise retraining the bladder to urinate less frequently in some circumstances. This involves resisting the urge to pee.

The idea is to increase the amount of liquid that the bladder can hold before the urge to pee arises. If successful, this will increase the amount of time between bathroom trips.

Typically, a doctor will create a personalized retraining timetable and supervise the instruction.

The following suggestions may assist someone in easing into the retraining process:

  • staying warm, because being cold may trigger the urge to pee
  • listening to music or watching television for distraction
  • actively engaging the brain with a game, puzzle, or problem to solve
  • reading a book or newspaper article
  • staying seated or walking around, whichever resolves the urge
  • making a telephone call or writing an email

The idea is to use your intellect and divert your attention away from the urge to pee.

Tips for reaching the bathroom in time

Although it is advisable to pee whenever the bladder is full, not everyone has rapid access to a restroom.

The following suggestions can assist a person in getting to the restroom on time:

  • Cross the legs while standing: This may compress the urethra and help avoid an emergency.
  • Pass gas: A buildup of gas may be putting added pressure on the bladder.
  • Pee right after waking up: People in a rush to leave the house may skip a trip to the bathroom, but it is important to start the day’s cycle of urination right.
  • Plan for regular bathroom breaks: A person may want to try scheduling a bathroom break every 2–3 hours. Set an alarm and head to the bathroom, whether or not the bladder is sending a signal. This can help relieve pressure and avoid emergencies.
  • Do not wait until it is an emergency: Regardless of deadlines or busy days, make a habit of heading to the bathroom the moment the urge to urinate hits.

Conclusion

Occasionally holding pee in will likely cause no harm. However, doing so on a frequent basis could put you at risk of infection or other consequences.

It may be beneficial to have healthy and consistent restroom habits. Anyone who believes they are urinating excessively or frequently should see a doctor.

Sources

  • https://training.seer.cancer.gov/bladder/anatomy/
  • https://www.stanfordchildrens.org/en/topic/default?id=anatomy-of-the-bladder-34-BBlaO2
  • https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-urinary-system
  • https://www.continence.org.au/about-continence/continence-health/bladder/bladder-training
  • https://www.ucsfhealth.org/education/bladder-training
  • https://www.medicalnewstoday.com/articles/321408
  • https://www.urologyhealth.org/urology-a-z/b/bladder-trauma
  • https://www.ncbi.nlm.nih.gov/books/NBK540963/
  • https://www.keckmedicine.org/is-it-dangerous-to-hold-in-your-pee/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849873/
  • https://www.ncbi.nlm.nih.gov/books/NBK531465/
  • https://training.seer.cancer.gov/anatomy/urinary/components/bladder.html
  • https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults

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