Bladder Boot Camp - Introduction

Millions of people across the country have found themselves planning their lives around their bathroom stops. It can become such a problem that some people will avoid making plans at certain times, or in new places, because they don't know if they'll be able to access a bathroom when they need it. In some cases, people even become afraid to leave the house. If you feel like your bladder is bossing you around, this article is especially for you.

Soldiers have certain physical fitness requirements they have to meet. So for our bladders, we should pause to consider, "what is normal?" For a healthy adult:

1. Urinating once every 2-3 hours during the day is considered normal.

2. Waking to urinate once during the night is normal only after age 65.

3. Urinating right before bed, and when first waking in the morning is normal.

4. Bladder urges to empty/void are normal, but don't mean you have to go right away. They just alert the brain that the bladder is beginning to stretch; it doesn't always mean your bladder is full.

5. Initiating urination once sitting on the toilet should take only a second or two.

6. Urine flow should happen easily without straining or pushing.

7. Emptying the bladder fully should take less than 30 seconds.

Our bladder is a creature of habit, but it's also a very trainable organ. If your bladder isn't following the normal rules, there are some things you can do to retrain it to have better habits. Next, we'll talk about some common objections people have and misconceptions about their bladder.

Myths & Misconceptions

1. Some people think, "If I drink less, I won't have to urinate as often". This is a myth. In fact, it can make you have to urinate more often. If the urine in your bladder is too concentrated with chemical irritants, it will trigger the urge to need to go. That is why drinking 8 ounces of coffee, or alcohol frequently makes you need to go to the bathroom sooner than drinking 8 ounces of water. Having enough water in your system to dilute the chemical irritants in your urine can actually help you have to go to the bathroom less often.

2. "My diet doesn't matter, only what I drink." Foods have moisture in them too, and many of our foods have chemicals in them that have been added during processing for flavoring or to act as a preservative. Even if you aren't eating processed food, sugar content and acidity can affect our bladder too. Food choices can absolutely influence your bladder.

3. "Before I leave the house, I should go to the bathroom just in case." What pelvic floor therapists call "just in case peeing" is not a good idea. Doing this often can train your bladder to go more often than it needs to. This can increase urinary frequency over time. You should only go to the bathroom if you have an urge to go, or it has been 3 hours since your last void.

4. "I've had babies, so it's normal for me to leak and need to pee more often. It's just the price you pay for having kids." - While urinary incontinence is more common after having children, not all women have this problem. You don't have to (and shouldn't) just live with it.

5. "I just have a small bladder" - This is typically not the case, even when people say it runs in their family. Remember, we inherit more than genetics from our parents, we learn a lot of habits from them too. When doing imaging studies of the bladder, many people who report feeling they have a small bladder don't actually have a different size bladder. More often, the pelvic muscles just have a hard time supporting their bladder, or people have adopted learned behaviors of going frequently and trained their bodies to do it from childhood.

6. "Waking up multiple times a night happens to everybody with age." - While waking up once is normal later in life, more than one time is not normal. Especially in men, this can be a sign of prostate problems and should be evaluated by a medical provider.

Now for the fixing-it part. Tips for where to begin:

1. Make appointments with appropriate healthcare providers for individual medical advice (see below).

2. Keep a bladder log for a couple of days. It's important to know where you are starting. (sample log & instructions)

3. Get your fluid intake right. Drink 4-6 ounces of water every hour, sipping on it throughout the day. If you have a hard time tracking your water intake, or you forget the drink, try using a water bottle to measure out what you're drinking. If you're tech savvy, there are even bottles that will remind you when it's time to drink (See product recommendations)

4. Avoid drinking bladder irritants (See list), and consider the foods you are eating too.

5. Plan out a schedule and set yourself a bladder alarm. If you are someone who goes to the bathroom too frequently, gradually start to increase the time you hold it before you go (i.e. if you normally go every 15 minutes, start trying to wait for 20 minutes, and gradually increase your time intervals). If you are someone who forgets to go to the bathroom all day, plan to go on your lunch break. If you need to, put an alarm on your phone to remind you it's time to go.

Tips for seeking care:

Each provider will have different treatments to offer you. You should consider what type of treatment you want before choosing a provider. You may also want to schedule appointments with providers while you try the tips above. It can sometimes take time to get in to see a specialist.

• Pelvic floor physical therapists: Treat pelvic floor muscle dysfunction that contributes to bladder issues, provide patient education on lifestyle habits and changes to improve bladder health naturally.

• Primary care doctors: Can prescribe medication management, order testing for urinary tract infections, screen for cancer and prostate problems, and write referrals to other specialists.

• Pharmacists: Can review your regular medications to see if any of them may be impacting your bladder

• Urologists: Specialists who treat urinary tract problems. They can prescribe medications and may do surgical procedures.

• OBGYNs: Check for pelvic organ prolapse, screen for pelvic cancers, may perform surgical procedures.

Lastly, don't forget to ask about cost. See our tips for Navigating Healthcare Billing to learn how to be sure you're paying a fair price.

Disclaimers: This article is intended for educational purposes and is not intended to serve as or replace individual medical advice from a healthcare provider. If you are seeking personalized medical advice, please contact our office to schedule an appointment with a licensed medical provider.