Taming bladder overactivity during CNY

Dear Dr G,

The arrival of Chinese New Year is undoubtedly one of the busiest periods in our Asian calendar.

The celebration involves an abundance of rich food and flavourful beverages which help create a joyful atmosphere at all gatherings.

However, while rejoicing the arrival of the New Lunar Year, I am quietly suffering from troubling bladder symptoms that are making life somewhat miserable.

I am a 30-year-old sales executive who is suffering from symptoms of frequent urination and urgency.

This is also coupled with nighttime urination that results in insomnia.

I initially thought the symptoms were associated with a urinary tract infection.

Despite multiple courses of antibiotics, the symptoms persisted.

I then went to the urologists and was told I suffer from overactive bladder.

Apparently, the condition can be provoked by lifestyle and diet.

As I would like to limit my suffering during Chinese New Year, and therefore wishing to put Dr. G on the spot for some guidance.

First, can you tell me what exactly is an overactive bladder?

What triggers bladder overactivity?

How does lifestyle and diet exacerbate bladder overactivity?

Lastly, are there any treatments available that can tame an overactive bladder?

Thank you in advance and wishing you and all the readers Gong Xi Fa Cai!

Warmest regards

Overactive Oliver

Overactive Bladder (OAB) is a medical condition characterised by the frequent feeling of needing to urinate, and adversely affecting the quality of life of the sufferers. Frequent urination may occur during the day or night. More than 40% of individuals with overactive bladder also encounter urgency with some degree of incontinence. Conversely, about 40% to 70% of urinary incontinence is due to overactive bladder. Although OAB is not life-threatening, the condition causes significant impairment to sufferers quality of life.

The three major symptoms of OAB are daytime frequency, urgency and night-time urination. Urinary frequency is considered abnormal if the person urinates more than eight times in a day.

The amount of urine passed during each urination is relatively small. Night time urination is a symptom where the person complains of interrupted sleep because of an urge to void. One Finnish study revealed two or more voids per night can affect quality of life.

Urge incontinence is a form of urinary incontinence characterised by the involuntary loss of urine. The severity of OAB clearly varies and depending on fluid and dietary intake, medications, and lifestyle factors.

The cause of overactive bladder is unknown. Risk factors include obesity, caffeine, poorly controlled diabetes and irritable bowel syndrome.

Sufferers of OAB often have the symptoms for a long time before seeking treatment. Diagnosis is based on a person’s signs and symptoms and often mimics other conditions such as urinary tract infections. Pain while urinating suggests that there is a problem other than overactive bladder.

Treatment for OAB includes nonpharmacologic methods such as lifestyle modification such as fluid restriction and caffeine avoidance. Certain foods and beverages contain irritants which amplify OAB symptoms should also be avoided.

Beverages to be avoided include carbonated, alcoholic and caffeinated beverages, such as sparkling water, coffee and tea.

Fruit and vegetables such as raw onions, citrus fruit, tomatoes and tomato-based products should also be avoided. Spicy foods containing capsaicin, sugar substitutes and food containing artificial flavourings and preservatives can also provoke OAB and should be taken in moderation.

Eliminating irritating foods doesn’t have to be an all-or-nothing approach as certain food can be tolerated in small quantities.

On the other hand, foods that are rich in vitamins, such as non-acidic fruits and vegetables can reduce the OAB symptoms.

These include bananas, apples, grapes, coconut and watermelon. Vegetables for bladder health include asparagus, broccoli, cucumber, carrots, celery and lettuces. High fibre diet is also important, as they prevent constipation, which can put additional pressure on your bladder. Fibre-rich foods include lentils, beans, barley, oats and almonds. Protein is also essential for your overall health, including fish, tofu and eggs.

The abnormal contraction of the bladder muscle is essentially causing the undesired effects of bladder overactivity. Therefore, medications such as anticholinergic and Beta-3 agonists can be utilised to reduce the bladder contractions and improve the symptoms of OAB.

Although the efficacy for medication intervention can be as high as 80%, treatment discontinuation is also common due to the side effects. The adverse effect of the medications includes dry eyes, dry mouth and constipation which can be quite unbearable.

The true aetiology of overactive bladder is unknown, however the association of abundance of certain dietary intakes such as caffeine, spicy food and alcohol with the condition is well-established. This becomes even more apparent during the festive seasons when the overstepping the bounds of moderation is the norm.

On that note, wishing all a pleasurable Moderation Rabbit New Year!