Certain foods and beverages contain ingredients that can irritate the bladder. The best documented is caffeine; any product with this substance (like cocoa, chocolate, cola, etc.) may encourage that urge to void. Caffeine can lurk where you least expect it, cautions Diane Newman, MSN, CRNP, Co-Director of the Penn Center for Continence & Pelvic Health at the University of Pennsylvania Health System in Philadelphia. "Over 300 over-the-counter medications contain caffeine; read the label carefully! Even decaf has a bit of caffeine; whether it's enough to affect you depends on how sensitive you are. Brewed coffee is stronger than instant and has more of an impact," she notes.
Identifying the Dietary Culprits
"Patients need to drink adequate fluids - not necessarily eight glasses a day, which produces a physiological urge to urinate - but enough to produce approximately 1,800 cc of urine per day." Logically enough, many people with overactive bladders reduce their fluid intake, but that's a mistake. "They end up with concentrated, acidic urine, which aggravates their problem," she finds. Another tactical error is choosing to urinate often, to avoid accidents. "By going every hour, you train your bladder to hold less fluid. Let it hold a normal amount," urges Newman.
When eliminating the 4 Cs makes a difference, Dr. Lightner discusses avoiding other high acid foods, like tomatoes and vinegar. Dairy products may also cause a problem, because of their high fat content. Once dietary culprits are identified, it's up to the patient to decide what she's willing to avoid. "It does not make a chronic problem irreversibly worse if they have coffee, but might make a good day less bearable," says Dr. Lightner. Newman agrees, citing alcohol, a natural diuretic and bladder irritant. "You can have wine with dinner, but it may get you up at night. Tailor your choices to their impact," she suggests.
Sometimes the problem isn't what you consume, but when. "See when your symptoms occur in order to address the problem," Newman advises. For example, do you usually have coffee after dinner? If your bladder is waking you during the night, "cut back on fluids after 6pm, and avoid both diuretics and coffee at night. Drink your last fluids of the day not later than three hours before bedtime," recommends Dr. Lightner.
When To Seek Help
Who should you call? Not all gynecologists or urologists are trained in this area, so you might look for one who's doing incontinence research at an academic institution, Dr. Lightner suggests. The National Association For Continence (NAFC), the world's largest consumer organization devoted to incontinence, can help locate a specialist in your area. It's well worth seeking a knowledgeable doctor, nurse or physical therapist: "For the majority of women with urinary leakage, behavioral techniques really help. Nonsurgical therapy for incontinence is 60 to 75% successful," reports Dr. Lightner, president of the Society for Women In Urology.
A Frequently Occurring Problem
As many as 50% of people with urinary incontinence do not even report their problem to a doctor! They simply turn to absorbent products. Nancy Muller, Executive Director of NAFC in Spartanburg, SC, suggests experimenting to see if you can find a dietary cause. "Eliminating a certain food may not make your symptoms go away altogether, but may mitigate them enough for you to manage them," she says.
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