Complaints & connections · borters.ch
Überaktive Blase
The urge comes before the filling — training helps, drinking less does the opposite.
Also known as: irritable bladder · overactive bladder · urgency · urge incontinence
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
With an overactive bladder the urge announces itself before the bladder is full — sudden, strong and hard to postpone. Typical are many trips to the toilet with small amounts each time, getting up at night and, in some, an involuntary loss of urine on the way there. That distinguishes it from stress incontinence, where something leaks on coughing, sneezing or lifting without any urge beforehand. The bladder is not diseased in the sense of an infection; the control between bladder muscle and brain has become oversensitive. Before calling it that, other things should be ruled out: a urinary infection, high blood sugar, in men an enlarged prostate with residual urine, after menopause a thin, dry lining, water tablets, bladder stones. The good news lies in the treatment: bladder training and pelvic floor work well and come first — but they need six to twelve weeks of patience. And the most common self-attempt goes the wrong way: drinking less makes urine concentrated, and that irritates the bladder further.
Frequent urgency without loss is an irritable bladder. If involuntary loss of urine is added, distinguishing stress from urge incontinence is worthwhile — the two are treated in opposite ways.
Time, amount drunk and passed. It sorts more than any investigation.
Extend the interval in small steps. Six to twelve weeks, then judge.
It helps with urgency too, not only with coughing — guided, it works distinctly better.
Concentrated urine irritates more. Better: spread over the day and stop earlier in the evening.
Caffeine, alcohol and strongly fizzy drinks — two weeks are enough as a test.
As unsweetened juice or a preparation daily over months — not as treatment of an acute infection.
Frequent urge and burning after a swim in a lake or river in Africa or the Middle East is not a finding of irritable bladder but a lead. The urine is examined for eggs.
Anticholinergics damp the bladder muscle — they lower urgency by one to two toilet visits a day, dry the mouth and are used cautiously in older people because of the effect on thinking. Mirabegron works by a different route and does not have that effect. It is judged after four to eight weeks. What works just as strongly in reviews and has no side effect is bladder training over six to twelve weeks: pushing each visit back by fifteen minutes.
A bladder counts as overactive with more than eight toilet visits a day and a sudden urge that is hard to postpone. About twelve in a hundred adults are affected, more with age. A bladder diary over three days is the single most informative examination. Bladder training pushes the visit back in steps of fifteen minutes and needs six to twelve weeks. Caffeine above about two cups and alcohol raise the urge measurably.
It can hardly be postponed — that is the hallmark.
Unlike high blood sugar, where a lot of urine comes.
Urge incontinence — it follows the urge, it does not come without it.
Learned cues — this is exactly where bladder training starts.
That separates it from a bladder infection; if it burns, the infection comes first.
High blood sugar makes a lot of urine and favours infections — clarify that first.
A sufficient amount of urine across the day dilutes what would otherwise crystallise or irritate. Spread evenly it works better than in two large portions.
With reduced kidney function it rises and becomes dangerous for the heart rhythm; under water tablets it falls. In both directions it belongs measured and not guessed.
Cutting out calcium is the wrong route with stones: it binds oxalate already in the bowel. Calcium with the meal instead of between meals is the lever, not avoidance.
Much salt drives calcium into the urine and so raises stone formation; it also lifts the blood pressure that strains the kidneys. Most of it sits in bread, cheese and ready meals.
Traditionally used for an irritable bladder; the studies are small and open-label — 500–1000 mg extract a day over 12 weeks. Bladder training has better numbers for these complaints.
The best-supported point on this page, and it goes the other way: less caffeine measurably reduces urgency and getting up at night. Alcohol and fizzy drinks count in too.
Studied in two small older trials in women with an overactive bladder, with reported improvement. It was not repeated — 200–400 mg a day over 4 weeks is a cheap attempt.
Bladder and urethra have receptors for this hormone. After menopause urgency and getting up at night therefore increase — a local treatment works there and is barely taken up into the body.
With the years the night-time rise of this hormone becomes weaker — which is why more urine is made at night than before. That is one of the reasons for getting up at night and has nothing to do with the bladder itself.
Sugar that is too high drives water out through the kidney and causes urgency. With newly appeared frequent urination and thirst that is the first question, not the bladder.
All three irritate the bladder wall. In studies leaving out caffeine alone over 4 weeks measurably reduced urgency. Drinking less does not help — concentrated urine irritates more.
For some they worsen the complaints. Which ones shows best in a bladder diary over 1–2 weeks — they differ from person to person.
Bladder training and pelvic floor work better than most medicines — and without their side effects.
Not studied for an irritable bladder without infection — it belongs to infection prevention.
Traditionally flushing; without infection the benefit is less clear than in infections.
Relaxing in a belly compress, in the evening. Caffeine and alcohol count for more here than any oil — the last cup in the afternoon has a say in the night.
Traditionally used for an irritable bladder and bedwetting, diluted on the lower belly.
The Kidney stands for reserve, warmth and takes in the bladder as well. Night-time urination is traditionally placed there and treated with warmth.
At the inner ankle, the main point of the Kidney meridian. One of the classic points for complaints that increase in the evening and in the cold.