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The Cause Of Over Active Bladder

May 29, 2008
You've been invited to a friend's house for dinner and the first thing you do after arriving is ask where the bathroom is. You worry about taking long trips or getting stuck in traffic because a bathroom may not be nearby. If any of this sounds familiar, you're not alone!

If you have sudden intense urges to visit the bathroom in order to empty your bladder that are difficult to postpone, you may have a real medical condition known as overactive bladder or OAB. People with OAB may also experience having to empty their bladder very often (8 or more times per day), which may include getting up in the middle of the night to empty their bladder. Some people may even experience, on occasion, a little bit of urine leaking out as a result of the uncontrollable urge to urinate. Over 21% of adult Canadian women are affected by OAB. OAB affects men, too: about 15% of adult Canadian men have this condition.

If you think you may have OAB, visit your doctor. You may feel a bit embarrassed, but you have nothing to lose and everything to gain by talking with your doctor. Your doctor sees people with this condition often, and can recommend several treatment options to help you.

Normally, the muscle of the bladder wall (known as the detrusor muscle) sends a message to your brain to tell you that your bladder is getting full. To empty the bladder, the detrusor muscle contracts and the bladder outlet, the sphincter, relaxes. If you have OAB, the detrusor muscle contracts involuntarily even though your bladder may not be full.

Why does the detrusor muscle contract involuntarily? There are different reasons for different people. It may be caused by changes in the nerves that make the detrusor muscle more sensitive, by changes in the way the brain interprets messages from the muscle, or by changes in the muscle itself. As well, there may be other unknown reasons for involuntary detrusor muscle contraction.

If it is left untreated, OAB can affect your self-esteem, professional life, sleep, and even sexual relations.

Unfortunately, only 1 in 4 women with OAB seek help. Many find the condition embarrassing due to the stigma surrounding OAB and many may have misconceptions about the condition. Some may think the symptoms of OAB are just a part of getting older and aren't worth bothering their doctor about. But this isn't true! OAB is a real medical condition that can be treated, and your doctor can help. You don't have to put up with it.

If you have the symptoms of overactive bladder (OAB), don't be too embarrassed to talk to your doctor about it. Remember, OAB is a real medical condition that can be treated. You'll be relieved to know there are many medications and other treatments available to treat OAB once it's been diagnosed.

Most OAB treatments aim to slow down the involuntary contractions that cause feelings of urgency and sometimes cause urine to leak. These treatments help to reduce the number of accidents, visits to the bathroom, and strong urges to go.

The changes brought on by finding an effective treatment may help you regain your confidence, so that you can stop worrying about things such as not knowing where the bathrooms are located, getting stuck in traffic, or waiting in a long line for the bathroom.

Medications known as anticholinergics are the main medication option for OAB.

Since these medications work in a similar way, they also share certain side effects. The most common side effects are dry mouth and constipation.

To manage dry mouth, try chewing sugarless gum, sucking on ice chips or sugarless hard candies, or using a saliva substitute (available in pharmacies). If you're still troubled by dry mouth, speak to your doctor.

To prevent and manage constipation, try increasing the amount of fibre in your diet and getting more exercise. You can also speak to your doctor or pharmacist about using medications to prevent or relieve constipation.

Drinking plenty of fluids may also help in combating dry mouth and constipation, however, the increase in fluids may affect your condition. Talk to your doctor to see if this is a viable option for you.

These medications should not be used by anyone who has trouble passing urine (urinary retention) or who has any condition that slows down the movement of material through the stomach, intestines, or bowel (gastric retention). People with a type of glaucoma known as narrow-angle glaucoma should not use these medications (if you have glaucoma, ask your doctor if the type you have is narrow-angle glaucoma).

Speak to your doctor if you have other stomach or intestinal problems, heart problems (including whether you or any family members have a rare heart problem called QT prolongation), neurologic disease, liver disease, or kidney disease, or if you are pregnant or breast-feeding.

As with any medication, anticholinergics may interact with other medications. Always make sure your doctor and pharmacist know all the medications you are taking (including non-prescription and herbal medications).

The Canadian Urology Association (CUA) recommends trying lifestyle changes and bladder training before considering other types of treatment. Non-medication treatments may be used alone or in combination with medications. Talk to your doctor about which treatments would be appropriate for you.
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