The Heat is on: Keep Drinking Your Fluids and have a Healthy Bladder!

Most people who suffer with bladder control problems feel embarrassed and would rather not talk to anyone about it, including their own doctors. For many women, incontinence starts during their first pregnancy, after childbirth or during menopause. However, this is a problem that can also affect women who have never been pregnant, including children and teenagers.

One common mistake that people who cannot control their bladders make is to limit the amount of fluids they drink, in the hope that it will reduce their number of trips to the toilet or they won't leak any urine when running, coughing or laughing. Unfortunately, this is not the best strategy and, especially in the heat of Singapore, it can have many negative consequences.

Stress urinary incontinence is the involuntary leakage of urine on effort, such as high impact exercise, sneezing or coughing, whereas urge incontinence is the leakage of urine associated with a strong urge to empty your bladder. Overactive bladder syndrome is defined as urinary urgency with or without incontinence, usually also associated with increased daytime and nightime visits to the toilet.

So, you may be asking yourself: what is considered normal in terms of fluid intake and bladder habits?

It is normal to empty your bladder about every 3-4 hours during the day (4-8 times in 24 hours). Waking up in the night once to have a pee is considered normal. However, if you are under 65 years old and your bladder is waking you up twice or more in the night, it is not normal and you should discuss this with your doctor.

Health care professionals usually suggest drinking 6-8 cups of fluids per day, although more when it is hot or when exercising (also if you are pregnant or breastfeeding). However, a better measure of self assessing is to make sure that you are drinking enough fluids to keep your urine a very pale yellow colour and without any strong smells.

Instead of limiting the amount of fluids you drink, have a good look at what types of fluid you are drinking. Sugary and caffeinated drinks, such as coffee, tea, fizzy drinks and chocolate can produce strong bladder contractions and increase frequency and urge. It appears that some women have higher concentrations of caffeine-sensitive receptors inside the lining of their bladder muscle. That is a difficult thing to test, so the best way is to try and eliminate it from your diet for at least one week to see if has a positive effect.

Limit the number of 'just in case' toilet trips to empty your bladder. On average, the adult bladder can hold 400-800 ml of urine. If you have frequent visits to the toilet, where you are passing less than 200 ml of urine, you are not using your full bladder capacity and your bladder is likely to become smaller and 'weaker' in the long run.

Fluid restriction can also lead to constipation and cause women to strain when trying to open their bowels, which can further contribute to weakness in the pelvic floor muscles and to incontinence. Eating a well-balanced diet with plenty of fluids can help to ensure your bowels stay healthy.

There are plenty of treatment options for urinary incontinence and bladder overactivity. Remember, it is not normal to leak any urine (unless you are a baby...), so please seek help if you think you may have a problem, and DO NOT limit your fluid intake in the meantime.

Monica Donaldson

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