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How to train your bladder to behave

Always on the toilet? Always looking out for a toilet? Going Just incase? Having to rush back and forth during the day or night?

It’s time to Optimise your Bladder

How does a bladder normally act?

It’s normal to go to the toilet up to 8 times a day and not at all at night unless you’re over the age of 65. Each time you use the toilet you should pass between 200-300mls of urine. Your bladder should be able to comfortably store up to around 600mls, and because of this you should pass a larger volume during your first toilet trip of the day.

What can happen?

The bladder can become irritable or ‘overactive’. This is exacerbated by concern about leakage, irritation and pain. It may also be a result of habit, by emptying the bladder too often during the day. It’s important that you first get this checked out by your doctor, then if appropriate seek help from your local pelvic health physiotherapist.

If the bladder is never allowed to fill to its capacity it can shrink, making the problem worse. Thankfully problems with your bladder are easily rectified.
What to do

If you feel the need to go more than every 2 hours try not to give in to the first urge. By holding you can gradually increase the time between toilet trips and improve your bladder control.

When you do feel the need to go:
• Tighten up your pelvic floor muscles (pull in your back passage)
• Sit down on a hard surface
• Stop moving and stand still
• Press up against the pelvic floor with your hand
• Raise up and down on your toes
• Avoid running water
• Most importantly, keep calm and distract your mind

Doing these things should help the urge to subside. Now distract yourself for a few minutes. If you still need to go, walk to the toilet slowly – don’t run! If you feel the urge again strongly on the way there try to supress it again to regain control before walking to the toilet. Over time try and elongate the time between toilet trips, aiming for a maximum of 3 hours.
Incomplete Emptying

It can be common to feel your bladder hasn’t fully emptied. You may also dribble when you get up from the toilet. If this is the case, firstly make sure that you sit properly on the toilet seat as hovering doesn’t allow the pelvic floor to relax fully. Now relax and give yourself time! Try rocking forwards and backwards slowly whilst you go, and then when you’ve fully finished try tightening your pelvic floor muscles once before you stand up – this may create another little dribble. If when you stand up you feel you still aren’t empty, sit and repeat the above. If this feeling persists after two goes, stand and leave the toilet. Sit down on something hard and try to distract your mind.

You should never have to strain to urinate.

Fluid Intake

It is important not to restrict your drinks, this makes your urine more concentrated which can irritate the bladder and isn’t good for your kidneys. You should aim to have around 2 litres, or 3 pints of fluid a day. This is about 6-10 drinks.
If you find that you need the toilet more than twice a night it may be useful to have your last drink two or three hours before bed-time.

Caffeine

Caffeine is found in coffee, tea (including green tea, and in high quantities in Japanese Sencha tea), Coke/Pepsi and chocolate. Up to 30% of the population are sensitive to caffeine. It is recommended that you trial removing caffeine from your diet, replacing your drinks with decaffeinated versions slowly over a number of days or weeks. Then see how you feel without caffeine. If you find that it makes a significant difference to how often you have to rush to the toilet then it would be beneficial to reduce your caffeine in the long term.

Bladder Urgency Triggers

There are several triggers for a sensitive bladder that you could try to avoid:

• Alcohol, especially lager
• Running water
• Cold
• Anxiety
• Cystitis, urine infections
• Artificial sweetener (aspartame)
• Blackcurrant drinks
• Fizzy drinks

Conversely, there are several drinks that do not irritate the bladder:
• Water
• Milk
• Decaffeinated tea and coffee
• Fruit tea
• Milkshakes
• Cranberry juice (one glass per day, diluted)
• Squash (not berry flavoured)

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