Step 0. Do Nothing
As
the majority of cases of urge incontinence are idiopathic, that is, they have
no known cause, even after extensive testing, spare yourself the health risks
of i...
Step 0. Do Nothing
As
the majority of cases of urge incontinence are idiopathic, that is, they have
no known cause, even after extensive testing, spare yourself the health risks
of invasive tests.
Step 1. Collect Information
It
is estimated that 34 million Americans deal with overactive bladder, defined as
an urgent and frequent need to urinate, or urinating more than 10 times in 24
hours.[1]
Most are older than 40, and one-third to one-half are men.
Urge
incontinence comes on so quickly and so powerfully that there is no time to get
to a toilet, even if you are standing right next to one! For some women, even
the thought or sight of a toilet causes leakage.
There
are many causes of urge incontinence. Invasive diagnostic tests requiring
catheterizations are best refused, however, as the results are often
inconclusive. In general - unless there is a known cause such as an enlarged
prostate, a bladder infection, vaginal yeast overgrowth, interstitial cystitis,
fibromyalgia, or multiple sclerosis - urge incontinence/overactive bladder is
thought to be caused by abnormal nerve signals to the bladder, which initiate
spastic muscle contractions and an often uncontrollable need to urinate, even
when the bladder is not full.
A
bladder diary lists the times of day you urinate (including leaks), the
amount of urine you void, what you drink and eat and when, and medicines you
took. Over a period of a week or two, patterns emerge that can help you retrain
your bladder.
“About 30% of women [with overactive
bladders] get better simply by understanding what’s happening and thinking
about it.”[2]
Step 2. Engage the Energy
A
powerful visualization coupled with a physical trigger can put you in control
of your bladder, fast. Choose an image, visualize it repeatedly, then use it to
help prevent leaks and urgency. If you visualize for even two minutes a day,
you will get results faster than if you take drugs. If you use the physical
trigger while you visualize, eventually it, alone, will be enough to control
your urge incontinence, you won’t need the visualization any more.
Sitting alone, in a tranquil environment (a bathtub
is fine), close your eyes and imagine vividly, using all your senses: see the
scene, taste it, smell it, feel its texture, listen to it. As in a dream, you
can create whatever you want. Take many quiet sessions to make your
visualization real; don’t try to do it all at once. Create your own
visualization or try one of these.
Visualize
the nerve message between your bladder and your brain as a stream of water; in
your imagination, install dams and locks to slow it down. When you visualize,
squeeze your fist in a slow rhythm.
Visualize
the nerve pathway as a road; set up gates or toll booths all along it, starting
at the bladder and working your way up to the brain. When you visualize this,
gently bite your lower lip.
Imagine
a large, strong hand gently pushing up between your legs and comforting you.
When you do so, smile.
Homeopathic remedies for urge incontinence include:
§
Belladonna: if there are chronic spasms
§
Eupatorium pur.: bladder always feels full
§
Sulphura:
urge is sudden and intense
§
Nux vomica: urge accompanied by pain
§ Uranium
nitricum: burning pain
Biofeedback
using electrical or pressure-sensing devices can increase awareness of the
bladder, foiling urge incontinence. It is so well-studied, and so effective in
relieving incontinence, that Medicare covers the cost.
Everyone
who is incontinent has weak muscles. Those with stress incontinence “deny the problem, pay little attention to
bladder signals, and are surprised when a slight physical exertion forces urine
out. The urge patient, on the other hand, is preoccupied with bladder signals …
and rushes to the toilet at the first signals. … the brain learns to stop
inhibiting the reflexive contractions of the bladder …”
Leslie
Talcott, director Perineometer Research Institute
Step 3. Nourish and Tonify
Retrain your bladder to relieve urge incontinence. Since the bladder is only half full when
urge begins, countering the urge to urinate, and gradually lengthening the time
between visits to the toilet can work wonders. With practice, the threshold of
urge is raised and the nerves no longer signal so frequently.
Food
additives such as MSG, potassium sorbate, aspartame, and food colorings
aggravate urge incontinence.[3]
Vitamin
B12 deficiency - common among vegetarians and epidemic among vegans -
can mimic MS, including causing uncontrollable bladder spasms or urge
incontinence.[4] Vitamin B12, in its
usable form, is available only from milk, eggs, fish, and meat.
Including
at least 25 grams of real fiber from whole grains, beans, and nuts in
the daily diet may significantly ease urinary overactivity and urge incontinence.
Step 4. Stimulate/Sedate
For
men with overactive bladders, herbalist Terry Willard uses a tea of parsley
leaf, corn silk, and dandelion leaf to reduce urine acidity and
bladder irritability. When needed, he adds wild yam root to soothe or valerian
to calm.[5]
To
counter the heat and reduce the inflammation that underlies an overactive
bladder, herbalists in India suggest infusions of soothing herbs like marshmallow
root (Althea off.), plantain leaf (Plantago species), or mullein
leaf (Verbascum thapsus). For those with severe problems, 1-4
tablespoons of powdered turmeric (Cucurma longa) are added to the
daily quart of infusion.[6]
Saw palmetto berries, in tincture or tea, relax the smooth muscle in the bladder neck and
help reduce overactivity.
Herbal
nurse Martha Libster reminds us of the usefulness of Chinese ephedra (ma
huang) - to reduce mucus surface swelling and relax spastic muscles -
when treating an overactive bladder.
Acupuncture
can bring significant relief from urgency, urge incontinence, and overactive
bladder say researchers at the Oregon Department of Health and Science
University. Four weekly bladder-specific acupuncture treatments improved
bladder capacity, reduced urgency and frequency, and improved the quality of
life as well as drug or behavioral therapies.[7]
If
you can’t get the knack of doing pelvic floor exercises (Kegels), don’t despair. Physical therapists, personal trainers for
your bladder, can help you with these critically important exercises.
Step 5a. Use Supplements
A
deficiency of magnesium triggers muscles spasms and incontinence.[8] Supplements
of 200-600mg daily may help.
Vegans
and vegetarians bothered by overactive bladders probably lack vitamin B12
- a critical nutrient found only in animal foods. Supplements or, better yet, a
healthier diet that includes organic dairy and meat, are indicated. You may
wish to be tested for methylmalonic acid level, a better indicator of
deficiency than tests for vitamin B12 itself.[9]
Step 5b. Use Drugs
Some
drugs - such as “water pills” and tranquilizers - cause or aggravate an
overactive bladder. Instead, use herbal
diuretics such as corn silk, burdock root, and dandelion; they calm the
bladder. Tranquilize with bladder friendly St.Joan’s wort (Hypericum
perforatum) tincture, a dropperful 3-6 times a day, or motherwort (Leonurus
cardiaca) tincture, 15 drops 4-8 times a day.
Antimuscrinic
or anticholerinergic drugs relax the bladder’s detrusor muscle, extending the time between urge and voiding. They
are especially useful for those dealing with traumatic incontinence, but are
often suggested as a bridge to control leakage from urge incontinence while
lifestyle changes take effect. I wonder how useful this is, as antimuscrinic
drugs can take up to three months to be effective, and “side effects may be
nearly as troublesome as the incontinence itself.”[10]
Detrol
(tolterodine), Ditropan (oxybutynin), Enablex (darifenacin), Sanctura (trospium
chloride), and Vesicare (solifenacin), can calm an overactive bladder, but dry
the mouth and the eyes and cause memory impairment as well as constipation and
heart arrhythmias. In one study, three-quarters of those taking 4mg of
tolterodine and 0.4mg of tamsulosin, and two-thirds of those taking the
placebo, reported improvement after three months.[11]
Although
lack of estrogen does not cause incontinence, topical vaginal estrogen cream is a fairly safe, and very easy, way for
older women to calm a hyperactive bladder.
§
Tofranil
(imipramine) is an antidepressant that is used in conjunction with an
antimuscrinic to tighten the urinary sphincter and relax spasming bladder
muscles. Dizziness, drowsiness, and low blood pressure are side effects more
frequent in those over 60.
Step 6. Break and Enter
In
Europe, injections into the lining of the bladder block the nerve impulse that
triggers overactive bladder. This is not yet approved in the USA. But
injections of Botox are. The effects - significant increase in bladder capacity
before urgency - mimic bladder retraining but only last 6-12 months.
Surgical
implantation of a sacral neuromodulator can relax bladder muscles and
relieve overpowering urges to urinate. This is obviously a last resort.
Legal Disclaimer: This
content is not intended to replace conventional medical treatment. Any suggestions
made and all herbs listed are not intended to diagnose, treat, cure or prevent
any disease, condition or symptom. Personal directions and use should be
provided by a clinical herbalist or other qualified healthcare practitioner
with a specific formula for you. All material in this article is provided for
general information purposes only and should not be considered medical advice
or consultation. Contact a reputable healthcare practitioner if you are in need
of medical care. Exercise self-empowerment by seeking a second opinion.
Susun Weed
PO Box 64
Woodstock, NY
12498
Fax: 1-845-246-8081
[1] “Overcoming overactive
bladder,” Women's Health Advisor, April
2007.
[2] “Get it under control,” John Hopkins
Medical Center, 2007.
[3] “Calming an overactive bladder,”
Mark Hyman MD, Alternative Medicine, April 2007.
[4] Ibid, Alt Med, April 2007.
[5] “Best remedies for a healthy
bladder,” Herbs for Health, April 2006.
[6] Ibid; Healthy bladder,” Herbs for
Health, April 2006.
[7] “Acupuncture aids overactive
bladder,” Obstetrics & Gynecology,
July 2005.
[8] British Journal of Ob/Gyn,
105:667-669, 1998.
[9] (46) Alt Med, April 2007.
[10] “What is Urinary Incontinence?”
HealthNews, March, 2001.
[11] “Two-drug combo improves overactive
bladder,” Focus on Healthy Aging, Feb 2001 (from an article in JAMA, Nov 2006).
