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BLADDER SPASMS

BLADDER SPASMS

Most people have had to cross their legs and wait until they can get to a washroom.  Uncomfortable!   But not the same as always feeling like you have to go. Embarrassing leaks can lead to lifestyle changes and can be the direct result of unwanted bladder spasms.  You CAN manage your symptoms and ease the pain they cause you.  Keep on reading to find the information you need about causes and treatment options. There is even information about prevention.


 
Bladder spasms happen when your bladder muscles contract and it feels like you need to pee. Overactive bladder (OAB) causes a sudden and often uncontrollable urge to urinate. Sounds similar right? Because of the similarity, people often use these terms interchangeably or even use the term urge incontinence instead. In reality, a bladder spasm is just one symptom of OAB, but other things could be causing your bladder spasms.
 
 
Causes
We’ve already talked a little bit about overactive bladder,  it is one of the most common conditions associated with bladder spasms. The Urology Care Foundation estimates that about 40% of women and 30% of men in the United States right now have symptoms of OAB.


Bladder spasms can happen when you have a urinary tract infection (UTI) infection. UTIs occur when excess bacteria enter the urinary tract. If you have ever had a UTI you will likely know that burning searing pain may accompany the spasms and the need to go.  Other symptoms could include a fever,  and pain in your lower back, sides, or abdomen.   With proper treatment, these infections can clear up and your symptoms will go away.
Other causes of bladder spasms include:

What Does a Bladder Spasm feel like?

Ummm… bad?  The most common symptom of bladder spasm is that your brain keeps telling your bladder it’s full and that you need to pee, (except maybe you don’t or only just a tiny bit). This dreadful urge to pee can persist and you might even experience a small amount of urine leakage.
UTIs can certainly cause some very uncomfortable bladder spasms,  but additional symptoms like those listed below help identify a bladder infection as the culprit or causal factor.
  • burning sensation when you void your bladder
  • ability to pass only small amounts of urine each time you use the bathroom
  • urine that looks cloudy, red, or pink
  • urine that smells bad
  • pelvic pain
Bladder spasms that are the result of OAB or urge incontinence, also have specific symptoms that indicate OAB as the problem.
  • you often leak urine before reaching the bathroom
  • peeing eight or more times each day
  • interrupted sleep caused by getting up to pee two or more times during the night

Nervous System Disorders That Lead to Bladder Spasms

When your bladder is full the brain should automatically signal the bladder muscle that it is time to tighten (contract) and release urine. Sometimes nervous system disorders cause damage to the nerves that send signals between the brain and the bladder. Neurogenic bladder is the fancy term for the bladder not working right because there was nerve damage.
Several different nervous system disorders or even an injury can cause bladder spasms:
  • Diabetic neuropathy (when the nerves are damaged by long-standing diabetes)
  • Brain damage that is caused by a stroke
  • Brain tumor
  • Cerebral palsy
  • Herpes zoster is an infection that acts on the nerves in the sacrum(also known as Shingles)
  • Parkinson's disease
  • Multiple system atrophy (Shy-Drager syndrome)
  • Spinal cord injury
  • Multiple sclerosis

Surgical Procedures Causing Bladder Spasms

Surgery is a vital and often necessary option to improve health issues that cannot be resolved with less invasive procedures or treatments. There are almost always risks associated with any operation.   Surgical procedures in the lower abdomen run the risk of weakening the bladder or pelvic floor muscles.  It is also possible an operation in this area could damage the nerves that control the bladder.
So what specific types of surgery are most like to cause bladder spasm issues? 
  • Cesarean section
  • Bladder surgery (a common cause of bladder spasms in both children and adults)
  • Hysterectomy (full or partial).)
  • Prostatectomy (prostate removal)
  • Other lower abdominal surgery

More Bladder Triggers

Medications
Some medications may cause bladder spasms as a side effect. Medications that commonly cause bladder spasms include:


Bethanechol (urecholine) is a drug that is designed to help with problems emptying the bladder, spasms can be an obvious side effect. Dizziness, lightheadedness, nausea, vomiting, abdominal cramps/pain, diarrhea, increased saliva/urination, sweating, flushing, watery eyes, or headache can also occur. 
 
A chemotherapy drug called valrubicin (Valstar) is used to treat bladder cancer. Yes, this drug has side effects like urinary frequency and bladder irritation, and spasms, but most cancer drugs have side effects.  However, the side effects are often preferable to having cancer. 
 
Diuretics like Lasix or hydrochlorothiazide are used to remove excess water from the body and can also lead to problems with bladder spasms.
 
Irritants from Food & Drink
Some people just tend to have sensitivities caused by their diet.  Irritants introduced into the bladder by what you eat or drink can bother a fragile bladder causing spasms. If you suffer from Interstitial cystitis, a condition that is part of a group of diseases known as painful bladder syndrome, expect some unpleasant reactions to spicy, acidic, or citrusy foods.
Chemicals found in food, particularly preservatives and other food additives can also irritate the lining of the bladder.
Things to avoid:

  • Alcohol
  • Artificial sweeteners
  • Caffeinated beverages such as soda, coffee, and tea
  • Chocolate
  • Citrus fruits and drinks, such as oranges and orange juice
  • Pickled foods
  • Tomatoes

Diagnosing the Problem

Before running any tests, your doctor will look at your medical history and any medications you’re taking. They’ll also perform a physical exam.
Depending on what the doctor discovers they may order a urine test to check if there is bacteria or blood in the urine.  Once an infection is ruled out the doctor can order other tests to help pin down the cause of your problem.
 
Some tests can measure how much urine is left in your bladder after you go to the washroom. Other tests measure the speed of urination and bladder pressure.
As other options are eliminated the doctor may request a neurological exam to determine if you are suffering from neurogenic bladder a condition where the nerves that carry messages back-and-forth between the bladder and the spinal cord and brain don't work the way they should.


Treatment
Doctors can choose from a variety of different medications to help reduce the incidence of bladder spasms. Antimuscarinics are the predominant pharmacological treatment for patients with overactive bladder…

  • darifenacin (Enablex)
  • oxybutynin chloride (Ditropan)
  • extended-release oxybutynin (Ditropan XL)
  • solifenacin succinate (VESIcare)
  • tolterodine (Detrol)
  • tolterodine extended-related (Detrol LA)
  • trospium chloride (Sanctura)

Side effects from this particular group of drugs can be very unpleasant.  They can cause dry mouth and pupil dilation, (which can cause light sensitivity). Doctors can switch your prescription if the side effects are too severe. 


Tricyclic antidepressants can also be used to treat bladder spasms. These include amitriptyline (Elavil), doxepin (Sinequan), and imipramine (Tofranil).

Other Therapeutic Treatment Options

A doctor may recommend types of treatments that will work in conjunction with prescription medication.
For example, if a person is unable to fully empty the bladder after they urinate normally, they may require self-catheterization. This involves inserting a thin, flexible catheter into the bladder to safely remove the excess urine. Another option is injecting Botox into the bladder wall, which can reduce the incidence of uncomfortable bladder spasms.


Electrical nerve stimulation sends electrical impulses through the nerves that affect the bladder, which can provide symptom relief in some cases.


When to See a Doctor
Bladder spasms usually only require emergency care when a person also has a high fever, severe pelvic pain, or a significant amount of blood in their urine.
But everyone who has frequent bladder spasms has difficulty making it to the bathroom in time, or has urine leaks, should see a doctor and establish a treatment plan.


Natural Remedies
Lifestyle changes are one of the first things you should try if you are dealing with an overactive bladder and/or bladder spasms. Lots of people use a combination of these options to control their symptoms. Maybe one or more of these alternatives could improve your bladder health!

Dietary Changes

One of the most straightforward methods in the treatment of OAB involves making dietary changes. This involves avoiding known food irritants and controlling your consumption of fluids.

You will want to avoid the following foods and drinks:
  • alcohol
  • artificial sweeteners
  • caffeine
  • chocolate
  • citrus fruits and juices
  • corn syrup
  • cranberry juice
  • dairy
  • pop and carbonated beverages
  • spicy foods
  • sugar and honey
  • tomatoes
  • vinegar

Managing Fluids
Adequate levels of hydration are essential for good health. If you don’t drink enough water your urine will get dark and have a strong odor as it is concentrated, which can irritate the bladder lining and increase feelings of urgency. On the other hand, too many liquids may increase the number of times you need to use the washroom, especially if you have too high a fluid intake before bedtime.


Try Some Bladder Control Techniques
Retraining the bladder is often recommended to reduce bladder leaking. There are several ways to do this:


Scheduled urination
A person with OAB can keep a diary of urinary habits, including bathroom trips, leakage, and symptoms of urgency. Based on the patterns noticed in the diary, they can begin to schedule trips by adding 15 minutes to the usual urination times.


Delayed urination
As soon as you feel the need to pee take note of the time. Try to wait five minutes before you urinate. Many individuals find using deep breathing and relaxation techniques can be helpful during this delay.


Double-Void
This simple practice is useful for any individual who feels like their bladder does not fully empty when they go to the bathroom.  It is a great way to fully empty your bladder before bedtime, or if you are pregnant pretty much any time of the day.


To double-void follow these steps:

 

  1. lean slightly forward while sitting on the toilet
  2. rest your hands on your knees or thighs
  3. urinate as normal
  4. wait for half a minute before trying again
  5. lean slightly further forward and urinate once more
Kegel Exercises
A Kegel exercise is a contraction of your pelvic floor muscles, a more accurate description would be a pelvic muscle contraction or exercise. By strengthening your pelvic floor muscles you can better control your urinary flow.
 

Lifestyle changes

A lifestyle change can improve OAB symptoms. There are lots of options you could try.


Quit Smoking
Smoking can increase the intensity of the symptoms of OAB. Coughing fits are a part of almost every smoker's daily life, these episodes often cause leaking.


Talk to Your Doctor about Medicine You Use
Certain medications can promote bladder leakage. People with OAB who are taking the following medications should discuss the alternative treatment options with a doctor:

  • narcotics, (eg. oxycodone)
  • muscle relaxants and sedatives
  • alpha-adrenergic antagonists
  • antihistamines
  • diuretics

Maintain a Healthy Weight
Excess weight can put pressure on the bladder and pelvic muscles. Staying within a healthy weight range may help with bladder control.


Managing Medical Concerns
Chronic conditions such as diabetes, Parkinson’s, and Multiple Sclerosis can OAB worse. People need to manage the symptoms of chronic conditions that may contribute to OAB.


Herbs & Supplements
A variety of herbs and natural supplements have been recommended for the treatment of OAB.  Further studies are recommended to provide evidence of effectiveness.

  • Gosha-jinki-gan
  • Ganoderma lucidum
  • Vitamin D
  • Corn silk
  • Capsaicin
  • Pumpkin seed extract
  • Magnesium hydroxide

Alternative therapies

The following complementary or alternative treatments may prove to be useful remedies for OAB.


 Acupuncture
Recent research suggests that acupuncture may be beneficial for those with OAB symptoms.  A knowledgeable acupuncturist can insert thin needles or use an electronic acupuncture unit in specific points on the body to minimize urgency and frequency of urination.  Acupuncture can help improve your quality of life if you have bladder spasms and leakage.

Biofeedback
Biofeedback uses electrical sensors to monitor muscles. This therapy is sometimes used to treat bladder leaking. Research suggests it is a beneficial first-line treatment for children.


Homeopathy
Homeopathy offers a good scope in the treatment for OAB. Before prescribing a suitable homeopathic medicine, the patient's mental symptoms are well analyzed in detail and then the remedies are given.


Prevention
Stress can trigger or worsen many health concerns and bladder spasms are no exception. Lifestyle changes to reduce stress may lead to less frequent bladder spasms.


Try some of these options:

  • adequate rest
  • exercising regularly
  • meditating
  • reading a book
  • engaging in a hobby

Urgency suppression is just bladder training.  When you have the urge to urinate sit down, try some deep breathing or other relaxation techniques, continue until the need to pee passes. 
Practicing pelvic floor exercises, such as Kegels, may also help reduce urine leakage.


According to the National Institute of Diabetes and Digestive and Kidney Diseases in the U.S., no changes in nutrition have been shown to reduce the incidence of urinary incontinence.


However,  a large amount of anecdotal evidence suggests that avoiding foods such as alcohol, tomatoes, caffeine, chocolate, and citrus drinks may help to reduce bladder symptoms by removing dietary choices that lead to bladder irritation.


The Bottom line
Bladder spasms are uncomfortable, painful, and sometimes embarrassing, but they are also quite treatable. If you experience bladder spasms on a regular basis, especially when they lead to urinary incontinence - speak to your  doctor!  Investigate your options, do some research, like reading this article.  From acupuncture to exercise, from medication to surgical intervention, there are so many treatment options.  Don’t let your discomfort or embarrassment stop you  from getting treatment and feeling comfortable again.

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