How Caffeine affects the Bladder
It is a controversial topic regarding the role of caffeine and bladder problems. Some studies claim that caffeine is a bladder irritant and also possibly a reason for urinary incontinence. A recent meta-analysis claims that caffeine is not linked to incontinence.
How does the bladder work?
The bladder is a storage and elimination organ. It collects urine from the kidneys via the ureter which are two tubes, one from each kidney.
How does caffeine affect the bladder?
Caffeine is thought to be a bladder irritant and can cause the symptom of always having to urinate and it acts as a diuretic to make you go more frequently, although that has been disputed by doctors because the volume of coffee ingested as fluid can account for the excess need to pee. However, if you are poorly hydrated, the concentration of the urine is higher and that would make caffeine a bit more concentrated.
Caffeine can potentially lead to urinary incontinence
A recent meta-analysis found no relationship between coffee/caffeine consumption and moderate to severe urinary incontinence (UI). Moreover, coffee/caffeine consumption was not associated with types of UI (stress, urge, and mixed UI). However, another study showed that the bladder muscle had more pressure on it after caffeine exposure in women who already had a spastic bladder. There was another study that some women had less involuntary urinary loss when they decreased their caffeine intake.
Overall, an estimated 50-70% of women with urinary incontinence fail to seek medical evaluation and treatment for urinary incontinence due to embarrassment. People with incontinence often live with this condition for 6-9 years before seeking medical therapy. The prevalence of urinary incontinence was 49.0% in women versus 22.6% in men. In both men and women, the prevalence of urinary incontinence increases with age. Urinary incontinence has been estimated to affect 10-13 million people in the United States and 200 million people worldwide.
What is urinary incontinence?
The involuntary loss of urine from the bladder that can come without warning or sometimes preceded by the sense of urgency.
Types of urinary incontinence
Stress Urinary Incontinence (SUI)
SUI is urine leakage associated with increased abdominal pressure from laughing, sneezing, coughing, climbing stairs, or other physical pressure abdominal cavity and the bladder. Additionally, exercises like aerobics, golf, and tennis worsen the SUI symptoms. The amount of urine loss can be small or large. The sufferers usually use thin to medium pads. (1-3 per day is common).
Urge incontinence is involuntary leakage accompanied also by or immediately preceded by the feeling of imminent urination or urgency. Moreover, it is uncontrolled urine loss that cannot be prevented and usually a large quantity of urine is lost. Frequency symptoms and urge at night is also present. Excess intake of water, tea, coffee, and alcohol can also aggravate the symptoms.
Patients with mixed incontinence have symptoms of both stress incontinence and urge incontinence. Therefore, there is mild to moderate loss of urine with activity or without warning. Urinary frequency, urgency, and nocturia can also be present.
Overflow incontinence occurs when the bladder is over-filled and the increased bladder pressure exceeds the ability of the urethra to keep the urine from coming out. People experience a sense of incomplete emptying, slow-flowing urine, and urinary dribbling. Moreover, symptoms of overflow incontinence may be confused with mixed incontinence. Patients may lose a small amount of urine when waking, sneezing, or coughing. Symptoms of frequency and urgency are present as the muscle of the bladder attempts to push out urine.
The inability to hold urine due to reasons other than neuro-urologic and lower urinary tract dysfunction (delirium, psychiatric disorders, urinary infection, impaired mobility).
Managing urinary incontinence
Medications can help.
Medications used in stress and urge urinary incontinence:
- Alpha-adrenergic agonists-pseudoephedrine (Sudafed)
- Anticholinergic agents-dycyclomine (Bentyl); tolteradine (Detrol)
- Antispasmodic drugs-oxybutynin (Ditropan)
- Tricyclic antidepressants
- Alpha-adrenergic blockers
- Botulinum toxin
- Pelvic floor exercises, electrical stimulation
- Physical Therapy
- Anti-incontinence devices like pessaries
- Changes in diet
- Behavioral modification
- Pelvic-floor exercises
- Medications- vaginal estrogen or antispasm drugs
- New forms of surgical intervention
- Pelvic floor physical therapy
- Laser vaginal rejuvenation with FemTouchTM
- Anticholinergic drugs
- Vaginal Support devices such as pessaries
- Catheterization regimen or diversion
- Treatment of the underlying cause
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