ANNOUNCER: Millions of men and women suffer from urinary problems known as overactive bladder, or OAB.
DIANE NEWMAN: The core symptom of overactive bladder is urinary urgency. Urgency is a sudden, intense desire to have to go to the bathroom to void.
ANNOUNCER: People with OAB also can experience the need to urinate often. They may have incontinence, and they may need to wake up frequently at night, for trips to the bathroom.
Effective treatments are available. Often medicines are combined with changes in lifestyle.
RAY RACKLEY, MD: Studies have shown that the adoption of behavioral modification plus drug therapy actually gives you your best treatment outcome for people with the overactive bladder condition.
ANNOUNCER: Doctors usually start by asking patients about fluids they drink, and about caffeine.
RAY RACKLEY, MD: Probably the biggest area of improvement with behavioral modification is awareness of how much fluid we drink per day and really how much caffeine slips into our diet. I would say they're both equally important and most patients are amazed when they add up what liquids they take in general, how much, and how much caffeine is involved with that fluid intake.
ANNOUNCER: It may seem obvious that drinking too much fluid may aggravate bladder problems, but so too can drinking too little.
DIANE NEWMAN: If you don't drink enough water or another type of fluid, your urine becomes very concentrated. This will lead to overactive bladder symptoms of urgency and frequency.
ANNOUNCER: The trouble with caffeine is that it stimulates bladder muscles.
RAY RACKLEY, MD: Caffeine is a muscle stimulant and, if you have a hypersensitive or hyperactive bladder condition, you can imagine that caffeine actually makes that worse.
ANNOUNCER: Other stimulants and irritants can include sugar substitutes, spices, and citrus. Alcohol can be a problem too.
DIANE NEWMAN: Alcohol, beer, wine, cocktails, can affect the bladder. We find that, if someone has maybe a glass of beer before they go to bed or a glass of wine, that it may cause them to get up the night to urinate. Alcohol is a natural diuretic. It increases urine output. It also is a bladder irritant.
ANNOUNCER: Diuretics used to treat heart conditions can also aggravate bladder problems. So too can other heart medications, such as calcium channel blockers. And then there is smoking. Nicotine is a bladder stimulant. Smoking causes poor circulation, which is bad for the bladder. Coughing is a problem, too.
DIANE NEWMAN: A person who smokes for a long period of time who has chronic coughing, it actually puts pressure on the ligaments in the pelvis and can actually lead to some nerve damage in the pelvis, leading to urgency, frequency and incontinence.
ANNOUNCER: Some health experts think losing weight can help with bladder problems, because excess weight can put pressure on the bladder. Constipation can also lead to extra pressure.
DIANE NEWMAN: One of the things I recommend to persons who have overactive bladder and constipation is that they increase their fiber. You can do this through food intake or even some of the supplements. Sometimes that can be very helpful and I'm always pleasantly surprised when a patient comes back and says, "You know what? I regulated my bowels and my urgency's not as severe."
ANNOUNCER: People with overactive bladder can also benefit from what are known as "Kegel" exercises.
RAY RACKLEY, MD: There's a known reflex in the bladder function that is dependent upon the muscle around the bladder called the pelvic floor. We're all familiar with this muscle because it's the muscle that we start and stop the flow of our bladder stream or -- or flow of urine.
DIANE NEWMAN: We find that as people age the pelvic floor muscle weakens. If they learn to exercise the muscle to increase strength and support, they can use this muscle to prevent urinary urgency and also incontinence.
ANNOUNCER: Another tool in the treatment of OAB is good record-keeping.
RAY RACKLEY, MD: Sometimes the physician will ask the patient to fill out a voiding diary or a bladder diary that documents the actual amount of fluid that one takes in on a 24-hour basis and the times of urination, the actual times in which loss of urine takes place.
DIANE NEWMAN: A bladder diary's very valuable, because sometimes people are not aware of what they're doing unless they write it down. And then, whenever they start to look at it and maybe the doctor looks at it with them, they start to see patterns to what they're doing on a daily basis. And I can't emphasize enough that sometimes changing some of those habits can really change overactive bladder symptoms.
ANNOUNCER: Lifestyle changes can help a person who suffers from overactive bladder. And there are many effective medicines available, too. So people who suffer in silence may be suffering quite needlessly.