The holidays tend to be a time of indulgence for most of us. Unfortunately most holiday treats such as sweets, cookies, alcoholic beverages, and sugar-sweetened drinks - are full of empty calories. For those with diabetes who have bladder control issues, it is important to remember that the high sugar content in these treats can lead to frequency and urgency. When there is excess sugar in the blood the kidneys work harder to remove the glucose. The brain gets the signal that water is needed to dilute the blood. If the kidneys cannot filter all the glucose, then excess glucose gets dumped into the urine. Fluid is taken from bodily tissues to help move the sugar to the urine. This leads to dehydration and thirst. As water is consumed to quench the thirst, urination happens more frequently. Drinking more water is good and helps the kidneys remove the sugar. Control of blood sugar levels can help prevent any of this from happening.
The holidays make it difficult to avoid known bladder irritants: caffeine, alcohol, and artificial sweeteners.
- Caffeine is found in coffee, tea, soft drinks, chocolate, and certain over-the-counter medicines such as cold medications and diuretics for weight loss. It can have effects on the body's metabolism, including stimulating the central nervous system and increasing bladder activity. Caffeine is a known diuretic. Consuming caffeine may result in urgency, frequency, and/or incontinence. Studies have demonstrated that individuals with bladder symptoms who have reduced caffeine intake to less than 100mg/day noted improvement in symptoms. If you choose to limit products containing caffeine, do so slowly over a period of several weeks as strong headaches may result during the withdrawal period.
- Alcohol has also been shown clinically to act as a bladder stimulant, triggering symptoms of urgency. In addition, it acts as a diuretic and may induce greater frequency of urination. Alcohol inhibits arginine vasopressin, also known as antidiuretic hormone or ADH. The purpose of ADH is to conserve water in the body by reducing its loss in urine. Without ADH, the kidneys don’t reabsorb water as easily therefore you fill the bladder quickly with water-diluted urine leading to frequency. Alcohol affecting the availability of ADH can lead to urination being induced 20 minutes after a person consumes.
- Artificial sweeteners (sodium saccharine, acesulfame K, and aspartame) have been shown to affect bladder function in limited animal studies. They have been found to cause bladder irritation in people with interstitial cystitis (IC) or chronic bladder inflammation. Additionally, they are known to aggravate symptoms in someone with a urinary tract infection. But the good news is that stevia, a natural sweetener, does not appear to cause bladder irritation.
- Some individuals have noted bladder control issues after consuming high acid and hot and spicy foods such as tomato-based dishes and citrus fruit drinks.
However, if caffeine, alcohol, artificial sweeteners, or spicy food is a regular part of your diet, try eliminating them for a week to see if your symptoms improve. Then gradually, every one to two days, add one food/drink back into your diet, making note of any changes in urinary urgency, frequency, or bladder control loss. There may be individual circumstances that causes an individual’s bladder to spasm.
Tips for Success Around the Holidays:
- Avoid alcoholic beverages, coffee, and tea. Drink plain water when possible. Don’t restrict fluids to control bladder control.
- Drink water, at least six 8-ounce glasses a day. Limiting your amount of liquid will result in less, but the smaller amount of urine is highly concentrated and irritating to the bladder.
- In order to avoid the feeling of deprivation around the holidays: if you want a special treat, choose one that you cannot live without, have it, enjoy it, and count it in your dietary record and move on.
- Establish regular bowel habits. If you are constipated, add fiber to your diet, or use a laxative. Fluid intake also helps with constipation. Eliminating chronic constipation can also eliminate a source of signals to the brain suggesting that the bladder has an emptying problem when the source of discomfort is really the large intestine and rectum.
- Avoid going to the toilet “just in case”. This bad habit may lead to frequent urination because you will reduce the bladder’s holding capacity.
- Use the toilet regularly – every 2 ½ to 3 ½ hours.