What is Overactive Bladder (OAB)?

What is Overactive Bladder (OAB)?

An overactive bladder (OAB), sometimes referred to as an irritable bladder, is a common condition of the urogenital system characterised by a pressing and/or rapid and urgent sensation of needing to urinate.

This feeling of urgency may or may not occur frequently and can be difficult to control, resulting in urinary incontinence (involuntary loss of urine control). An overactive bladder may be caused by ineffective urination where the bladder loses its muscular tonicity and can not hold onto the 300ml capacity of urine. As a result, frequent urination is experienced. 

Helping to restore bladder tone can be achieved by slowly increasing your water intake to the recommended 2 litres per day. This helps strengthen the integrity of the bladder and ensures that the body is eliminating adequate amounts of wastes. Increasing water intake also has a positive effect on bladder tone because metabolic waste can cause irritation which can contribute to an overactive bladder.

Possible causes of overactive bladder (OAB)

  • Diabetes
  • Obesity
  • Prolapsed uterus
  • Stress
  • Recurring urinary tract infections (UTIs)
  • Dehydration
  • Infections
  • Side effects of medications
  • Underlying inflammatory conditions (i.e. acidity)
  • Hormone replacement therapy
  • Detrusor muscle overactivity
  • Nerve damage to the area due to birthing trauma, multiple sclerosis (MS), stroke or spinal cord injury
  • Urinary or kidney stones
  • Weak pelvic floor muscles 

The connection between the kidneys and the urinary system

You may also consider addressing any kidney deficiency as the bladder, urinary system and kidneys have an influencing relationship with each other. In Chinese medicine, an overactive bladder can be attributed to dampness and weak kidney energy.

The kidneys are a pair of organs situated at the back of the abdomen, below the diaphragm on each side of the spine just under the rib cage. Each kidney weighs about 150 grams. The major functions of the kidneys are:

  • regulate blood pressure
  • reduce acidity (metabolic acidosis)
  • dispose of waste material from the blood
  • regulate water and fluid balance
  • produce erythropoietin to build new red blood cells
  • maintain acid-alkaline balance

Waste flushed out from the kidneys (i.e. sodium, nitrogen, aluminium, urea,  and metabolic waste) are removed from the body via the urine.

Healthy kidneys act as a filter to remove waste and fluids from the circulating blood. They also help keep the proper balance of salts and acids in the body and produce hormones. 

Did you know that our kidneys filter 200 litres of blood every single day?

This is an essential process together with removing about 2 litres of waste products diluted in water. To remove this waste and extra water, blood enters the kidneys through the renal artery and is then cleaned as it passes through tiny filters called nephrons. One kidney contains about one million nephrons and each nephron contains a filtering apparatus called a glomerulus. Fresh, clean blood returns to the circulatory system via the renal vein and the wastes removed from the blood via filtration are excreted through the bladder and urine.

Diet tips to improve an overactive bladder

  • Drink herbal teas such as Dandelion Leaf and Green Tea. Besides optimising kidney function and filtration, they’re also gentle diuretics that help expel more waste and encourage better urinary tonicity.

  • Ensure adequate fluid intake by drinking at least 2 litres of water daily. The saying, “The solution to pollution is dilution” best explains the vital role the kidneys in eliminating waste from the body.

  • Reduce or eliminate diuretics in your diet. These include sugar, tea, alcohol, coffee and carbonated drinks. Diuretics place an extra burden on the kidneys’ filtration and cause the body to lose more water. They can also disrupt the sodium-potassium balance. 

  • Watch your alcohol intake. Alcohol can dramatically impair kidney function by causing a diuretic action. This can lead to dehydration and place a burden on the kidneys to remove the waste aldehyde from the system.

  • Go for an alkaline diet. It cleanses and tones the kidneys and urinary system. An alkaline diet involves eating foods such as fresh vegetables and fruits, lemon juice, water, brown rice, miso soup and vegetable juices. An acidic diet includes inflammatory foods like sugar, wheat, dairy, red meat, oranges, alcohol, and preserved or processed food.

  • Have a vegetable juice each day to encourage liver detoxification and kidney filtration. Some great options are freshly juiced beetroot, carrot, celery and ginger or watermelon, pineapple, green apple and mint.

  • Check for any food sensitivities or allergies which may be aggravating urinary system issues.

  • Decrease sodium (table salt) consumption and replace with sea salt or vegetable salt. Sodium is important for the health of the kidneys, but not in excessive amounts which can result in fluid retention. Sea salt is rich in many minerals without being refined and does not contain aluminium (used in table salt to keep the salt dry).

  • Vegetable broths are very rich in nutrients that are essential for the health of the kidneys as well. They’re also great for alkalising excess acidity levels to help take the burden off the kidneys’ filtration system. You can make a broth by boiling kidney beans and a mix of vegetables such as onions, celery, carrots, beetroot, spinach, sea salt, wakame (sea vegetables/ seaweed) and drinking a cup of the broth daily. This recipe is also very rich in minerals which again will help to fortify and nourish the kidneys while improving urinary system function.

Lifestyle factors to improve urinary bladder health

  • Address underlying causes of decreased kidney function and overactive bladder (OAC). These include stress, acidity, dehydration, inflammatory conditions and a history of urinary tract infections.

  • Heavy metals such as cadmium, lead, mercury and aluminium dramatically reduce kidney function and cause bladder irritation. Heavy metals are used in domestic, agricultural, industrial, technological and pharmaceutical applications so it’s best to keep an eye on environmental toxins that can affect our health.

  • Some pharmaceutical medications cause fluid retention and a decrease in kidney and bladder function. Speak to your GP about possible side effects from any medications you may be currently taking.

  • Practice your pelvic floor (Kegel) exercises daily as these exercises are aimed to strengthen the pelvic floor muscles and, ideally, the bladder. The pelvic floor muscles go around the urethral opening, vagina, and rectum in women. Like all exercises, they require frequent practise to strengthen the muscles and keep them strong.

Overactive bladder (OAC) syndrome can have a significant effect on the quality of life and affects 12-17% of the population. Its prevalence increases with age. 

Medical Management

The management of OAC primarily involves the exclusion of the underlying pathology, with the first line of treatment focusing on lifestyle interventions, pelvic floor exercises and bladder training.

Natural Approach

Natural medicines can play a supportive role in managing symptoms due to their effectiveness and safety.

Crateva and Horsetail help to improve the tone of the bladder wall. Crateva has beneficial effects on neurogenic bladder and post-prostatectomic atony of the bladder. Crateva is shown to produce a significant reduction in urinary symptoms of frequency, incontinence, pain and retention of urine in men with hypotonic bladder as a result of benign prostatic hypertrophy. Crateva acts to increase the tone of the bladder and the expulsive force of urine, thereby helping effective evacuation. Crateva normalises the tone of the urinary bladder and significantly decreases residual urine volume.

Crateva has been shown to increase the tone of both smooth and skeletal muscle in vitro. Animal studies support this. Forty days of treatment produced a dramatic improvement in bladder control.

 Research also supports the effectiveness of the combined Crateva and Horsetail for bladder control. A pilot study using this combination showed improvements in bladder frequency, leakage, urgency and bladder pain or discomfort with over 80% of participants experiencing a reduction in symptoms. A larger-scale placebo-controlled trial also shows this combination improves bladder symptoms of incontinence, frequency, nocturia, urgency and bladder discomfort with 85% of participants finding improvement.

Lindera has a long history of use in Traditional Chinese Medicine for Kidney and bladder health and is specific for frequent urination and loss of bladder control. Lindera is also recommended for the treatment of renal disease.

A recent randomized double-blind, placebo-controlled trial confirms Happy Bladder reduces urinary frequency, urgency, nocturia and bladder accidents.

Summary

Poor bladder control is shown to negatively impact on emotional health and reduce the quality of life for the sufferer. Research shows that Happy Bladder significantly improved quality of life measures including feeling less frustrated, social activities and better travel. Using natural medicines is a side effect and effective way to manage symptoms impacting on the quality of life.

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