Bladder control issues that is.  Urinary incontinence can affect individuals of all ages and genders.  A NIH article indicates the following prevalence rates of urinary incontinence in the US: young adult women 20-30%, middle aged women 30-40%, elderly women 30-50%, and males of all ages 3-11%. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476070/).  There is a variety of factors that can contribute to urinary incontinence including pelvic floor dysfunction or weakness, over sensitivity of the bladder, hormonal changes, pregnancy, lifestyle factors (dietary intake, smoking, and obesity), decreased sensation due to chronic conditions, as well as declines in functional mobility.

The primary types of incontinence are :

• Stress incontinence – Small leaks with coughing, laughing, lifting, etc. associated with pelvic floor and/or sphincter weakness.
• Urge incontinence – Strong urge to urinate, generally with larger leaks resulting.  (You know, “gotta go, gotta go.”)
• Mixed incontinence – A combination of stress and urge incontinence
• Functional incontinence – Inability to get to the bathroom in a timely manner due to declines in functional mobility.
• Overflow incontinence – Results when bladder completely fills and the individual does not void, and there is a slow continuous leakage.  This most typically indicates a visit to the urologist.  

The first step in addressing urinary incontinence is considering if you have lifestyle habits that may be contributing to the problem:

Here are some lifestyle changes to consider for improving your bladder control:

• Drink adequate water – If you are not drinking enough water your urine can become quite concentrated and irritate the lining of your bladder, resulting in urge incontinence.  How much water should you drink?  Here is a simple formula to estimate an appropriate amount of water intake for your weight – Divide your weight (in pounds) by 2, then multiply that by 80%.    *  (___lbs / 2) x .80 = _____ ounces of water per day.

• Avoid trigger beverages / foods – Different people have different things that may irritate their bladders.  If you are having problems with frequent urination or strong urges, consider what foods you consume on a very regular basis, and consider eliminating or decreasing them for 2-3 days to see if the problem improves.  Some common irritants include caffeinated or decaffeinated coffee or tea, citrus fruits and  juices, sodas, artificial sweeteners, , alcohol, tomatoes and tomato based products, large amounts of dairy products, chocolate (argh!), spicy foods, vitamin C supplements, and in some cases even cranberry!

• Keep your weight in check – As little as 5-7 extra pounds of body weight can decrease your bladder control by increasing the pressure on your bladder.

• Kick the habit, stop smoking – Studies show that women who smoke are two times as likely to develop incontinence, than women who don’t smoke.  This may be due to the “smoker’s cough” which can stretch and weaken the pelvic floor, and aggravate the bladder.

• Stay regular, keep constipation under control – Choose high fiber foods to improve your bowel function.  Constipation can increase pressure in the pelvic region irritating the bladder.  Also, adequate hydration and regular exercise can help you keep regular.

• Get out and walk! – For many, walking can be the almost perfect exercise.  Walking helps strengthen many of the pelvic floor exercises, improves your functional mobility, helps maintain healthy bowel function, and just feels great!

Bladder control issues can have significant negative effects on individuals’ quality of life including inability to participate in certain enjoyable activities, fear of being too far away from an available toileting facility, increasing costs of incontinence medications and supplies, skin and hygiene issues, social isolation and depression.  The good news is that, in many cases, urinary incontinence can be resolved, or at least better controlled, with changes in lifestyle, exercises to improve function of the pelvic floor, and retraining of the neurological system to reduce the urge to urinate into a more appropriate balance.  

Over the next few weeks, I will be addressing the different  types of urinary incontinence and tips to address them using strengthening exercises, neurological quieting, and bladder retraining.  Please share these blogs with your friends, family, and acquaintances if you suspect that they may have “control issues.”

“By changing nothing, nothing changes.” ~ Tony Robbins

Katey Hawes, owner and founder of Posabilities, Inc., is a physical therapist, registered yoga teacher, and yoga therapist.

You may find her at Facebook.com/posabilities4u, Twitter @Posabilities4u, and Google+.