Louise Chang, MD
If you have overactive bladder, travel may sound enticing, but the thought of searching frantically for a bathroom in an unfamiliar city fills you with dread. Why bother? Since the urge to urinate strikes so suddenly -- or frequently -- maybe it’s better just to stay at home.
But with proper management and trip preparations, you can travel with less fear of toileting accidents, experts say.
Don’t assume that nothing can be done. "Control your bladder. Don’t let your bladder control you," says Nancy Muller, executive director of the National Association for Continence in Charleston, S.C. Too often, overactive bladder causes people to drop activities they once enjoyed and become isolated, she says.
Overactive bladder is characterized by symptoms such as urgent or frequent urination and the need to urinate two or more times each night. In most cases, involuntary spasms of the bladder muscles cause a strong need to urinate, even if the bladder isn’t full.
At least 30 million Americans have overactive bladder. About 1 out of 6 people past age 40 has symptoms of the disorder.
If you’re planning to travel with overactive bladder, here are some tips to help make your trip more successful.
If possible, try training your bladder several weeks before you travel. Bladder training encompasses multiple techniques, but here are a few useful ones:
This means urinating on a set schedule, "by the clock, rather than by what your bladder tells you," says Tomas L. Griebling, MD, MPH, professor and vice chair of the department of urology at the University of Kansas and a faculty associate in the Landon Center of Aging. "That can be helpful because for some people, they really only have problems when their bladder gets quite full," he says.
Travelers should use a restroom whenever they have the chance, whether or not their bladder feels full, Muller says.
Kegels or pelvic floor exercises
Strengthening your pelvic muscles can help prevent urine leakage. To find the right muscles, try to slow or stop your urine flow. Once you’ve found these muscles, you can do Kegel exercises at your desk, in your car, or in front of the TV. But don’t do them while you’re urinating; doing so could lead to a bladder infection.
To do Kegels, simply squeeze your pelvic muscles tight for about 3 seconds, then relax for 3 seconds. Repeat 10 times for one set of Kegels. Don’t overdo it, but try to gradually work up to 3 sets of Kegels per day.
"They work in both men and women," Griebling says.
Freeze and squeeze
"One of the symptoms of overactive bladder is that sudden sensation that you have to urinate very quickly. The natural tendency is for people to get up and rush to the toilet," Griebling says. During such an episode, the bladder may be contracting involuntarily, causing urine to leak.
Instead of rushing, people should try a "freeze and squeeze" technique, Griebling says. "They should stop and focus on what they’re feeling in their bladder and do two or three pelvic floor contractions. Often, they will have less urgency. It will help them to have more time to get to the toilet."
To help control urinary urgency, doctors can prescribe anticholinergic drugs, which Griebling describes as "bladder relaxant medications."
"All of them can work quite well, but they can have side effects, mostly dry mouth and constipation. In some older people, they can cause visual problems or confusion," he says.
If patients want to try these drugs, he suggests that they begin taking them a few weeks before their trip. “That’s so that they’ll know how they respond to them, rather than traveling and being in a new place and taking a new medication and having problems or side effects,” he says.
It also takes about two weeks for bladder relaxants to become most effective, says Amy Rosenman, MD, a urogynecologist in Santa Monica, Calif., and a clinical assistant professor at the David Geffen School of Medicine at UCLA.
Bladder relaxants don’t cure, but treat only the symptoms of overactive bladder, according to Griebling, so patients can discontinue the drugs if they no longer need them back home.
Remember to pack medications in carry-on luggage, he says. "If people are going to take extended trips or travel abroad, take a copy of your prescription. That way, if you run out, it’s easier to get things refilled," he adds.
Rosenman also suggests bringing along a stool softener in case a bladder relaxant causes constipation.
Bring adequate supplies
Bring enough absorbent pads in case you can’t find them at certain destinations, Muller says. Also tuck clean underwear into a purse or day pack so that you’ll always have a pair on hand. It’s also a good idea to include a small plastic bag to carry soiled clothing or discarded pads, she says.
"I also recommend taking a barrier cream," Rosenman says. "If you get damp, it’s good to waterproof that area so that it doesn’t get irritated and inflamed." Use it each time after you urinate, she says.
Choose food and drink wisely
Certain foods and drinks can irritate the bladder and cause more urination. During travel, limit or avoid coffee and other caffeinated drinks, alcohol, carbonated beverages, artificial sweeteners, and spicy or acidic foods if experience has shown that these things worsen your symptoms. "Know what your own bladder irritants are," Muller says.
On airplanes, be especially careful not to overdo the coffee, tea, alcohol, and soft drinks. Also try to book an aisle seat near a lavatory, Muller says.
Some people skimp on drinking water during travel to cut down on bathroom trips, but this strategy can backfire, Muller says. "That causes the urine to be more concentrated, and more highly concentrated urine is itself an irritant to the lining of the bladder and can trigger spasms." Instead, travelers should take care to drink enough water to prevent dehydration.
Finding public restrooms
Travelers can plan ahead to locate public restrooms. For example, the National Association for Continence web site has a tool called "Find a Bathroom." Or visit the web site sitorsquat.com to find public bathrooms around the world.
For car trips, travelers can go online to find freeway exit guides that list rest areas with bathrooms.
Furthermore, there are some free mobile apps for finding restrooms.
SOURCES:Tomas L. Griebling, MD, MPH, professor and vice chair, department of urology, University of Kansas; faculty associate, Landon Center of Aging.Nancy Muller, executive director, National Association for Continence.Amy Rosenman, MD, urogynecologist, Santa Monica, California; clinical assistant professor, David Geffen School of Medicine at UCLA.Cleveland Clinic: "Overactive Bladder." National Kidney and Urologic Diseases Information Clearinghouse: "Nerve Disease and Bladder Control"
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