Bladder Spasms – When You Really Gotta Go!

Have you ever had that strong desire to urinate or a cramping sensation in your lower abdomen that comes without warning and if you didn’t get to the restroom in a nanosecond, you would urinate on yourself?  Most of us have one of these bladder spasms at one time or another but some people have them all the time and their quality of life is certainly diminished.  This article will discuss the causes and the treatment of bladders spasms.

Causes of bladder spasms

Bladder spasms can occur because of something in your diet, such as alcohol, acidic or citrusy foods, that irritate the bladder.  There are also medications such as diuretics that can make you go to the bathroom frequently.  A urinary tract infection, or an irritation of the nerves that supply the bladder are frequently associated with bladder spasms.  The latter situation is referred to as neurogenic bladder.  Another condition that causes bladder spasms is interstitial cystitis, which is associated with urinary frequency, burning on urination, pelvic pain and bladders spasms.  Bladder spasms are commonly associated with the use of a urinary catheter, which is inserted into the bladder to drain the urine from the bladder to a bag on the outside of the body.  When the catheter is removed, the bladder spasms will quickly subside.  However, there are many times when the cause of bladder spasms cannot be identified.

Who is at risk for bladder spasms?

Anyone at any age can have bladder spasms. You are more likely to have bladder spasms with urine leakage if you:

  • Are elderly
  • Are going through menopause
  • Recently delivered a baby or are pregnant
  • Have a urinary tract infection
  • Have recently had lower abdominal or pelvic surgery
  • Have nerve or bladder muscle damage caused by disease or injury

Treatment of bladder spasms

Your doctor will attempt to identify the cause of your bladder spasms and select an appropriate treatment.  Often a combination of treatments will work best.

Change in diet. This may help prevent bladder pain if certain foods and beverages are the culprit behind your spasms. Avoid spicy, acidic, or citrusy foods, as well as excessive caffeine and alcohol.  Your doctor can provide you with a food list of the most common culprits.

Timed voiding. This involves timed trips to the bathroom to urinate, usually every 1.5 to 2 hours. As the bladder spasms get better and fewer wetting accidents occur, you can extend the time between trips to the bathroom.

Pelvic floor exercises (“Kegels”). Kegels and other forms of physical therapy help strengthen and relax the bladder and other muscles that help the body hold in urine. To tighten your pelvic muscles, squeeze your muscles in the same way as if you were trying to stop the flow of urine or prevent yourself from passing gas. Your doctor can provide you with instructions for performing Kegel exercises.

Medicines to relax the bladder. The most commonly prescribed drugs to prevent spasms are called anticholinergics. They include Detrol, Ditropan, Vesicare, Enablex, Gelnique, and Toviaz.  A common side effect of all of these medications is dry mouth.

Electrical stimulation implant (Inter-Stim). This is placed under the skin to deliver gentle electrical pulses to the bladder at regularly timed intervals. This treatment is only recommended for the most severe bladder spasms that do not get better with other treatments.

Biofeedback. Biofeedback is a method that teaches the mind how to control normally automated body functions. Bladder training is a type of biofeedback. Some doctors believe biofeedback and behavioral changes work better than medicines for treating urge incontinence. A combination of biofeedback and medications may work best.

Bottom Line:  Bladder spasms occasionally occur in nearly everyone.  However, if they are so frequency that they impact your quality of life, then it is time to see your doctor.  Help is available for nearly everyone who suffers from bladders spasms.

Dr. Neil Baum is a physician at Touro Infirmary and can be reached at (504) 891-8454 or via his website, http://www.neilbaum.com

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