Developing OAB

I suspect I may be developing OAB. At my doctor's request, I've been keeping a log of my bathroom trips on a daily basis for the past month, and have noticed a gradual uptick in frequency, starting with 6-7 at the beginning of the month, and progressing to 11-20 as time has gone on. I notice now that I will feel as if I have to go suddenly and not insignificantly, but when I go to the bathroom, there's hardly anything there, or I'll feel like I have to go minutes after I've already gone. I have IBS, and have also been tracking my bowel progress. It seems to fit a pattern with nothing at all for two days, then one solid BM and two leaks all on the third day. What would cause sudden-onset OAB in an otherwise-healthy young person? I've never had a history of bladder problems in the past, not even bedwetting as a child. I'm scheduled to see my doctor again next week, is this something I should be especially concerned about medically speaking? I'm already wearing 24/7 for the bowel leakage, which makes it easy to go when my bladder acts up. Should I be working harder to hold it?

Im afraid that its a common thing for Urine IC (OAB is a MILD form Urine IC ) to develop after certain time of IBS or Fecal Ic and as you im averaging 15 + /24 Hoers (incl more then 2 + times a night /and as SOON as i wake up ) i would say wait until you seen the doc dear but over al i wouldn't worry to mush its as i sed more common than you would think. In my opinion and what i do is i try to hold as best i can as when you let it go the point of no return will quickly come BUT you should NOT try to hold it to long and NEVER if you feel pain . and that goes for both Fecal as well as urine

This is link to a very good info reg the relationship between IBS and Urine IC

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654175/

Thanks Missy, that's a very interesting article. I'm surprised that the prevalence of OAB was slightly higher in men in that study, as I've always been told it's more common in women. The losing control part isn't great, but at least I know that it's unlikely I have anything to be concerned about medically speaking.

Youre very welkome dear glad i can help :graduate: ,for us IC often has to do with childbirth starting it dear. Again unlikely BUT still wait for the docs opinion.

Most of the time I don’t get a lot of warning that I have to pee, until it’s almost too late and depending on the situation I am in it is just way easier to use my diaper at that point because getting to the bathroom fast enough is usually impossible I pee about 12 to 16 times over the course of a 24 hour day. At night I sometimes have accidents but a lot of times for me it’s just easier to use the diaper and not interrupt the sleep that I may or may not be getting, it is also important to note that I have A few medical issues. Diabetes controlled with Metformin, sleep apnea and using cpap for that, and blind with very low vision makes travel eexcrutiaringly slow. Plus I always drinking something like water or coffee or whatever and I ride the bus a lot. I noticed that a lot of times having to P comes at certain times during the day and the amount of times I have to pee can differ a lot and some of it depends on how much I drink but some of it really doesn’t, there are days when I drink a lot and I end up using my diaper quite a bit during the day but then there are days when that doesn’t happen so it’s kind of weird. I noticed that when I get up in the morning are usually P2 or three times before I leave for work and during the hour and a half of getting to work and hanging out before I punch and even though I’m already diapered are usually don’t have to pee although for the three hours that I am working I can usually count on peeing like once an hour so by the time I punch out I’ve usually wet myself at least twice and then also another one or two times at least before I get home. As I write this I am up way too early because of crappy sleep and I am on my second diaper of the night which is unusual for me and this one is already thoroughly soaked.

Wuggle said:

I suspect I may be developing OAB. At my doctor's request, I've been keeping a log of my bathroom trips on a daily basis for the past month, and have noticed a gradual uptick in frequency, starting with 6-7 at the beginning of the month, and progressing to 11-20 as time has gone on. I notice now that I will feel as if I have to go suddenly and not insignificantly, but when I go to the bathroom, there's hardly anything there, or I'll feel like I have to go minutes after I've already gone. I have IBS, and have also been tracking my bowel progress. It seems to fit a pattern with nothing at all for two days, then one solid BM and two leaks all on the third day. What would cause sudden-onset OAB in an otherwise-healthy young person? I've never had a history of bladder problems in the past, not even bedwetting as a child. I'm scheduled to see my doctor again next week, is this something I should be especially concerned about medically speaking? I'm already wearing 24/7 for the bowel leakage, which makes it easy to go when my bladder acts up. Should I be working harder to hold it?

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I've been there with the oab- you don't want this. And you're right, it's getting worse because you are attempting to go every time you get the urge, and it will keep getting worse and even painful. Your bladder is becoming less elastic and likely shrinking as well. It will get worse if you maintain going all of the time, and will develop into full blown urge incontinence.

As you suggested, yes you absolutely need to practice holding it if you want to avoid becoming urge incontinent. Be warned though, restretching your bladder can be a painful experience. Remember all the whining and dancing little kids do when they have to go? Yup, you'll need to go through that all over again in order to strengthen your sphincter and restretch your bladder. It seems some adults don't have the tolerance for that though, so good luck.

Or, option two is to actively try and keep your sphincter relaxed at all times. (Focus on what your sphincter is doing when you release to pee, and focus on what it feels like to clamp it back shut, then try and keep it open all the time). This will eliminate your urges, but also accelerate your becoming functionally incontinent and constantly leaking all the time.

I know neither is a good choice, but in my experience either one is better than being urge incontinent. Trust me.

That's interesting Slomo, so you think just being completely bladder incontinent and having a constant uncontrolled dribble like infants do is preferable to urge incontinence? Is that because it's less painful? I'll have to do some thinking, honestly I'm not sure which would work better for me at this point. Maybe I'll try holding it and see how painful it is, then make a decision from there.

Wuggle said:

That's interesting Slomo, so you think just being completely bladder incontinent and having a constant uncontrolled dribble like infants do is preferable to urge incontinence? Is that because it's less painful? I'll have to do some thinking, honestly I'm not sure which would work better for me at this point. Maybe I'll try holding it and see how painful it is, then make a decision from there.

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Oh yes. No question. With full blown urge incontinence you get a sudden and intense urge to pee. Usually that means less than 30 seconds before you will pee. Trying to delay that urge becomes painful. Badly so, and it gets worse untill you finally do go. Not to mention, when you do pee it tends to be a full flooding which many mid grade diapers just can't handle.

With full functional incontinence you don't even feel the need to pee at all. It's completely automatic and you often will only notice it when you're already mid wetting. It happens much more often and in small spurts, other times it's a near constant dribble. Your diaper is also able to absorb everything much more easily, and will have time to wick the pee away too. Heck, you can even use mid grade diapers here, as long as you don't mind changing more often anyways.

Now you can see why I warn that urge incontinence is to be avoided when youre facing one of the two. Your suggestion is a good one though. By all means do try holding it. The next time you get the feeling you need to pee, start a timer for 15 minutes. When it runs out then go pee. The next day set it for 20, then 30, and so on until you're confident your bladder control is returning. Also watch out for how long inbetween bathroom breaks become. If you can make it for 4+ hours you're probably good again.

That’s helpful, thanks Slomo. I’m seeing my doctor in two days, and until then, I’ll work on seeing how long I can hold it for. I have a weird thing developing as well where, if I don’t feel the need to go for a coulple of hours, I’ll try, and suddenly discover that I had to go a lot but my brain didn’t tell me and it felt like my bladder was completely empty. This is concerning to me as well. Either I feel like I have to go constantly when I don’t, or I don’t feel like I have to go at all when I do.

Oh i had that for yeas hon thats perfectly normal for this condition .You`l get used to it hon and adapt accordingly , actually have the same with Feces as well many times

I decided years ago to must relax and use my diaper most of the time, as I rarely get any warning I need to pee and I usually would not make it any ways. My incontinence has gotten worse over time but I am over all ok with being back in diapers I try to look at the positive side I no longer have to worry if the bathroom is busy or closed as long as I am not near the saturation point of my diapers capacity.

Missy1 said:

Oh i had that for yeas hon thats perfectly normal for this condition .You`l get used to it hon and adapt accordingly , actually have the same with Feces as well many times

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Oh joy, that sounds fun! (sarcasm). At least it doesn't sound like an immediate red flag for a problem though, thanks Missy. My bladder was being annoying today; it kept telling me it had to go, but there was never anything there. I think it's just attention-seeking!

Hi Wuggle,

you wrote that you wear 24/7 because of bowel leakage. You should ask your doc to check for a bladder infection. This can cause also exactly these symptoms. If you are bowel IC it's a much higher risk to get such a infection because this is caused normally by enterobacteria.

I know when I was in 8th grade and started my first year of high school I had OAB (not diagnosed by a doctor though) and my mom just told me to hold/potty train my bladder. So I would say it would be best to try and hold your pee, but still wear the diapers in case you have an accident. It'll be really hard at first but over time you might be able to lessen the OAB. Drinking less fluids might help, but I can't say if it will work for you (didn't work with me). I still do have OAB now, but it's lessened and will sometimes happen randomly (like at nighttime/really early morning or just on some days). I don't know how much I go to the bathroom now though. But do what you can and if you get really concerned about it then let your doctor know. OAB could lead to bladder incontinence if it becomes way too frequent, like going every minute or hour.

Drinking less fluid will NOT help al it will do is to concentrate you pee and you risk dehydration and further more its not healthy.

Actually Oab IS a sort of MILD IC Sparkle Bunny & if you need to pee more then 2 times at night thats signs of Nocturia (usely accompanied with Moderate Urine IC )

Usely the ord expected times (i do that before early afternoon ) to pee is 6 sometimes up to 10 but over that usely means it might be time to visit the docs as it might be IC or something not good like Diabetes etc....

I started my path in the urine IC First of al sadly i do remember having certen accidents both day and night as a VERY young girl so probably Moderate mixed already there Moderate . then it held up many years . THEN started again a few years ago with OAB ,developed again rapidly to moderate Mix urine IC , and then just as fast Severe Mix Urine IC BUT as i also sed before IC is very individual so the only way to find this out is by the docs. same story with IBS and the Severe Fecal actually come to think of it .

SparkleBunny said:

I So I would say it would be best to try and hold your pee, but still wear the diapers in case you have an accident. It'll be really hard at first but over time you might be able to lessen the OAB. Drinking less fluids might help, ...

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In general this is one way - how ever - it‘s not a good idea to try that on your own for sevaral reasons. It‘s part of the conventional therapy for OAB, but the important think is, that it‘s monitored by the doc - who setup a plan baised on your miktation protocol that include times for dringing and times when to voiding. If you do it on your own there is the risk to:

a) dehydrate - what is not only dangerous but also makes the urge even worse, because of the concentrated urin
b) if you hold it to long there is the risk to demage your kindneys.

So if you have problems check with a doc - don‘t try to cure yourself...

Well spoken Micki i agree 101 % in youre above statements

lets also not forget holding for to long is VERY painful

mickdl said:

Hi Wuggle,

you wrote that you wear 24/7 because of bowel leakage. You should ask your doc to check for a bladder infection. This can cause also exactly these symptoms. If you are bowel IC it's a much higher risk to get such a infection because this is caused normally by enterobacteria.

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I saw my doc last Thursday and provided a urine sample which was negative for bacteria or glucose, so no infection or diabetes. She also took me off Miralax and recommended Immodium and to cut out caffeine. I’ll go back in a month or so with my updated log to see if anything has improved.

Wuggle said:

I saw my doc last Thursday and provided a urine sample which was negative for bacteria or glucose, so no infection or diabetes. She also took me off Miralax and recommended Immodium and to cut out caffeine. I’ll go back in a month or so with my updated log to see if anything has improved.

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Ouch, they'd have to put me through narcotics anonymous to get me off of caffeine. It may only be 2-3 cups per day, but my days don't start until after that first cup or two. I know my moderate alcohol consumption at night doesn't help my bladder either, but I'd have to be on a dialysis machine before I'd even think about cutting it out since my day doesn't want to end until after 2-3 shots.

To me, it's all about the trade offs which allow me to live my life to the fullest. I'd rather have bladder problems and keep the coffee and alcohol. Some things you just have to put into perspective and ask yourself; are diapers REALLY that bad?

Slomo said:

Ouch, they'd have to put me through narcotics anonymous to get me off of caffeine. It may only be 2-3 cups per day, but my days don't start until after that first cup or two. I know my moderate alcohol consumption at night doesn't help my bladder either, but I'd have to be on a dialysis machine before I'd even think about cutting it out since my day doesn't want to end until after 2-3 shots.

To me, it's all about the trade offs which allow me to live my life to the fullest. I'd rather have bladder problems and keep the coffee and alcohol. Some things you just have to put into perspective and ask yourself; are diapers REALLY that bad?

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For me, it’s less about the caffeine (since I really don’t drink much of it and doc said I could keep chocolate due to the negligible amounts of caffeine it contains) and more about the meds. I’m already on two prescription meds for anxiety and autism, and am reluctant to keep altering my body chemistry by taking so many different chemicals. I’m being evaluated for ADHD right now, and if that test comes back positive, I’m going to have to have a long conversation with my psychiatrist about whether taking meds for it will be helpful in the long run.

If I had to choose between a life with no diapers but no chocolate and one with chocolate in which diapers were needed, honestly, I’d choose the chocolate. Pretty sure I’m literally addicted.