Frequent Urination: Causes, Symptoms, and Treatment Options

Frequent urination issues?

Hello, Doctor.
About a month ago, I was diagnosed with gastritis at a clinic and took medication for two weeks without improvement.
I then went to Tzu Chi Hospital for an endoscopy, where the physician confirmed that I only had inflammation and no significant issues.
After that, I was prescribed medication for another two weeks.
Subsequently, I developed some other symptoms, including light sleep, vivid dreams, frequent urination, and nocturia.
Due to the frequent urination, I visited an internist for a urinalysis, and the doctor said my urine test results were normal.
He prescribed URACARE for me, and I noticed some improvement; I didn't feel the urge to urinate as much during the day, but I still woke up two to three times at night to urinate.
The urine volume was significant, and I felt that the medication caused blurred vision.
I mentioned this to the pharmacist, who said it might be a side effect of the medication.
Later, during a follow-up visit with a different internist, I explained my sleep disturbances, and he prescribed me URACARE and Aprazo.
After taking Aprazo, I no longer experienced light sleep or vivid dreams, but I still woke up around 5 AM to urinate and again around 7 AM.
Yesterday morning, after taking my last URACARE pill, I went back to Tzu Chi Hospital for a follow-up to get my gastric medication.
While I was outside, I didn't feel the urge to urinate frequently, but when I got home after dinner and took my gastric medication, I experienced frequent urination again.
During my follow-up with the internist, I explained that the medication was effective but caused blurred vision.
The doctor suggested that I see an endocrinologist, stating that endocrinology and metabolism are the same.
I would like to know how to explain my situation when I visit the endocrinology and metabolism department.

Awei, 20~29 year old female. Ask Date: 2016/08/18

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your description, it seems that you don't have much trouble during the day, although you do wake up several times at night to urinate, and each time the volume is quite large.
The most common reason for this could be that you are drinking too much water in the evening.
I suggest trying to drink more water during the day and avoiding fluid intake after dusk (or even in the afternoon) to see if this improves your situation.
If the issue persists, it would be advisable to seek medical attention.
Your previous doctor recommended consulting an endocrinologist, likely due to concerns about the possibility of "diabetes insipidus," which is a condition caused by a dysfunction of the pituitary gland.
You can describe your symptoms to the doctor, and it would be best if you could keep a record of your daily fluid intake and urine output to share with them.
Thank you for your question.

Reply Date: 2016/08/18

More Info

Frequent urination, medically known as polyuria, can be a distressing symptom that may arise from various underlying causes. Understanding the potential reasons behind this condition, as well as the associated symptoms and treatment options, is crucial for effective management.

Causes of Frequent Urination
1. Urinary Tract Infections (UTIs): UTIs are one of the most common causes of frequent urination, often accompanied by a burning sensation during urination, urgency, and sometimes fever. Although you mentioned that your urine tests came back normal, it’s essential to consider that some infections might not always show up in standard tests.

2. Bladder Overactivity: This condition, also known as overactive bladder (OAB), is characterized by a sudden urge to urinate frequently, often leading to involuntary leakage. It can be triggered by various factors, including stress, anxiety, or even certain foods and drinks.

3. Prostate Issues: In men, conditions such as benign prostatic hyperplasia (BPH) can lead to increased urinary frequency and urgency. While you indicated that prostate inflammation was ruled out, it’s worth noting that other prostate-related issues could still contribute to your symptoms.

4. Diabetes: Both type 1 and type 2 diabetes can lead to increased urination due to high blood sugar levels, which cause the kidneys to excrete more glucose, pulling water with it and leading to increased urine production.

5. Medications: Certain medications, particularly diuretics, can lead to increased urination. You mentioned experiencing blurred vision as a side effect of URACARE, which may indicate that the medication could be influencing your urinary patterns.

6. Psychological Factors: Anxiety and stress can also manifest physically, leading to symptoms such as frequent urination. The fear of needing to find a restroom can create a cycle of anxiety that exacerbates the frequency of urination.

Symptoms to Monitor
In addition to frequent urination, you should be aware of other symptoms that may accompany your condition, such as:
- Burning sensation during urination
- Urgency or inability to hold urine
- Pain in the lower abdomen or back
- Changes in urine color or odor
- Sleep disturbances due to nighttime urination (nocturia)

Treatment Options
1. Lifestyle Modifications: Reducing caffeine and alcohol intake, maintaining a healthy weight, and practicing bladder training techniques can help manage symptoms.

2. Medications: Anticholinergic medications are often prescribed for overactive bladder. If URACARE is causing side effects, discussing alternative medications with your healthcare provider is essential.

3. Behavioral Therapies: Cognitive-behavioral therapy (CBT) can help address anxiety-related symptoms, which may contribute to your frequent urination.

4. Pelvic Floor Exercises: Strengthening the pelvic floor muscles can help improve bladder control.

5. Follow-Up Testing: If symptoms persist, further evaluation by a urologist or an endocrinologist may be necessary to rule out other underlying conditions, such as diabetes or hormonal imbalances.

Communicating with Your Endocrinologist
When you visit the endocrinology and metabolism department, it’s important to clearly articulate your symptoms and concerns. Here’s how you might structure your explanation:
1. Introduction: Briefly introduce yourself and mention your primary concern about frequent urination.

2. Symptom Description: Describe your symptoms in detail, including how long you’ve been experiencing them, any patterns you’ve noticed (e.g., more frequent at night), and any associated symptoms like blurred vision or sleep disturbances.

3. Previous Evaluations: Mention the tests you’ve undergone, including urine tests and any medications you’ve been prescribed, along with their effects and side effects.

4. Concerns About Underlying Conditions: Express your concerns about potential underlying conditions, such as diabetes or hormonal issues, and your desire for further evaluation.

5. Questions: Prepare specific questions you have regarding your symptoms, potential tests, and treatment options.

By providing a comprehensive overview of your situation, you can help your healthcare provider better understand your condition and tailor an appropriate treatment plan. Remember, open communication is key to effective healthcare management.

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