Urinary Incontinence: Causes, Diet, and Recovery Tips

Regarding urinary incontinence issues?

Hello Doctor,
Since last Wednesday morning, I have experienced urinary leakage the moment I got out of bed from the upper bunk.
At first, I didn't think much of it since it was just a few drops, but as the days went by, the situation gradually worsened.
Initially, it was just a few drops that would slightly wet my pad, but by Saturday, the pad was completely soaked.
I started leaking even while moving around the kitchen, and after drinking just a little water, I found myself running to the bathroom frequently.
Sometimes, as soon as I took off my pants, urine would flow directly into the toilet, unlike before when I would sit down and wait for it to flow gradually.
I often felt the urge to urinate, but when I sat on the toilet, I couldn't urinate as I normally would; even when I did, the amount was less than usual.

On that day, I visited a gynecologist, and after I described my symptoms, the doctor diagnosed me with acute cystitis and prescribed medication for three days, with a follow-up appointment.
After taking the medication, the urinary leakage was not as severe, but strangely, two mornings after the visit, I started experiencing leakage again.
On Sunday, it was a bit better, but today, Monday, not only was my pad completely wet, but even the area where the pad was placed was soaked with urine.
I quickly changed into new underwear and a leak-proof pad, and during the day, there was not much noticeable leakage, although there were still a few drops of urine on the pad.
However, in the evening while taking the bus, I felt leakage again for some reason.

I would like to ask you a few questions:
1.
Regarding the diet for acute cystitis, I found online that it mainly advises avoiding alcohol, caffeine (tea, coffee, chocolate), sweets, spicy foods, pasta, and bread.
However, some sources say that eggs, milk, chicken, soy, or fish are acceptable, while others say those should also be avoided.
What is the actual guideline? Specifically, which foods should I avoid, and which ones are safe to eat?
2.
I usually have a protein drink for breakfast.
Could the morning urinary leakage be related to this? Before taking the bus in the evening, I had a small piece of bread (a sample size), and after eating it, I suddenly felt the urge to leak.
Could this be related?
3.
During the consultation, I mentioned that I rarely hold my urine and that my bathroom visits are relatively regular (about every two to three hours, and once or twice at night), but I don't drink much water.
The doctor suggested that I should drink more than 2000 cc of water daily.
I have tried to drink more water over the past two days, but it's a bit challenging to reach that goal; I usually drink between 1000 cc to 1500 cc, and today I think I urinated at least ten times, with the shortest interval being three times within one hour.
Is this normal with cystitis? I sip water throughout the day rather than drinking large amounts at once.
Before and after becoming ill, I have not experienced burning sensations or blood in my urine, just a yellowish color.

4.
Sometimes I also experience leakage when squatting.
Does the squatting position have an impact?
5.
Generally, how long does it take for such symptoms to recover? Besides drinking more water, taking cranberry supplements, and maintaining a normal diet and lifestyle, what else should I pay attention to in order to prevent recurrence?

Ann Her, 20~29 year old female. Ask Date: 2019/04/08

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Since last Wednesday morning, I have experienced urinary leakage the moment I got down from the upper bunk.
At first, I didn't think much of it because it was only a few drops, but as the days went by, the leakage gradually worsened.
Initially, it was just a few drops that would slightly wet my pad, but by Saturday, my pad was completely soaked.
I started leaking urine even while moving around the kitchen, and after drinking just a little water, I found myself running to the bathroom frequently.
Sometimes, as soon as I took off my pants, urine would flow directly into the toilet, unlike before when I would sit down and wait a moment before it would flow slowly.
I often felt the urge to urinate, but when I sat on the toilet, I couldn't urinate as I normally would; even when I did, the amount was less than usual.
That day, I visited a gynecologist, and after I described my symptoms, the doctor diagnosed me with acute cystitis and prescribed medication for three days, asking me to return for a follow-up.
After taking the medication, the leakage was indeed not as severe, but strangely, two mornings after seeing the doctor, I started experiencing leakage again.
On Sunday, it was a bit better, but today, Monday, not only was my pad completely wet, but the area under the pad was also soaked with urine.
I quickly changed into new underwear and a leak-proof pad, and after that, I didn't have noticeable leakage during the day, although there were still a few drops of urine on the pad.
In the evening, while taking the bus, I suddenly felt like I was leaking again.
I would like to ask the doctor a few questions:
1.
Regarding the dietary recommendations for acute cystitis, I found online that it mainly advises against alcohol, caffeine (tea, coffee, chocolate), sweets, spicy foods, pasta, and bread, but some sources say that eggs, milk, chicken, soy, or fish are acceptable, while others say those should also be avoided.
What is the actual recommendation? Specifically, which foods should be avoided, and which can be consumed?
Answer: It varies based on individual constitution.
2.
I usually have protein drinks for breakfast.
Could the morning leakage be related to this? Before taking the bus in the evening, I had a small piece of bread (a sample size), and after eating it, I suddenly felt the urge to leak.
Could this be related?
Answer: Try changing your diet.
3.
During the consultation, I mentioned that I rarely hold my urine and that my bathroom visits are relatively regular (about every two to three hours, and once or twice at night), but I don't drink much water.
The doctor suggested that I should drink over 2000 cc of water daily.
I have tried to drink more water these past two days, but it's been difficult to reach that goal, usually around 1000 to 1500 cc, and today I think I urinated at least ten times, with the shortest interval being three times within one hour.
Is this normal given my cystitis? I drink water in small sips rather than chugging large amounts at once.
Before and after becoming ill, I haven't experienced burning sensations or blood in my urine, just a yellowish color.

Answer: This is not considered normal for cystitis.
4.
Sometimes I also experience leakage when squatting.
Does the squatting position have an effect?
Answer: Yes, it does.
5.
Generally, how long does it take for such symptoms to recover?
Answer: Diagnosing cystitis requires a urine test and bacterial culture to find effective antibiotics.
Antibiotics usually need to be taken for more than seven days, and you should return for a urine test after finishing the medication.
6.
Besides drinking more water, taking cranberry supplements, and maintaining a normal diet and lifestyle, what else should I pay attention to in order to prevent recurrence?
Answer: Those are the main points to consider.

Reply Date: 2019/04/08

More Info

Understanding urinary incontinence, especially in the context of acute bladder infections, involves a multifaceted approach that includes recognizing the causes, dietary considerations, and recovery strategies. Your experience with urinary incontinence, particularly following a diagnosis of acute cystitis, raises several important questions that can be addressed through a combination of medical knowledge and practical advice.

Causes of Urinary Incontinence
Urinary incontinence can stem from various factors, including urinary tract infections (UTIs), anatomical changes, neurological conditions, and lifestyle choices. In your case, the acute bladder infection likely exacerbated your symptoms. Infections can irritate the bladder lining, leading to increased urgency and frequency of urination, as well as involuntary leakage. Additionally, factors such as hormonal changes, pelvic floor muscle weakness, and even certain medications can contribute to incontinence.

Dietary Considerations
Diet plays a significant role in managing urinary symptoms. It is generally advised to avoid irritants that can exacerbate bladder issues. Common dietary triggers include:
- Caffeine: Found in coffee, tea, and chocolate, caffeine can stimulate the bladder and increase urgency.

- Alcohol: It can irritate the bladder and lead to dehydration, worsening incontinence.

- Spicy Foods: These can irritate the bladder lining.

- Artificial Sweeteners: Some individuals find that these exacerbate bladder symptoms.

On the other hand, certain foods can be beneficial:
- Hydrating Foods: Fruits and vegetables with high water content can help maintain hydration.

- Lean Proteins: Chicken, fish, and plant-based proteins are generally safe and can support overall health.

- Whole Grains: Foods like brown rice and whole grain bread can provide fiber, which is beneficial for digestive health.

Regarding your specific questions about protein drinks and their impact on incontinence, it’s essential to consider the overall composition of the drink. Some protein drinks may contain additives that could irritate the bladder. If you notice a correlation between consuming these drinks and increased leakage, it may be worth exploring alternatives.

Fluid Intake and Urination Patterns
Your doctor’s recommendation to increase fluid intake to 2000 cc per day is aimed at ensuring adequate hydration and promoting urinary tract health. However, if you are experiencing frequent urination, it’s crucial to balance fluid intake with your body’s needs. Drinking smaller amounts throughout the day, rather than large quantities at once, can help manage urgency while still keeping you hydrated.

The frequency of urination you described, especially during a bladder infection, can be normal. However, if the urgency and frequency persist beyond the infection, it may warrant further evaluation.

Posture and Incontinence
You mentioned experiencing leakage when squatting. This can be related to pelvic floor muscle function. Certain positions may put additional pressure on the bladder, leading to involuntary leakage. Strengthening pelvic floor muscles through exercises like Kegels can be beneficial in improving control.

Recovery and Prevention
Recovery from an acute bladder infection typically takes about a week with appropriate antibiotic treatment. However, if symptoms persist, further evaluation may be necessary. To prevent recurrence, consider the following strategies:
- Stay Hydrated: Continue to drink plenty of fluids, focusing on water.

- Practice Good Hygiene: Wipe from front to back and urinate after intercourse to reduce the risk of UTIs.

- Avoid Irritants: Limit intake of bladder irritants as mentioned earlier.

- Pelvic Floor Exercises: Regularly perform exercises to strengthen pelvic muscles.

In conclusion, managing urinary incontinence, particularly in the context of acute bladder infections, requires a comprehensive approach that includes understanding the causes, making informed dietary choices, and implementing recovery strategies. If symptoms persist or worsen, it’s crucial to follow up with your healthcare provider for further evaluation and tailored management.

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