When You’ve Always ‘Gotta Go’



Are frequent trips to the bathroom keeping you up at night? Do you find yourself avoiding social situations because you’re afraid you’ll need the bathroom? It might be time to see your health care professional and talk about that busy bladder.

The job of the kidneys is to filter wastes and excess water from your blood to produce urine. The bladder, a hollow, balloon-shaped organ, holds the urine until the brain receives a signal to loosen the pelvic floor muscles and contract the bladder muscle to push the urine out of the body through the urethra, a tube connecting the kidneys and bladder. In men, the prostate sits at the opening of the bladder and urethra passes through the center of the prostate as it carries urine out of the body.

“The first urge we feel is when the bladder is only one-quarter full; the strongest urge is when the bladder is full, about 16 ounces,” says Katie Ahart, an occupational therapist at Cortland Regional Medical Center. “Urinary frequency varies by person,but the general guideline is that there should be two to four hours between voids.” Anything more often could be a sign of overactive bladder (OAB) – a sudden and frequent uncontrollable urge to urinate that troubles some 33 million Americans.

“I tell patients that incontinence is not normal, that we do have ways to deal with it,” says Dr. Mahmoud Chehab, a urologist at Cortland Regional Medical Center. “There are medications you can take, and surgery is an option. In many cases, behavior modification can help.”

Ahart works with patients on behavior modification, starting with having them keep a bladder diary to record how often they void and for how long they go. They also track what they eat and drink since caffeinated drinks, alcohol, carbonated beverages, spicy, and acidic foods can irritate the bladder and increase the feeling that you need to go more often. Ahart also reminds people to drink enough liquid – “lt’s the timing of when you drink and not the amount that’s the issue,” she says.

She gives patients exercises that strengthen the pelvic floor muscles to help hold in the urine. She also teaches toilet re-training.

“We’ve all picked up some bad habits,” Ahart says. “A lot of us engage in the ‘just in case’ stop – we go to the bathroom before we go out or get in the car. If you do this, you’re not letting the bladder fill completely, and you’re training your bladder to need to go sooner. It’s better to hold off for a bit. Instead of going every hour, go every 90 minutes,” she explains. Dr. Chehab cautions that holding your urine for too long also creates its own set of issues. “People with jobs where they can’t go regularly, like truck drivers who don’t stop for seven, eight, or nine hours, will stretch their bladders. This can lead to difficult urinating and always feeling like your bladder is full.”

To keep your bladder healthy, Dr. Chehab tells patients not to smoke (nicotine can collect in the bladder), keep your weight down, avoid bladder-­irritating food and drinks, drink enough of the right fluids, and empty the bladder completely on a regular schedule.

“And remember that you don’t have to live with having to go all the time,” he says. “We have things that we can do to with medication, physical therapy, non-invasive procedures, and surgery. We’re here and ready to help you.”

Make your appointment today with Dr. Chehab at 607-428-5757.

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