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Beginning in March 2021, the Social Justice Ministry team began providing this monthly health awareness article written by fellow parishioner, Sylvia Thomas.  Sylvia is a Board Certified Nurse Practitioner who specializes in oncology.  Scroll down to read the current article. You may also download a printable version of the current and past articles by selecting one of the following:

November 2021 Edition

November is Bladder Awareness Month

Bladder Health 

The bladder is a hollow organ, just like a balloon, that is located in the lower abdomen and stores urine. It is part of the Urinary system, which also includes the kidneys, ureters and urethra. Urine contains waste and extra fluid left over after the body takes what it needs from what we eat and drink. When full, an adult bladder can hold about 500 to 600 milliliters of urine, which must be released about every 2 to 5 hours.

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As the bladder fills with urine, nerve signals are sent to the brain telling it the bladder is getting full. The brain then sends impulses back to the bladder to empty its contents. The bladder responds to the messages by causing the muscles of the urethra to relax, while the muscles of the bladder contract and squeeze. If all the signals are in order, normal urination occurs.

As the bladder fills with urine, nerve signals are sent to the brain telling it the bladder is getting full. The brain then sends impulses back to the bladder to empty its contents. The bladder responds to the messages by causing the muscles of the urethra to relax, while the muscles of the bladder contract and squeeze. If all the signals are in order, normal urination occurs.

As one gets older, the bladder changes. The elasticity of the bladder tissue may get tough and do not stretch as much, therefore it is not able to hold as much urine as before and a person may need to go to the bathroom more often.  The bladder wall and pelvic floor muscles also becomes weaker, making it harder to empty the bladder fully, causing urine to leak from the bladder.  Bladder problems are common, especially as people age, and can disrupt day to day life. When people have bladder problems, they may avoid social settings and have a harder time getting things done at home or at work. 

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Common Bladder Problems: 

  1. Urinary Tract Infections (UTI):

This is a common type of infection and can occur anywhere in the urinary system. More than half of all women will have at least one urinary tract infection in their lifetime. 

Older women are more likely to get a UTI because the bladder muscles weaken and makes it harder to empty the bladder. This causes urine to stay in the bladder. When urine stays in the bladder for too long, it makes an infection more likely to occur. 

Types of UTIs include: 

  • Bladder infection:

This is the most common type of UTI in which bacteria enter the bladder and causes symptoms such as a strong and sudden urge to urinate. 

  • Kidney Infection:

Infections in the bladder can spread to the kidneys which can lead to severe infection. Kidney infections can last a long time and may cause permanent damage to the kidneys. 

  • Urethral Infection:
  • A UTI can develop in the urethra, but is less common.
  1. Lower Urinary Tracts Symptoms:

This is a group of symptoms such as difficulty urinating, loss of bladder control, leaking urine (urinary incontinence) and frequent need to urinate. Sometimes there is burning and pain with urination. 

  1. Bladder Cancer:

Bladder cancer, when it occurs, usually is in the lining of the bladder. 

Signs and symptoms include :

  • blood in the urine
  • Unexplained pain
  • UTI-like symptoms
  • Postmenopausal bleeding in women

 

Things that Can Affect Bladder Health 

Many things can affect bladder health, and there are many bladder health behaviors that we can control, some of which include: 

  1. Constipation:  When too much stool builds up in the colon, it puts pressure on the bladder and keeps it from expanding the way it should normally 
  2. Diabetes: Diabetes can damage the nerves around the bladder that helps with control.
  3. Being Overweight: People who are overweight may be at a higher risk for urine leakage.
  4. Low Physical Activity: Physical activity is quite helpful in preventing bladder problems as well as helping to prevent constipation and maintain a healthy weight.
  5. Smoking: Bladder problems are more common among smokers. Smoking increased the risk for bladder cancers.
  6. Alcohol: For many people, drinking may cause bladder problem to get worse, as alcohol is a diuretic and make people to have frequent urination.
  7. Diet: Some people may experience that eating spicy foods, citrus fruits and tomato-based foods may worsen the problem.
  8. Pelvic Injury: Trauma such as prostate surgery, childbirth or sexual assault can damage the muscles and nerves that help control the bladder.

 

Reasons that increase the risk for Urinary Tract Infections: 

  •  Sexual Activity: Can cause bacteria to move from the bowel or vaginal area to the urethral opening. Urinating after sex helps to lower this risk.
  • Uncontrolled blood sugar in diabetic people.
  • Using a Urinary catheter: This a small tube that is place in the bladder to help some people empty their bladder. However, placing a catheter may cause a direct path for bacteria to reach the bladder.
  • Using certain types of birth control, for example diaphragms may cause bacteria to enter the bladder when they are placed

 

Signs of a Bladder Problem include: 

  • Needing to urinate eight or more times in a day
  • Waking up many times at night to urinate
  • Sudden, urgent need to urinate
  • Pain or burning before, during and after urinating
  • Cloudy or bloody urine
  • Passing only small amounts of urine after a strong urge to urinate
  • Difficulty starting a urine stream or having a weak stream
  • Incomplete emptying of the bladder.
  • Urinary Incontinence, which is the inability to hold urine, or leaking urine.

There are different types of urinary incontinence:

  • Stress incontinence which is leakage of urine from the bladder due to increased pressure, such as from coughing, sneezing, laughing or carrying a heavy load. It is more common in women.
  • Overactive Bladder (OAB) which is a problem with the bladder function that causes a sudden need to urinate. Symptoms include urinary incontinence, urinary urgency, frequency and may even cause bedwetting.
  • Benign Prostatic Hyperplasia (BPH) which is an age-related prostate gland enlargement that can cause a man to have difficulty with urination. The prostate becomes enlarged and blocks the urethral passage making it difficult to start a urine stream and to completely empty the bladder. Symptoms include urinary incontinence, sexual dysfunction and frequent urination, especially at night.
  • Urge incontinence in which there is a sudden, strong urge to urinate and some urine starts to leak out before making it to the bathroom.
  • Functional Incontinence happens when a physical or mental disability or some other problem keeps a person from making it to the bathroom in time, example: people with Alzheimers, Parkinsons disease, arthritis, etc.
  • Diabetic Neuropathy, which is nerve damage that can occur with diabetes.
  • Pregnancy in which the weight of the growing fetus pushes against the bladder and may cause leakage of urine.
  • Pelvic organ prolapse in which pelvic organs such as the rectum, bladder or uterus shifts out of their normal place. When this happens the bladder and urethra do not function normally which may cause urine to leak out.
  • Weak bladder muscles.

Signs of a Urinary Tracy Infection (UTI): 

  • In some older people, mental status changes and confusion may be the only sign of a UTI. Some people may feel tired, shaky, muscle aches and abdominal or pelvic pain.
  • Other symptoms include:
  • Cloudy, bloody or foul-smelling urine
  • Pain or burning during urination
  • Strong, frequent need to urinate even right after emptying the bladder
  • A mild fever or fever 100 to 101 degrees
  • Nausea and /or vomiting

If a UTI spreads to the kidneys, symptoms are much worse and may include: 

  • Fever and shaking chills
  • Night sweats
  • Feeling ill or tired
  • Pain in lower back, side or groins
  • Mental status changes / confusion
  • Abdominal pain and cramping in some people.
  • Nausea/vomiting.

However, some people may have bacteria in their bladder or somewhere along the urinary tract and may not feel any symptoms unless a urine test show bacteria present in the urine. 

There are a number of tests that can give you and your healthcare provider an insight into your bladder health. The test your provider performs depends primarily on the problem you are having, but some common tests that may be performed include:

  • Urinalysis: A urinalysis is one of the most basic and common tests to diagnose bladder problems. A urine sample is collected and tested in a laboratory. This test can detect abnormal substances or an infection.
  • Urine culture: Also collected from a urine sample, a urine culture will commonly be used to diagnose a bladder or urinary tract infection. The sample is monitored in the lab for growth and identification of bacterial or fungal organisms. The culture indicates the type of bacteria present, allowing the healthcare provider to tailor the antibiotics used to the specific type of bacteria that is present.
  • Ultrasound/bladder scan: This non-invasive test uses sound waves to show a picture of what is going on inside the bladder. A bladder scan is another type of ultrasound and may be used to estimate the amount of urine that is present in your bladder.
  • Cystoscopy: This is a procedure that is done to take an internal look at the bladder. A small catheter with a light, camera, and other tools is inserted into the bladder through the urethra. The healthcare provider is able to see the inside of the bladder and take tissue samples, if needed.
  • Imaging studies: Imaging studies provide a detailed view of the bladder and other organs in the pelvis. Techniques might include injecting iodine-based contrast material and performing an X-ray (intravenous pyelography) or a CT scan.

Treating Bladder Problems:

 Treatment for bladder problems may include behavioral or lifestyle changes, exercises, medications, surgery or a combination of treatments.

Antibiotics are the usual treatment for UTIs. The type of antibiotics and the length of treatment depends on the person’s history and type of bacteria causing the infection.  Drinking lots of fluids and urinating often may also help. It is recommended that adults drink about eight 8oz glasses of water per day.

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