Overactive bladder causes a frequent and sudden urge to urinate that is difficult to control. The person will have the feeling of the need to pass urine many times during the day and night, and at times, unintentional loss of urine (urgency incontinence). Rather than being a disease, it causes embarrassment, isolation, and limitation to work and social life. The good news is that a brief evaluation can determine whether there’s a specific cause for the overactive bladder symptoms. In most cases, symptoms of an overactive bladder can be managed with simple behavioural strategies, such as dietary changes, timed voiding and bladder-holding techniques using pelvic floor muscles. Signs & symptoms
Causes The exact cause of an overactive bladder is mostly unknown. But several conditions may contribute to signs and symptoms of overactive bladder, including:
Other risk factors include:
Pathophysiology Three main factors have been proposed regarding the cause of overactive bladder: myogenic (related with muscles), neurogenic (related with nerves) and urotheliogenic (related to the lining of urinary organs). Disturbance of any of the three factors or a combination of these factors can attribute to an overactive bladder. Normally, as the urinary bladder fills, nerve signals sent to the brain eventually trigger the need to urinate. When urinated, these nerve signals coordinate the relaxation of the pelvic floor muscles and the muscles of the urethra (urinary sphincter muscles). The muscles of the bladder tighten (contract), pushing the urine out. When this process and the contraction mechanism becomes completely deranged, involuntary bladder contractions occur leading to an overactive bladder. It happens when the muscles of the bladder start to contract involuntarily even if the volume of urine in the bladder is low. Such involuntary contractions create an urgency to urinate. Metabolic derangement, bladder outlet obstruction and inflammation can increase the excitability of the nerve, the detrusor muscle and alter the sensory and barrier functions of the urothelium. The detection of proteins in the urine such as NGF, PGE2, and proinflammatory chemokines leads to the pathophysiology of overactive bladder and offer novel diagnostic biomarkers of overactive bladder. Diagnosis
Measuring urine left in the bladder (post-void residual urine) Measuring urine flow rate.
Treatments A combination of treatment strategies may be the best approach to relieve overactive bladder symptoms. Behavioural therapies Behavioural interventions are the first choice in helping manage an overactive bladder. They’re often effective, and they carry no side effects. Behavioural interventions may include:
Medications After menopause – vaginal oestrogen therapy Medications that relax the bladder include:
Nerve stimulation therapy like Sacral nerve stimulation, Percutaneous tibial nerve stimulation etc.Surgical procedures include:
Prognosis The overall prognosis for overactive bladder is good in young patients. Many medicines and non-invasive therapies are available and surgery can be done as a last resort. Yet, overactive bladder along with other co-morbidities in old age people show a bad prognosis. Complications
Disease & Ayurveda Diseases of the urinary system are elaborated in detail in Ayurveda classics. All of them are classified broadly into two. The first set of diseases are those where urine content is low & the flow is obstructed(mootraghata) and the second set comprises diseases in which the urine output is high & the flow is uncontrollable (Prameha). Overactive comes under the term prameha which broadly enumerates the diseases of uncontrolled, increased & turbid urination (prabhoota&aavila mootrata). 20 types of Prameha are described. Overactive bladder with clear urine can be compared with udakameha. Nidana
Purvaaroopa
Samprapti Due to the causative factors, the vitiated doshas, mainly kapha vitiate the whole body (especially kleda, sweda, medas, rasa and aamisham) and starts the disease. In turn the kapha is lessened and Pitta-Rakta get aggressive. Thus, Paittikaprameha develops which in turn leads to Vaatikaprameha when chronic. Lakshana
Accham(clear), Bahu (more in quantity), Sitam (whitish discolouration), urine output Seetam (cold in touch), Nirgandham (without any smell), Udakopama(watery) Divisions Not mentioned for udakameha Prognosis Saadhya Chikithsa Ayurveda treatment of Prameha for a strong patient starts with Sodhana therapies for cleaning the body by expelling the accumulated toxic waste materials. It should be done after oleation with kledahara snehadravyas like Sarshapataila, arishtataila nikumbhataila akshataila or karanjataila. Once the doshas are expelled out and the body is clean, the patient should be given strengthening preparations like meat soup. Samana Aamapachanam Agnideepanam Haridra+dhatreerasa + honey in empty stomach in the morning Sodhana Vamanam Virechanam Kashayavasti Commonly used medicines Gandharvahstaadi kashayam Sukumaram kashayam Katakakhadiradi kashayam Nisakatakadi kashayam Ayaskriti Mehari choornam Brands available AVS Kottakal AVP Coimbatore SNA oushadhasala Keraleeya Ayurveda samajam Vaidyaratnam oushadhasala Home remedies
Diet
Sweet food items and artificial sweetners Heavy meals and difficult to digest foods – cause indigestion. Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine Carbonated drinks – makes the stomach more acidic and disturbed digestion Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire) Milk and milk products – increase kapha, obstruct channels and obesity Curd – causes vidaaha and thereby many other diseases
Light meals and easily digestible foods Green gram, soups, ragi, raw jackfruit, etc. Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc Behaviour: Protect yourself from extreme climate changes. Better to avoid exposure to excessive sunlight wind rain or dust. Maintain a regular food and sleep schedule. Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc. Avoid a sedentary lifestyle. Yoga Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended. Regular exercise helps improve the bioavailability of the medicine and food ingested and leads to positive health. Yoga can maintain harmony within the body and with the surrounding system. Pavanamuktasana Nadisudhi pranayama Bhujangasana Simple exercises for lungs and heart health All the exercises and physical exertions must be decided and done under the supervision of a medical expert only. Research articles https://pubmed.ncbi.nlm.nih.gov/26676700/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476015/ *These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake. Ayurveda Supplement with GMP Certification from India. Writer: Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage. Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India. Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him- Whatsapp – +91 9446918019, +91 8075810816 URLs: https://www.ayurvedaforall.com/ To give you a quick idea about Ayurvedaforall, we are a group of ayurvedic practitioners committed to propagating Ayurveda in its best tradition around the world. Our online store sells authentic ayurvedic formulations backed by professional advice. Now into the seventeenth year of operation, the site has helped us build a dedicated clientele which regularly uses our products and services as well as refers others to us. Needless to say, this has been achieved through our adherence to the highest standards of customer service and professional ethics. Author information
Licensed Ayurvedic doctor focused on providing individual Ayurvedic consultation services. Specialized in work related stress, Womens’ issues, diabetes, Pecos, arthritis, male and female sexual problems and infertility. Interested in academic work as well. Now working with www.ayurvedaforall.com as senior consultant, Ayurveda.
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