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How To Deal With Bladder Function and Dysfunction Post-Stroke

One favorite aspect of being an Occupational Therapist is that I am able to learn so much from the people I get to work with. I can take what I have learned educationally and combine it with people’s practical experiences and help even more people. Today I want to pass along information to you about bladder function and dysfunction. This topic is not typically at the forefront of daily conversation or even regularly talked about with primary care providers but my patients have taught me that it is very important to be addressed. It is my hope that you can pick up at least one piece of information that can make a positive difference for you or for someone in your life.

Bladder dysfunction is not a guaranteed problem that comes along with a certain number of birthdays nor is it guaranteed to be a lifelong part of you because you have had a stroke. When explored in more detail, there are usually many factors that have contributed to urinary incontinence, frequency or getting up to use the toilet in the middle of the night. Addressing these factors may just be the key to stopping your symptoms and avoiding one more medication. Many people I have worked with, have found that they don’t need to be controlled by their too talkative and not so reliable bladder. In no particular order, let’s look at some of the more common areas that contribute to a chatty bladder (you know, the one that is always telling you that absolutely nothing is more important than getting to the toilet right now) and some factors that can affect your functions following a stroke.


Hydration

What are you drinking every day? Unless your primary care provider has instructed you otherwise, it is common to have a goal of 48-64 ounces of non-caffeinated and non-alcoholic fluids each day.


Caffeine and alcohol can be considered diuretics and bladder irritants. They help to keep your bladder talking and in control. Other fluids such as citrus juices can also be irritating to your bladder.


Water is a great choice. It is hydrating, gives our bodies some of what it needs and keeps our urine from getting too concentrated, which can also make our bladder too talkative.


Constipation

Your bladder and rectum are in close quarters in your pelvis. When our bowels are not moving regularly the rectum may take up more space than usual and put pressure onto the bladder. The added pressure can make your bladder believe it needs to be emptied more often than it does. It can also put more stress on the muscles that make up the pelvic floor. If these muscles aren’t working their best already, constipation can add too much stress and prevent them from keeping you dry. Drinking water and eating foods with fiber help keep our bowels moving. Find out what works best for you to stay regular.


"Just In Case" Toileting

This bad habit was started for many of us when we were kids. Our parents would have us go to the bathroom “just in case” before we left the house so that they didn’t have to stop to find a bathroom for us once we were riding in the car. I have found many adults who use this logic as a way to keep from having accidents.


The problem with this thinking is that it does not allow our bladders to work as they are designed to work. Bladders are meant to stay quiet until they reach an imaginary fill line. Once this line is reached the bladder to brain conversation begins. By going to the bathroom “just in case” over and over, we are lowering the conversation starting line and not allowing the bladder to work at its best.


Medications

When was the last time you have looked at the side effects of your medications? People with high blood pressure may be taking a medication that acts as a diuretic. Talk with your pharmacist or primary care provider about how your medications affect your bladder or bowel function.


Timing

It is everything when it comes to getting onto the toilet in time to stay dry. My recommendation is to plan ahead. If you take longer to get into the bathroom these days then pay attention to the signals. If it has been awhile since you last went to the bathroom and your bladder is talking, don’t put if off. Figure out how long it takes you to get there and manage your clothes. Give yourself the right amount of time to avoid an accident. Consider wearing pants that are easier to manage.

There is so much more that I could share with you but we are out of time. I encourage you to ask questions and find a rehab provider (Occupational or Physical Therapist specializing in Pelvic Floor Rehabilitation) to help you further.


Thank you for reading, have a wonderful day.

Bonnie Pond, OT

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