Overactive Bladder – What is overactive bladder ?


Overactive Bladder – What is overactive bladder ? Written by Victoria Watson 

Did you know the muscle around your bladder, can have a mind of its own! A very strong, very sudden urge that is not related to how full your bladder is, is your bladder muscle getting far too excited! This is called overactive bladder or OAB, it is very debilitating and very bothersome. Please don’t suffer in silence, there are multiple things you can do to help.

What is OAB? Overactive Bladder is characterised by a sudden desperate urge to empty the bladder. Normally, as the bladder fills up, the receptors on the lining of the bladder stretch. This stretch lets us know how full the bladder is – do we need to go now, or can we wait for 15 minutes? In the case of OAB, the urge is sudden, very strong and generally unrelated to the fullness of the bladder. In some cases, this urge results in urinary leakage. This can also be called Urge Incontinence.

Who does OAB affect? OAB affects both men and women, and whilst not a normal part of aging, the incidence does increase with age.

What can you do to treat OAB?  There are various factors which can exacerbate symptoms of OAB. In a lot of cases, managing these factors is a very effective way of treating the issue.

Fluid intake – This is a topic on which there is no real evidence. Where did the 2 litre a day guideline come from? There is no research to back this up. Most specialists advise to drink to thirst. If appropriate, a 25% reduction in fluid intake is usually enough to improve symptoms. However, many people are required to have a certain intake to manage other medical conditions. You will need to get advice by a health professional regarding this.

Fluid spacing – The bladder prefers to be filled slowly. Large volumes of fluid at one time will activate a stronger stretch and a stronger sudden urge to void.

Bowel Management – Fixing constipation will improve 50% of OAB cases. Rectal distention makes the bladder sensations stronger at smaller volumes.

Avoiding bladder irritants – The main irritants of the bladder are:

  • Caffeine – including tea, coca-cola, chocolate etc
  • Artificial sweeteners (found in many foods, not just in sachets or diet drinks)
  • Carbonated drinks
  • Smoking


There are many techniques which can be used to suppress a bladder urge. Attempting to reduce the anxiety of getting to the toilet on time can have a significant affect on reducing the sensation of urgency. Sometimes just knowing that the urge will pass in a few seconds is enough to allow people to wait for the bladder to relax, rather than rushing to find a toilet.

Perineal pressure –  Using your hand, heel, arm of a chair or corner of a desk to compress the perineum can inhibit the neural pathway involved in the bladder spasm.

Pelvic floor contraction – This can also inhibit the contraction of the bladder.

Toe curling, calf raising or calf stretching can influence the nerve pathway to the bladder.

Distraction techniques and relaxed breathing allow the brain to shift its focus off the bladder which then in turn can decrease the intensity of the spasm. Try counting backwards in 7’s from 431.

How do I know where to start?  There are many other interventions used to treat and manage the symptoms of Overactive Bladder. It is important to know that this condition is not something that needs to be suffered in silence. An appointment with a Women’s Health Physiotherapist or your GP can help you get the right advice.