From the Guidelines
If you have an overactive bladder, it is crucial to avoid substances and behaviors that can irritate the bladder lining, increase urine production, or put physical pressure on the bladder, such as caffeine, alcohol, and carbonated drinks, as recommended by the most recent guidelines 1. To manage overactive bladder effectively, consider the following:
- Avoiding or reducing caffeine intake, as it can exacerbate symptoms 1
- Limiting alcohol consumption, as it can act as a bladder irritant
- Avoiding carbonated drinks, artificial sweeteners, spicy foods, citrus fruits, tomatoes, and excessive fluid intake, especially before bedtime
- Certain medications like diuretics, muscle relaxants, and some antidepressants can worsen symptoms and should be discussed with your doctor
- Limiting bladder irritants such as tobacco products and maintaining a healthy weight, as excess weight puts pressure on your bladder
- Avoiding constipation by consuming adequate fiber, as straining can aggravate bladder symptoms
- Avoiding tight clothing around the waist and abdomen, as it can put pressure on your bladder These recommendations are based on the principle that behavioral therapies, including fluid management and dietary modifications, offer patients with overactive bladder some efficacy, excellent safety, and few if any adverse effects, as stated in the 2024 AUA/SUFU guideline on the diagnosis and treatment of idiopathic overactive bladder 1. Managing your fluid intake by drinking small amounts throughout the day rather than large quantities at once can help regulate bladder function while maintaining proper hydration, which is a key aspect of behavioral therapies for overactive bladder, as supported by the guideline 1.
From the Research
Lifestyle Modifications to Avoid with Overactive Bladder
- Reducing caffeine intake is statistically effective for urgency symptoms, but increasing fluid intake is not 2
- Decreasing caffeine and fluid intake is effective in treating frequency symptoms 2
- Restricting caffeine intake is effective in treating urinary incontinence episodes and nocturia, but restricting both caffeine and fluid intake is not 2
Medications to Consider
- Mirabegron, a beta-3 agonist, has been shown to be effective in reducing mean number of micturitions and incontinence episodes per 24 hours, as well as improving other secondary outcomes such as OAB symptoms and quality-of-life measures 3, 4, 5
- Antimuscarinics are efficacious, safe, and well-tolerated treatments that improve health-related quality of life, but may have anticholinergic side effects such as dry mouth and constipation 6
Potential Side Effects to Avoid
- Anticholinergic adverse events, including dry mouth and constipation, are more frequent with antimuscarinics versus mirabegron 5, 6
- Common adverse drug events seen with mirabegron include hypertension, nasopharyngitis, urinary tract infections, headache, constipation, upper respiratory tract infection, arthralgia, diarrhea, tachycardia, abdominal pain, and fatigue 3