Articles on urinary bladder disorders

Diet for Painful Bladder Syndrome

Dr. Anish Kumar Gupta, Andrologist
Painful Bladder Syndrome (PBS) is a chronic health condition that causes pain and pressure in the bladder and pelvic area. It can cause an urgent need to urinate, a frequent need to urinate, or both. Although PBS cannot be cured, it can be treated. Researchers have found there are dietary changes you can make to help manage and avoid flare-ups. Below are just a few examples of foods/beverages that are friendly for such patients and those that are not: FruitsFriendly - Bananas, melons, pears, apples   Avoid - Lemons, limes, oranges, strawberries, pineapple, kiwi fruitVegetablesFriendly - Cucumber, green beans, bell peppers, beans Avoid - Chili peppers, onions, tomato products, picklesMilk/Dairy Friendly - Cheeses, eggs, milk, sherbet / squash (no citrus or chocolate flavors)Avoid - Chocolate ice cream, processed cheeses, soya products, yogurt (lemon, lime, orange or chocolate)BeveragesFriendly - Water, pear juice, milk, tea (peppermint), vanilla milkshakeAvoid - Alcohol, chocolate milkshake, coffee, cranberry juice, soda, tea (regular, green, herbal, iced) tomato juice, sports drinksICN Food ListIf you need help selecting bladder-friendly foods, there's an app for that.  The ICN Food List, available for Android and iPhone, provides a reference guide you can use while shopping and eating out.  The app contains a database with foods divided into three categories: bladder-friendly foods, foods worth trying cautiously and foods to avoid.Happy eating, and have a healthy bladder!

Bladder Cancer - Risk Factors, Symptoms, Diagnosis

Dr. Anish Kumar Gupta, Andrologist
Risk FactorsLike most cancers, we do not know all the causes of bladder cancer, but there are certain factors which increase the chances of getting bladder cancer.Cigarette, “bidi”and tobacco chewing increases your risk of bladder cancer. In fact, more than half of all bladder cancer cases in India are caused by nicotine. Bladder Cancer develops in smokers 2 to 3 times more than in non-smokers.Long-term exposure to chemicals used to make plastics, paints, textiles, leather and rubber may also cause bladder cancer. Chemicals may cause about 23 out of every 100 bladder cancer cases.Symptoms of Bladder CancerBlood in the urine This is the most Common symptom of bladder cancer, and is generally painless. Not all Blood in urine means bladder cancer. Other commoner reasons are, urinary tract infection or kidney stones. Microscopic amounts of blood might even be normal in some people.Frequent Urination and Pain on Urination (dysuria)Frequent or painful urination is less common. If you have these symptoms, and do not have a urinary tract infection, you should talk to your Urologist to find out if bladder cancer is the cause.DiagnosisThe management of Bladder Tumor falls under the domain of Urology.There is no single test to check for bladder cancer. If you have symptoms of bladder cancer, your doctor may perform 1 or more of the following - History, Examination:This forms the primary part of any consultation with a physician.Urinalysis:  For this test you will have to give a urine sample. You may also be asked to perform urine cytology. Imaging Tests:The urologist may request an Ultrasound scan. A more detailed examination is normally done with a CT Urogram (CT scan focused on the urinary tract). Cystoscopy: For the examination of the inside of the bladder and also to take a biopsy if so required. In most cases you might be asked to take anaesthesia.If tumors are present, the doctor notes their appearance, number, location and size.If initial examination is done under local anesthesia or for only diagnostic purposes, you may be offered a formal Trans Urethral Resection of Bladder Tumor (TURBT). TURBT is done under regional / general anaesthesia and requires hospital stay.Treatment procedures will be covered in subsequent posts.Stop Nicotine Usage, to Prevent Bladder Cancer

"Shy Bladder" - Are You Afraid of Public Toilets ?

Dr. Anish Kumar Gupta, Andrologist
Do you have a “shy bladder”?A lot of Indian men and women have "Shy Bladder," also known as paruresis, the fear of using restrooms when others are near.Men still relive themselves without much thought, but women still exercise a lot of restraint in doing that and at times end up harming themselves.When using a western toilet, women tend to just stay a bit above the seat, which we call hovering. If you do that, you should think twice. This manoeuvre put stress on your pelvic muscles and makes it harder to fully empty your bladder. It's better to use a tissue paper / newspapers over the seat when you have to use the bathroom.Remember to stand up before flushing the toilet. The mist from the flushing toilet can spray germs.When in a public bathroom, be sure to hang your purses and bags on the door hooks. This keeps them off the floors, which is usually the dirtiest spots in bathrooms.Always wash your hands with soap and hot water for at least 30 seconds. If nothing is available cleaning with an alcohol based hand sanitiser will help.Studies have shown paper towels are more hygienic than hand dryers.But the most important thing is that when you have to go, you must go!! There is no dirtier thing for the urine than your bladder...Retaining urine in bladder for unduly long periods leads to genesis of dysfunctional voiding and over active bladder in later ages.So beware, take caution, but empty your bladder when you have the urge!

Ten Preventive Tips for Urinary Tract Infection

Dr. Prashant C Dheerendra, Nephrologist
The urinary tract is comprised of the two kidneys, two ureters, bladder and urethra. An urinary tract infection ('UTI') can involve the bladder ('cystitis') or the kidneys ('pyelonephritis'). Pyelonephritis is a more serious infection than cystitis but thankfully it is less common. Women of reproductive age group are the most susceptible to UTI but no age or gender is immune. The symptoms include frequent urination, burning sensation while passing urine, lower abdominal or pelvic pain in cystitis. High temperature with chills, vomiting and pain over the abdominal flanks are present in pyelonephritis. Some simple steps can help prevent UTIs. 1. Proper toilet hygieneA 'front to back' method of cleaning up after passing stools will avoid the bacteria from rectum getting access to the bladder. It would be prudent not to use a toilet paper twice. 2. Get screened during pregnancyHarmful bacteria may be present in the urinary tract without causing any symptoms during pregnancy. It is a routine practice to screen for bacteria in urine in early pregnancy. A course of antibiotics prescribed by your obstetrician should generally eradicate the bacteria. This will help in preventing more serious infections later in the pregnancy. 3. Prefer sanitary napkins over tampons Tampons might be more friendly towards the infection causing bacteria than sanitary napkins. If one has to use tampons, then remove them before urinating. 4. Don't suppress the urge to urinateThe longer urine lies stagnant in the bladder, the better it is for bacterial growth. On the other hand passing urine every few minutes is impractical. A golden rule is to not suppress the urge to pass urine. Urinating once every 2-3 hours during day should be a reasonable frequency. 5. After sexual intercourseSexual intercourse has the potential to provide the bacteria access to the urinary system. Voiding immediately after intercourse helps 'flush out' the germs that might have gained access. 6. Reconsider contraceptionSome contraceptive methods like diaphragms and spermicidal jellies increase the likelihood of contracting a UTI. Discuss the pros and cons with your doctor if you are using one of these. 7. Use loose garmentsA dry vaginal area is a deterrent to bacterial growth. Tight fitting clothes, undergarments made of non-breathable fabrics promote bacterial growth by increasing moisture in the area. Avoid them ! 8. If post menopausal consider need for estrogen cream Post menopausal status might predispose to bladder infections because of changes in the vaginal skin. Consult your doctor if estrogen creams might benefit you. 9. Cranberry juice is probably helpful Cranberry juice contains chemicals called proanthocyanidins which decrease the stickiness of bacteria to the bladder wall. While not conclusively proven, cranberry juice probably helps prevent UTI in young women. 10. Control blood sugars if you are diabeticDiabetics are one of the groups worst affected by UTIs. The infections can be severe and sometimes life threatening in this particular group. Uncontrolled blood sugar levels over long periods increase the risk of such infections. Meticulous attention to good blood sugar control should decrease the risk significantly. In-spite of above measures sometimes one may get a UTI occasionally. Recognise the symptoms and see your doctor immediately. You will probably need  a short course of antibiotics followed by a reinforcement of the preventive measures!

Urinary Incontinence - What You Need to know...

Dr. Abhinav Agarwal, Urologist
Urinary incontinence is a health condition in men and women, which causes loss of bladder control. Urinary incontinence usually occurs in cases of medical conditions such as an enlarged prostate, urinary tract infection, Parkinson's disease and diabetes, and may also occur after a prostate surgery. Urinary incontinence is an irritating and embarrassing condition, but with proper treatment, it can be cured.Here are several methods used to treat urinary incontinence:Caffeine, soda, and carbonated drinks cause irritation in the bladder and worsen the symptoms of urinary incontinence. Alcohol is a diuretic and increases the amount of urine too. So abstain from coffee, alcohol, and soft drinks to make a difference.Dietary adjustments are required for the treatment of urinary incontinence. Several spicy and acidic food items can make urinary incontinence worse. Hence, you should avoid having such foods for some time.Urinary incontinence can lead to stress and you must get rid of it for better health. You can try relaxation techniques, such as meditation and breathing exercises. Biofeedback is another option by which you can observe your bladder muscle contractions on a monitor.You should try a behavioral technique known as bladder training. This would require you to urinate every half hour, in spite of not having the urge. Slowly try to increase the time in between the bathroom breaks.You need to flex your muscles to gain control over urinary incontinence. Kegel exercises can be practiced as this boost the strength of your pelvic muscles. You should find the right muscles that are required to stop the passing of gas.Pads and disposable undergarments can be used by men. These help in preventing leaks and also protect the skin from irritation and odor.There are several medicines, which help in the treatment of urinary incontinence. Some of these work to relax muscles for preventing unwanted bladder contractions, while others help in blocking the nerve signals to the bladder. Drugs used for the shrinking of an enlarged prostate may also be used in some cases.Surgery is the ultimate option for the treatment of urinary incontinence. Options include a sling for urinary incontinence. A type of material is wrapped around the urethra for compressing it. Leaks because of coughing, sneezing or laughing are prevented. Artificial sphincter implants may also be used for the treatment of urinary incontinence. A cuff is used in order to close the urethra. Urine is released by squeezing the pump to open the cuff. A device similar to a pacemaker is used to stimulate nerves, which help in relaxing the bladder and pelvic floor.Urinary incontinence is a condition which causes reduced self-confidence. But there are several ways to treat this condition which include home remedies as well as medications and surgery.URINARY INCONTINENCE- TAKING CONTROL OF THE PROBLEM">URINARY INCONTINENCE- TAKING CONTROL OF THE PROBLEM

Role of Physiotherapy in Women’s Health

Dr. Richa Patil, Physiotherapist
​Women today are more competent and independent as compared to those of the previous era. They have redefined gender roles, claimed more authority and freedom for themselves and proved their potential to the fullest. However, in the process of fighting for equality and carving a niche for themselves, it’s usually their health that gets neglected. Here are a few benefits of physiotherapy for some of the top health issues faced by women. Women by nature are caregivers and there are numerous occasions when they tend to neglect their health in order to help a loved one. This neglect can cause a number of health complications as they grow older. Preventive healthcare is much better than taking medications after being diagnosed with a health condition. There are a number of therapy options available like Allopathy, Ayurveda and others. Physiotherapy is one such branch of medicine that can help you prevent a number of health issues when followed diligently.A simple assessment and structured exercise program by a physiotherapist is often sufficient to prevent these health issues in women across the life span, from the young athlete to the child bearing woman to the menopausal to the elderly.Women’s Health Physiotherapy refers to the non-surgical therapeutic treatment specific to various health problems affecting women. During the course of therapy, specially designed exercises and equipment are used to help patients restore their normal physical activities.Here are a few benefits of physiotherapy for some of the top health issues faced by women.Premenstrual syndrome: A physiotherapist assesses the physical effect PMS has on your body as well as the risk factors that can influence and worsen them, before offering a range of management options and advice. Treatment may include manual therapy to relieve tension as well as related discomfort such as headaches and constipation, relaxation point stimulation, kinesiotaping or electrotherapy. An important part of the treatment is teaching relaxation techniques and advice on self-management and self-care.Endometriosis: Physical therapy modalities may prove to be a fundamental treatment option for the patient with endometriosis, pre and post laparoscopic surgery, especially if they experience musculoskeletal impairments. Effective physical therapy treatment options include: myofascial manual therapy, pelvic floor muscle lengthening, trigger point release, stretching and flexibility exercises, spinal mobilizations, nerve glides, relaxation exercises and behavioral modifications.Polycystic ovary syndrome: Physiotherapists can provide a customized exercise program which would help in losing the weight gained due to the storage of estrogen in adipose tissue, lower insulin levels, and dietary changes to reduce consumption of carbohydrates.Heart diseases: Physical therapy can help to prevent the onset of heart disease, and reduce the negative consequences of heart disease by implementing a treatment program that addresses all the contributing factors of this disease. This may include advice on smoking cessation, an exercise program for weight management and improving cholesterol levels. There are cardiac rehabilitation programs for patients who have had a heart attack or severe heart disease.Osteoporosis: Post-menopausal women are at greater risk of developing osteoporosis. Physical therapy can help to prevent further bone loss and reduce the risk of bone fractures. Strengthening exercises for your bones is of high importance in maintaining the health of osteoporotic bones. Exercise programs also include weight bearing exercises, flexibility exercises, postural and balance exercises.Obesity: Physiotherapy has a role to play in the prevention and management of obesity.Obesity leads to restrictions in movement, affecting engagement in physical activity. Exercise and movement is the keystone of the scope of physiotherapy practice. A treatment plan for an obese patient may comprise of a provision of personalized lifestyle advice, prescription, supervision, and progression of appropriate physical activity to increase muscle strength, flexibility, and endurance, to sustain energy output to enhance and maintain weight loss under safe and controlled conditions.Depression: Exercise has been known to benefit patients with mild to moderate mood disorders, especially anxiety and depression. When performing aerobic exercises your body releases endorphins which are responsible for relieving pain and improving mood. These endorphins can also lower cortisol levels known to be elevated in patients with depression. Additionally, exercise increases the sensitivity of serotonin in the same way antidepressants work, allowing for more serotonin to remain in the nerve synapse. Exercise can be aerobic or resistive in nature, as both are known to be beneficial in a variety of patient types.Urinary Incontinence - Urinary incontinence, also referred to as overactive bladder, is the inability to control the flow of urine. Leakage of urine occurs due to weakness of the pelvic floor muscles as a result of injury, pregnancy, surgery or lack of exercise. Physiotherapy session includes: Diet modifications to avoid bladder irritation, Pelvic floor exercises to strengthen your pelvic floor, Methods to reduce the urinary urgency and frequency.Pregnancy related conditions - Pain in the lower back, pelvic region, rib and thoracic region, headache, neck pain and stiffness, muscle weakness of the pelvic floor, leg cramps, weakened abdominal muscles and bladder, pain or numbness in the wrist and hand, all can also be treated with physical therapy.At times, the only thing you need is the right assessment to prevent the onset of any kind of health issues.Your assessment and treatment often depend on your present condition. Whilst these sensitive issues are often difficult to discuss, understanding the onset of your symptoms and how your daily life is affected is vital in directing your treatment.

Do You Leak Urine on Laughing / Coughing ?

Dr. Anish Kumar Gupta, Andrologist
What is the definition of Stress Urinary Incontinence (SUI) ?Stress incontinence happens when physical activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder. It is not related to psychological stress.In what Situations can SUI Occur ?• Cough• Laugh• Sneeze• Standing up• Get out of a car• Lifting something heavy• Exercise, especially abdominal exercises• Sexual activityOne may not experience incontinence every time, but any pressure-increasing activity can make one more vulnerable to urine leak, particularly when the bladder is full.Factors that increase the risk of developing stress incontinence include:•Age. Although SUI isn't a normal part of ageing, physical changes such as the weakening of muscles, may make one more susceptible to stress incontinence. However, occasional stress incontinence can occur in women of any age.•Type of childbirth delivery. Multiple vaginal deliveries and Forceps assisted deliveries are associated with higher rates of the later development of stress incontinence.•Body weight. People who are overweight or obese have a much higher risk of stress incontinence. Excess weight increases pressure on the abdominal and pelvic organs. Weight loss can improve stress urinary incontinence.•Previous pelvic surgery. Hysterectomy in women and particularly surgery for prostate cancer in men can alter the function and support of the bladder and urethra, making it much more likely for a person to develop stress incontinence. This effect can be either immediate or delayed.Complications of stress incontinence may include:•Personal distress.•Skin rash or irritation.TreatmentYour Urologist may recommend a combination of treatment strategies to end or lessen the number of incontinence episodes. If an underlying cause or contributing factor, such as a urinary tract infection, is identified, you'll also receive treatment for the condition.Behaviour therapiesBehaviour therapies may help you eliminate or lessen episodes of stress incontinence. The treatments your doctor recommends may include:• Pelvic floor muscle exercises. Kegel exercises strengthen your pelvic floor muscles and urinary sphincter. Your doctor or a physical therapist can help you learn how to do them correctly. Just like any other exercise routine, how well Kegel exercises work for you depends on whether you perform them regularly.• Fluid consumption. Your doctor might recommend the amount and timing of fluids you consume during the day. Your doctor also may request that you avoid caffeine (tea / coffee / cold drinks) and alcoholic beverages to learn how these dietary irritants affect your bladder function. If using fluid schedules and avoiding dietary irritants significantly improves leakage, you'll have to decide whether changing your fluid consumption pattern or giving up coffee or alcohol is worth the improvement in leakage.• Healthy lifestyle changes. Quitting smoking, losing excess weight or treating a chronic cough will lessen your risk of stress incontinence as well as improve your symptoms.• Scheduled toilet trips. Your Urologist might recommend a schedule for toileting (bladder retraining) if you have mixed incontinence. More frequent voiding of the bladder may reduce the number or severity of urge incontinence episodes.Devices and Surgeries are the options, which your surgeon may suggest to you.Lifestyle and home remediesHealthy lifestyle practices can ease symptoms of stress incontinence. These include:• Shed extra weight. Moderate weight loss may markedly improve your stress incontinence especially if BMI > 25 to start with• Add fiber to your diet. If chronic constipation contributes to your urinary incontinence, keeping bowel movements soft and regular reduces the strain placed on your pelvic floor muscles. Try eating high-fiber foods — whole grains, fruits and vegetables — to relieve and prevent constipation.• Avoid foods and beverages that can irritate your bladder. If you have mixed incontinence and you know that drinking coffee or tea tends to make you urinate and leak more frequently, try eliminating that drink, especially on days you really don't want to be bothered by leakage.• Don't smoke. Smoking can lead to a severe chronic cough, which can aggravate the symptoms of stress incontinence. Smoking is also associated with a drop in your oxygen-carrying capacity, a factor thought to increase the risk of an overactive bladder. And smoking is associated with bladder cancer.

Bipolar Disorder- What Is It? (Symptoms)

Dr. Milan Balakrishnan, Psychiatrist
What Is Bipolar Disorder?Bipolar disorder, also commonly known as manic depression, is a brain disorder that causes shifts in a person’s mood, energy, and ability to function. The symptoms of bipolar disorder can result in damaged relationships, difficulty in working or going to school, and even suicide. There are generally periods of normal mood as well, but left untreated, people with bipolar disorder continue to experience these shifts in mood. The good news is that bipolar disorder can be treated, and people with this illness can lead full and productive lives.What Are the Symptoms of Bipolar Disorder?Bipolar disorder can cause dramatic mood swings—from high and feeling on top of the world, or uncomfortably irritable and excited, to sad and hopeless, often with periods of normal moods in between. The periods of highs and lows are called episodes of mania and depression.MANIC PHASE• Feeling on top of the world. A sensation of sheer and utter happiness that nothing—not even bad news or a horrifying event or tragedy can change.• Sudden or extreme irritability or rage. While mania is often portrayed as a pleasurable experience, that is not thecase for many people with bipolar disorder.• Grandiose delusions. Individuals believe that they have special connections with God, celebrities, or political leaders.• Invincibility or unrealistic beliefs in one’s abilities. The person feels that nothing can prevent him or her from accomplishing any task.• Hyperactivity. Scheduling more events in a day than can be accomplished; inability to relax or sit still.• Excessively risky behavior. Reckless driving, outlandish spending sprees, foolish business investments, or out-of character sexual behavior.• Uncontrollable racing thoughts/rapid speech. Ideas that abruptly change from topic to topic expressed in loud, rapid speech that becomes increasingly incoherent.• Less need for sleep.DEPRESSED PHASE• Intense sadness or despair. The person feels helpless, hopeless, and worthless.• No interest in activities they once enjoyed.• Loss of energy, fatigue.• Sleep difficulties. Either sleeping too much or not at all.• Changes in appetite. Either a noticeable increase in appetite or a substantial weight loss unrelated to dieting.• Difficulty concentrating, remembering, making decisions.• Thoughts of death or suicide.PS. 30th of March is World Bipolar Day. Birthday of Vincent Van Gogh who committed suicide due to the disorder. Follow #WBD2016 #Mumbai on Twitter.

Childhood Urinary Tract Infection

Dr. Anish Kumar Gupta, Andrologist
By the time a child is 5 years old, about 8 percent of girls and 1 - 2 percent of boys have had a urinary tract infection (UTI). Bacteria are not normally found in urine. UTIs are more common in girls than boys. Infections are more common in the urethra and bladder, which make up the lower part of the urinary tract. Infections that move up to the kidneys can be more serious. If left untreated, these infections have a risk of leading to kidney failure.Signs and SymptomsSigns of UTI may be difficult to assess in young not toilet trained children.Pain, or burning when urinatingFrequent urination or feeling an increased urge to urinate, even without producing urineFoul-smelling urine that may look cloudy or contain bloodFeverLow back pain or pain in the area of the bladderDiagnosis and TreatmentA sample of urine will be taken for examination. Older children will most often be asked to urinate in a sterile container. Babies and small children in diapers may need a catheter (tube) to collect urine. The catheter keeps the sample from being contaminated by bacteria on the skin. The type of bacteria found may help decide the best drug to treat the UTI, usually antibiotics. It is important to give your child all the antibiotic course, even if he or she is feeling better. Most UTIs will be cured within a week if treated properly. The child should be urged to drink plenty of fluids. If a child has more than one UTI or has fever along with symptoms of UTI, he or she should see a Urologist. A Urologist will see if anything is abnormal in the child’s urinary tract. A common problem causing UTIs in children is a backwards flow of urine,  condition known as VUR.PreventionFrequent diaper changes can help prevent UTIs in babies and small children.When children start toilet training, it is important to teach them good bathroom habits. After each bowel movement, children should wipe from front to rear — not rear to front. When feeling the urge to urinate, children should also avoid “holding it” if they can reach a bathroom. Urine remaining in the bladder gives bacteria a good place to grow.If in doubt, consult a pediatrician or a urologist immediately.