What is considered normal?

The average bladder can hold about 2 cups of urine before it needs to be emptied. It is normal to pass urine 5 to 7 times during a 24-hour period. As we get older, our bladder capacity can get smaller and we may need to pass urine more frequently. It is normal for an older adult to pass urine up to 8 times a day and to rise one time per night to void. Urine should flow easily without discomfort in a good, steady stream until the bladder is empty. No pushing or straining to empty your bladder should be necessary.

An urge is a signal that you feel as the bladder stretches to fill with urine. Urges can be felt even if the bladder is not full. Urges are not commands to go to the toilet, merely reminders and may be controlled.

What are good bladder habits?

Practice good toilet habits. Don’t let your bladder control your life.

• Take your time when emptying your bladder. Don’t strain or push to empty your bladder. Make sure you empty your bladder completely each time you pass urine. Do not rush the process.
• Ignoring the urge for more than 4-5 hours between daytime voids may be convenient, but not healthy for your bladder.
• Avoid going to the toilet “just in case” or more often than every 2 hours. It is usually not necessary to go when you feel the first urge. Try to go only when your bladder is full. Urgency and frequency of urination can be improved by retraining the bladder and spacing your fluid intake throughout the day.

Tips to maintain good bladder habits.

• Maintain a good fluid intake and diet. Try to drink 4-8 glasses of fluid per day (6 cups or more) unless otherwise advised by your doctor.
• Limit the amount of caffeine (coffee, cola, chocolate or tea) and citrus foods that you consume as these foods can be associated with increased sensation of urinary urgency and frequency. Refer to How Diet May Affect Your Bladder handout.
• Limit the amount of alcohol you drink as it increases urine production and also makes it difficult for the brain to coordinate bladder control.
• Avoid constipation and ask for tips on how to care for the problem if it does affect you.

Instructions for Controlling Urinary Urge

When you experience an urge to urinate:

FirstStop and stand very still. Sit down if you can or stand quietly. Do not move; try to stay very still to maintain control.SecondQuickly squeeze and let go of your pelvic floor muscles 5 to 6 times to keep from leaking. Use moderate to maximal effort for the exercise. This sends a message to the bladder to relax and hold urine. Try to distract yourself by thinking of something other than going to the bathroom.ThirdRelax. Take a deep belly or diaphragmatic breath and let it out slowly. Try to make the urge to urinate go away by continuing with distraction techniques and positive thoughtsFinallyIf the urge returns, repeat the above steps to regain control. When you feel the urge subside somewhat, walk normally to the bathroom. Do not rush. Continue to do your quick flicks to relax the bladder. You can urinate once the urge has subsided.

Acidic Foods and Drinks

Coffee, Caffeine, Tea, Chocolate, Alcoholic beverages, Apple Juice, Vinegar, Plums, Peaches, Guava, Apples, Pineapple, Cantaloupe, Chilies/Spicy Foods, Strawberries, Tomatoes, Lemon Juice, Grapes, Cranberries, Honey, Carbonated drinks**including Sprite and Coke, Citrus Fruits/Juices, Nutra-Sweet, and Onions.

Other Dietary Changes

• Eat a high fiber diet
• Stop smoking
• Avoid alcohol, caffeine, carbonated drinks and acidic foods
• Drink plenty of water

Approved Substitutions

• Coffee with acid removed – Kava and Rombauts are two brands found in grocery stores.
• Herbal teas – provided they do not contain large amounts of citrus.
• Weak tea – Dunk a tea bag in water four times quickly to color the water.
• Ovaltine instead of chocolate drinks.
• Fruit juices – apricot nectar, pear nectar and papaya juice.
• Late harvest dessert wines – low acid content.
• Fructose, as found in Superose instead of NutraSweet or Saccharine
• Carob for chocolate in a recipe.
• Orange or lime peel shavings for flavor – DO NOT use white part of rind.
• Pine nuts in place of other types of nuts.
• Breads made with potato flour, soya flour or rice flour