Urinary incontinence is under-reported and underdiagnosed.  According to the American Academy of Family Physicians, the direct cost of treating urinary incontinence was $26.3 billion in 1995 for people of all ages.  Involuntary leakage of urine can be caused by many factors, so it is important to review all facts with your family physician.  Along with a physical exam, your doctor may ask these simple-screening questions:

• Do you have an uncontrollable need to urinate?
• Have you not made it to the bathroom in time?
• Do you need to awaken two or more times during the night to go to the bathroom?
• Is it the urge to empty your bladder that wakes you?
• How long have you experienced these symptoms?
• Do you have accidental leakage during activities, such as, lifting heavy items or exercising?
• Do you have accidental leakage when coughing or sneezing?

Two common types of incontinence are stress incontinence (release during an activity that causes bladder pressure like laughing or lifting or coughing) and urge incontinence (leakage before getting to the bathroom, or waking up in the middle of the night).  The symptoms can be embarrassing and even limit your lifestyle.  While accidental urine leaks are common, they should not be considered normal, despite your age or sex. 

What are the treatment options?  They are, surgery, focused exercises, use of special devices such as pads, etc., medications, or diet change. 

What can I do?  Keep a daily bladder diary, including how many and what liquids that you consume, frequency of urination, amount of urine released, uncontrolled release, and the activities that proceed them.

Symptoms can worsen based on what we eat and drink.  For instance, you may want to decrease consumption of drinks and foods that aggravate bladder incontinence, like alcohol.  Caffeinated drinks (coffee, tea, colas) are diuretics and may cause more frequent urination.  Artificial sweeteners or sugar substitutes may aggravate symptoms in some patients.  Spicy and acidic meals can cause bladder irritation, as can citrus juices and tomato-based products.

Drinking less water may decrease your urination, but that causes the urine to be too concentrated, dark yellow, and strong smelling, which is also irritating to the bladder.  Maintain good bowel health, because constipation places pressure on the bladder.  Stay physically active.  Modifying your diet may help you manage your symptoms.