LBL Support

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What is LBL?
You’re sitting there, laughing and enjoying a nice luncheon with your gal pals when suddenly you feel some wetness down below. “Oh no!” you think to yourself, but stop right there, because you are not alone. In fact, 1 in 3 women will experience Light Bladder Leakage (LBL) at some point in their lives – and it happens to us of all different types and ages, and for many different reasons. It’s nothing to be embarrassed or ashamed of, and chances are your gal pals have already experienced LBL too! So what is LBL, and why does it happen? Let’s start by understanding some basics… Light Bladder Leakage, or LBL as it’s most commonly referred to is when your body can’t control your bladder resulting in loss of urine and leakage. It can be a few drops or even a light stream that leaks out.

Types of LBL:
The two most common types of bladder leakage are stress incontinence and urge incontinence, and some women can actually have a combination of both of these types. Stress incontinence happens when you experience a loss of urine from any activity that may put pressure on your bladder like sneezing, laughing, coughing, running or jumping. This is caused by pelvic floor muscles supporting your bladder beginning to weaken. A number of factors can contribute to the weakening of these muscles including pregnancy (or previous childbirths), smoking, obesity and chronic UTIs. But, even without these risk factors, stress incontinence can still occur.
Urge incontinence (sometimes called “overactive bladder”) occurs when you experience a frequent sudden need to urinate causing your bladder to have contractions and loss of small to moderate amounts of urine. Certain contributing factors including caffeine, alcohol, excessive hydration and even medications can increase the occurrence of urge incontinence.

What Causes it?
By the time we reach age 50, as many as over 60% of women will have dealt with some type of “uh-oh bladder moment”!  LBL affects twice as many women as men mostly due to factors that increase the likelihood of it such as pregnancy, childbirth and menopause. LBL is not a disease, but rather a symptom that can be managed and treated. It can be caused by everyday activities and habits, physical situations or medical conditions. Your doctor can properly diagnose and evaluate your situation to help you determine what’s behind your LBL. There are certain foods and medications that can act as diuretics which can further stimulate your bladder increasing your chance for leakage. These include: - Alcohol - Caffeine - Carbonated beverages - Artificial sweeteners - Chocolate - Spicy foods - Citrus fruits and tomatoes - Corn syrup - Heart and blood pressure medications, sedatives, and muscle relaxants

Certain treatable medical conditions may also be causing your LBL such as urinary tract infections or even constipation.

If you find that you have a very persistent leakage condition there may be underlying physical problems or changes, including:
Age – after menopause women produce less estrogen which is a hormone that keeps the bladder lining healthy, and this can cause increased LBL.

Childbirth – vaginal deliveries can weaken the muscles which support your bladder as well as damage bladder nerves and tissues. Without the support, your bladder can get pushed down from its normal position and can result in leakage.

Pregnancy – where changes in hormones as well as increased weight of the fetus and yourself can put stress on the bladder.

Hysterectomy – any surgery that removes the uterus can damage the pelvic floor muscles that support the bladder and increase the chance for LBL.

Obstruction – a more series medical condition such as a tumor may be blocking your urinary tract affecting the flow of urine and leading to LBL. Urine stones that form in the bladder can also contribute to LBL.

Neurological Disorders – certain medical conditions that interfere with nerve signals involved in bladder control can cause LBL including: multiple sclerosis, Parkinson’s disease, a stroke, tumor or spinal injury.

When Does it Happen?
Since all our bodies are different and a wide range of contributing factors can affect the likelihood of LBL, women can experience it at almost any age in life. The fear of an LBL accident can affect women not only physiologically, but also socially and emotionally too! It stops so many women from participating in normal, everyday activities, even ones they loved doing like meeting up with friends, family parties, exercising and other outdoor activities. Although certain factors can contribute to the likelihood of LBL, it’s important to evaluate your own health factors and habits to learn how to stay ahead and manage your unique situation. Don’t let LBL stop you from doing the things you love!

Do I Need to See a Doctor?
There may be some uncomfortableness discussing LBL and incontinence with others, including your doctor. But, like we pointed out, it is such a common situation women deal with at all times of their life. It’s not about being ashamed, but understanding why it’s happening and how to manage it.

If you feel your LBL is too frequent or deeply affecting your quality of life, it is important to seek proper medical advice as there may be other factors that are contributing to the leakage including possible more series health conditions.

Managing LBL:
So, you have started to have little leaks, but just because you are dealing with LBL doesn’t mean it has to ruin your life. It’s important to understand so many women have bladder leakage at some point and it’s about not letting little leaks stop you from the things you love.

It is always first best to seek the advice of a medical professional to discuss possible symptoms or other medical conditions causing your LBL. Just know that it is very common, and there are a lot of resources and tips available for how best to manage it.

Strengthen with Kegels: You can actually train your bladder to be under better control with some simple Kegel exercises. By regularly tightening certain pelvic floor muscles you can help strengthen them and help your body become more leak-proof. Kegels does require practice and you may want to talk to your doctor or physical therapist to ensure you are doing them properly.

- To find the right muscles, clench your pelvic muscles as if you are trying to stop the flow of urine

- Now squeeze and tighten these muscles for 3 seconds and then relax for 3 seconds. Do not flex the muscles in your abdomen, thighs or buttocks and avoid holding your breath. You should be breathing freely the entire time.

- Repeat this exercise for 10-15 times during a set and try to do 3 sets a day

- By continuing Kegel exercises regularly, you can expect less frequent urine leakage usually within a few weeks to a few months. In order to see continued benefits, be sure to make Kegel exercises part of your daily routine.

Other Exercises & Tips to Help:
Pilates: By engaging in some light Pilates exercises, you can help strengthen certain pelvic floor muscles that can help control bladder leaks. You will also help strengthen your core abdominal muscles at the same time! Hey, who wouldn’t want some nicer looking abs?! Certain strenuous exercises like aerobics and running may cause too much stress on your pelvic muscles also. Switching some of these strenuous exercises with Pilates may be the right change your body needs. Weight Loss: You can also help your body fight bladder leaks by losing excess weight. Being overweight puts pressure of fatty tissue on your pelvic floor muscles, which weakens it and can lead to leaks. By losing excess body weight, you can therefore improve this pressure and may see your LBL clear up completely. Plus, your heart will thank you too ;) Quit Smoking: Did you know that you are at an increased risk for experiencing stress incontinence (among many other health issues) if you currently smoke or have smoked in the past? The chronic coughing from smoking damages the muscles of the pelvic floor and can lead to bladder leaks. If you are currently smoking, it is recommended to stop now and reduce your risk for further pelvic muscle damage. Avoid Heavy Lifting: Besides putting your back muscles at risk, lifting heavy objects also puts strain on your pelvic floor muscles. If you do have to lift anything like children or even shopping bags, try to remember to tighten your pelvic floor muscles before and during the lift to minimize damage. Or better yet, have someone else help you lift. Re-Train Your Bladder: You can actually work to re-train your bladder and diminish leakage. Your ultimate goal is to increase the amount of time between emptying your bladder and also the amount of fluid your bladder can actually hold. You need to develop a schedule and then gradually increase your time increments between urination. For more tips and ways to begin bladder training, visit this Bladder Training Guide from the University of California San Francisco.

Your Diet & Healthy Bladder:
There is no known “diet” that will cure incontinence, but there are steps in your diet you can take to make sure you are not making symptoms worse. It’s important to eat healthy not only for our bladder but for our entire well-being. When we feel better, we certainly live better! There are certain foods in our diet that can bring on LBL, as well as ones that can help lessen our chances of dealing with it.

AVOID:
- Caffeine can increase bladder activity including higher urgency and frequency of urination which can result in LBL. Try avoiding it altogether or switch to decaffeinated/herbal versions of coffee, tea and sodas. You may need to limit caffeine slowly so that you do not incur headaches or withdrawal symptoms.

- Alcohol is a diuretic which in turn makes your bladder work overtime. If you can’t eliminate alcohol completely from your diet, try scaling back to less drinks to help improve your chances of LBL.

- Carbonated Drinks have carbon dioxide which can irritate the bladder. Try to avoid all fizzy beverages including sparkling water, seltzer water and club soda. Switch to plain ol’ H2O!

- Spicy Foods and Acidic Foods can irritate the lining in the bladder and makes leaks worse so try and limit those in your diet as much as possible.
Tomato products are common acidic foods and can include: pasta, pizza sauce, ketchup and salsa.
Also, cranberry juice has been said to help treat bladder infections, however, it is too acidic and should be on the list of foods to avoid for many women dealing with LBL.
Acidic Citrus Fruits like oranges, limes, lemons and grapefruits should be limited as much as possible. Try other fruits like apples and bananas to get your daily servings of fruit in.

- Artificial Sweeteners have been shown in certain studies to have a negative affect bladder function. It’s best to avoid these anyway!

- Chocolate contains some caffeine so it’s important to limit as much as possible. You can try white chocolate, which usually free of caffeine, or dark chocolate, which normally has a lesser amount of caffeine.

- Processed Foods have a lot of artificial ingredients, as well as many flavors and preservatives which can be irritating your bladder. Processed foods contain a lot of artificial ingredients, such as flavoring and preservatives, which can irritate your bladder and worsen OAB symptoms. A healthy, balanced diet should include natural and fresh foods, such as vegetables and whole grains. This is especially true for people who have OAB.

EAT MORE OF THESE:
Fiber can help prevent constipation, a common cause of LBL, so incorporating more fibrous foods such as legumes, whole grains, certain fruits and vegetables like apples, prunes, peas and corn.

Alkaline Foods can help cleanse the urinary system and help those who experience leaks. Some high alkaline foods include:
Vegetables: Artichokes, Eggplant, Beets, Kale, Lettuce, Asparagus, Onions, Parsnips, Squash
Fruits: Apples, Pineapple, Watermelon, Cantaloupe, Papaya, Avocado
Protein: Pumpkin Seeds, Chestnuts
Spices: Sea Salt, Ginger Root, Cinnamon, Cilantro, Parsley

Water – funny as it may seem, drinking more and keeping your muscles hydrated can help you leak less! It also helps keep your bladder at the capacity it needs to. It is recommended to drink 6-8 glasses of water a day (unless your doctor says otherwise). Just make sure to not drink too much before bedtime and always empty your bladder before going to bed.

Helpful Resources:
If you would like more information on dealing with LBL, check out some of these resources and articles below:

ORGANIZATIONS / WEBSITES:
National Association for Continence
Sign up for their Monthly Newsletter here
Connect with others on their Message Boards
Simon Foundation for Continence
AboutIncontinence.org
Urinary Incontinence - National Institutes of Health

ARTICLES:
“Let’s Talk About Bladders” by Dr. Bavendam  Program Director, Women's Urologic Health, National Institute of Diabetes and Digestive and Kidney Diseases
Bladder Training Guide: University of California San Francisco
“Incontinence Medically Reviewed” by Melissa Kaufman, MD, PhD Associate Professor Vanderbilt Department of Urologic Surgery
“13 Tips to Keep Your Bladder Healthy” National Institute of Aging

BLOGS:
BHealth Blog on Incontinence

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