By Katherine Kam
The thought of traveling to an exotic destination might sound enticing, but not when you know you'll be taking your overactive bladder along with you. Just the thought of frantically searching for a bathroom in an unfamiliar city can fill you with dread. When the urge to urinate strikes suddenly -- or frequently -- sometimes it’s better to just stay at home.
Too often, overactive bladder causes people to drop activities they once enjoyed and become isolated, says Nancy Muller, executive director of the National Association for Continence in Charleston, S.C. Yet with proper management and trip preparations, you can travel with less fear of toileting accidents. "Control your bladder. Don’t let your bladder control you," she says.
Recommended Related to Urinary Incontinence/OAB
Urinary incontinence, the involuntary loss of urine, affects an estimated 25 million Americans, mostly women. For most, incontinence is the result of problems controlling the bladder. For people with a type called functional incontinence, however, the problem lies in getting to and using the toilet when the need arises.
If you’re planning to travel with overactive bladder, here are some tips to help make your trip more successful.
If possible, try training your bladder several weeks before you travel. Bladder training encompasses multiple techniques, but here are a few useful ones:
This means urinating on a set schedule, "by the clock, rather than by what your bladder tells you," says Tomas L. Griebling, MD, MPH, professor and vice chair of the department of urology at the University of Kansas and a faculty associate in the Landon Center of Aging.
Use a restroom whenever you have the chance, whether or not your bladder feels full, Muller says.
Kegels or pelvic floor exercises
Strengthening your pelvic muscles with Kegel exercises can help prevent urine leakage. "They work in both men and women," Griebling says.
You can do Kegel exercises while sitting at your desk, in your car, or in front of the TV. To do Kegels, tightly squeeze the muscles you use to start and stop urine flow for about 3 seconds, then relax them for 3 seconds. Try to do three sets of 10 Kegels per day.
Freeze and squeeze
"One of the symptoms of overactive bladder is that sudden sensation that you have to urinate very quickly. The natural tendency is for people to get up and rush to the toilet," Griebling says. During such an episode, the bladder may be contracting involuntarily, causing urine to leak.
Instead of rushing, try a "freeze and squeeze" technique, Griebling says. "They should stop and focus on what they’re feeling in their bladder and do two or three pelvic floor contractions. Often, they will have less urgency. It will help them to have more time to get to the toilet."
To help control urinary urgency, doctors can prescribe anticholinergic drugs such as oxybutynin (Ditropan, Ditropan XL), solifenacin (Vesicare), and tolterodine (Detrol, Detrol LA), which Griebling describes as "bladder relaxant medications."
"All of them can work quite well, but they can have side effects, mostly dry mouth and constipation. In some older people, they can cause visual problems or confusion," he says. And like all medications they can interact with other medications you take so be sure to let your doctor know all your medications.
If you haven't used these drugs before and want to try them, Griebling suggests that you start taking them a few weeks before your trip. “That’s so that they’ll know how they respond to them, rather than traveling and being in a new place and taking a new medication and having problems or side effects,” he says.
It also takes about two weeks for bladder relaxants to become most effective, says Amy Rosenman, MD, a urogynecologist in Santa Monica, Calif., and a clinical assistant professor at the David Geffen School of Medicine at UCLA.
Bladder relaxants don’t cure overactive bladder, but they can relieve the symptoms, according to Griebling.
Remember to pack your medications in your carry-on luggage. Also bring along a copy of your prescription, Griebling says. "That way, if you run out, it’s easier to get things refilled."
Rosenman also suggests bringing along a stool softener in case your bladder relaxant causes constipation.
Bring adequate supplies
Bring enough absorbent pads in case you can’t find them at your destination, Muller says. Also tuck clean underwear into a purse or day pack so that you’ll always have a pair on hand. It’s also a good idea to include a small plastic bag to carry soiled clothing or discarded pads, she says.
"I also recommend taking a barrier cream," Rosenman says. "If you get damp, it’s good to waterproof that area so that it doesn’t get irritated and inflamed." Use it each time after you urinate, she says.
Choose food and drink wisely
Certain foods and drinks can irritate the bladder and cause more urination. During travel, limit or avoid coffee and other caffeinated drinks, alcohol, carbonated beverages, artificial sweeteners, and spicy or acidic foods if experience has shown that these things worsen your symptoms. "Know what your own bladder irritants are," Muller says.
On airplanes, be especially careful not to overdo the coffee, tea, alcohol, and soft drinks. Also try to book an aisle seat near a lavatory, Muller says.
Some people skimp on drinking water during travel to cut down on bathroom trips, but this strategy can backfire, Muller says. "That causes the urine to be more concentrated, and more highly concentrated urine is itself an irritant to the lining of the bladder and can trigger spasms." Instead, drink enough water to prevent dehydration.
Finding public restrooms
Plan ahead to locate public restrooms. For example, the National Association for Continence web site has a tool called "Find a Bathroom." Or visit the web site sitorsquat.com to find public bathrooms around the world.
For car trips, go online to find freeway exit guides that list rest areas with bathrooms. There are also some free mobile apps that can help you locate restrooms wherever you happen to be traveling.