Did you know your bowel health can impact the level of control you have over your bladder? If you experience symptoms of Overactive Bladder (OAB) such as urinary urgency, frequency and/or urinary incontinence (leaks), you may find that you also experience bowel problems such as constipation or Irritable Bowel Syndrome (IBS).
Let’s take a further look in to these bowel-bladder connections!
What is constipation?
Constipation is when bowel movements become less frequent. This is usually due to the stool (i.e. faeces) being dryer and/or harder than normal, making it a lot more uncomfortable and difficult to pass.
Constipation typically arises when stool stays in the colon (large intestine) for longer than what is normal for you. The body absorbs water from stool, so it will naturally become drier the longer it remains in the colon. It can also dry out if it moves through the colon at a slow pace. As you can imagine, if stool stays in the colon for too long, more stool will form and create a build-up if it’s not being passed in the toilet – unfortunately this can make symptoms of constipation even worse.
How can constipation impact bladder control?
Studies have found that constipation can contribute to symptoms of OAB, such as urinary urgency, frequency and incontinence1. The link between constipation and OAB symptoms is not fully understood, however one possible reason is the physical pressure being placed on the bladder by the bowels. As stool builds up in the colon, the colon becomes bulkier than usual and can start to put physical pressure on the bladder, which is located close by. The urethra, the tube that allows urine to flow out of the bladder, can also become tighter due to this pressure from the colon, making it more difficult to hold onto urine. When pressure is applied to the bladder, this can create sensations of needing to urgently pass urine, frequency and in some cases, episodes of urge incontinence.
When experiencing constipation, you may find yourself straining in an attempt to pass a stool, which can also weaken the pelvic floor muscles2 and subsequently worsen OAB symptoms as the pelvic floor supports the bladder too.
Is it common to have both IBS and OAB?
If you have IBS, you might also find that you experience bladder health issues. IBS is a group of symptoms, with the most common being abdominal pain, bloating, diarrhoea, constipation and changes in bowel habits. Just like OAB, IBS can have a very negative impact on quality of life and many women can experience both conditions at the same time - so you are not alone!
Research suggests that women with a diagnosis of IBS maybe more likely to experience OAB symptoms than those without IBS3. A study carried out by Matsumoto et al. in 2013, found that 34.8% of women with IBS, also had OAB4. Another study by Zingone et al. in 2017, found that people with IBS were at higher risk of experiencing urinary urgency andfrequency5.
Similarly to the constipation-OAB association, it isn’t yet understood how OAB symptoms are impacted by IBS. It may be due to pelvic muscle and/or nervous system interactions as the bowel and bladder are located so close together.
In summary
Whether you are experiencing bladder issues or bowel problems, or a combination of both, it is always important to speak to your healthcare provider. If you feel embarrassed about your symptoms, just remember that OAB alone affects approximately 1 in 7 women worldwide, so it is an extremely common condition that you deserve to get help for!
To improve your overall bladder health and reduce the impact of bladder issues on your life, the BladderBoss app is here to help! BladderBoss is an 8-week digital program that you can complete in the comfort of your own home via a mobile app. The program is backed by science and developed by experts in urogynecology, psychology, physical therapy and dietetics. You can find instructions on how to download BladderBoss on our website, or simply search for “BladderBoss” in the Apple App Store or Google Play Store.
References:
1. Coyne KS, Cash B, Kopp Z, et al. The prevalenceof chronic constipation and faecal incontinence among men and women withsymptoms of overactive bladder: PREVALENCE OF CHRONIC CONSTIPATION IN OAB. BJUInternational. 2011;107(2):254-261. doi:10.1111/j.1464-410X.2010.09446.x
2. Bharucha AE, Lacy BE. Mechanisms, Evaluation, and Management of Chronic Constipation. Gastroenterology.2020;158(5):1232-1249.e3. doi:10.1053/j.gastro.2019.12.034
3. Coyne KS, Kaplan SA, Chapple CR, et al. Risk factors and comorbid conditions associated with lower urinary tract symptoms: EpiLUTS. BJU International. 2009;103(s3):24-32. doi:10.1111/j.1464-410X.2009.08438.x
4. Matsumoto S, Hashizume K, Wada N, et al. Relationship between overactive bladder and irritable bowel syndrome: a large-scale internet survey in Japan using the overactive bladder symptoms core and Rome III criteria. BJU International. 2013;111(4):647-652.doi:10.1111/j.1464-410X.2012.11591.x
5. Zingone F, Iovino P,Santonicola A, Gallotta S, Ciacci C. High risk of lower urinary tract symptoms in patients with irritable bowel syndrome. Tech Coloproctol.2017;21(6):433-438. doi:10.1007/s10151-017-1653-5
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