不要让膀胱过度活动症扰乱你的生活
Written By Jennifer Larson，CNN Health
是否感觉你又要去上厕所了--？你这种情况叫膀胱过度活动症（OAB）。即使你的膀胱并没有充满，过度活动的膀胱仍然导致你突然尿急和经常需要解小便。一些人不能控制膀胱，尿液不自主流出，导致一些窘迫的事情。
你可能会听天由命，或把这归于老龄化所致。但这不是老龄化的该有的症状，你可以做点什么，来解决尿急，尿频。你可以治疗和学习管理膀胱过度活动症，以减少它对你生活的影响。学会管理膀胱过度活动症，区别在于，你是一直待在家里，还是重新回归社会活动。
一． 学会在生活中管理，控制膀胱过度活动症。
第一步是去看大夫，是否诊断为膀胱过度活动症，然后和膀胱过度活动症的专家一起协作，找到适合你的正确治疗膀胱过度活动症的方法。这些治疗措施包括，药物；训练；日常生活方式的改变；和其他办法。
你的大夫可能会建议你使用抗胆碱能药物，它通过阻断一种化学物质传导信号至膀胱，这种信号促使膀胱收缩，和排出尿液。这一类药物包括托特罗定，奥昔布宁，托罗珠胺，达非那新，索利那新，弗斯特罗定。还有一类新药，β-3肾上腺素能激动剂也有治疗效果。这类药物包括米拉贝隆，维贝格龙，他们可以松弛膀胱肌肉，增加膀胱容量。如这些药物仍然没有效果，肉毒碱，膀胱壁注射，也有很好的效果。如果第一步治疗无效果，不要犹豫，可考虑其他治疗。这些药物维持效果需要一定时间，你需要规律服用以达到最好效果。
二． 学习一些锻炼方法。
就像运动对你的身体有好处一样，一定的运动对控制膀胱过度活动症有好处。凯格尔运动可以加强盆底肌肉力量，这些盆底肌肉维持膀胱功能。你收缩盆底肌肉，来抑制排尿或中断排尿，保持5分钟，再放松。重复上述过程10次。每天可多做几组上述运动。当你训练盆底肌肉时，同时也在训练膀胱功能。这种运动可自己做。通过凯格尔运动，你可以学会延迟排尿，特别是你有尿意时延迟几分钟排尿。你可以收缩盆底肌肉抑制排尿。刚开始抑制排尿较困难，但是你先延时几分钟，逐渐延长，那么，最后你就可以减少排尿次数了。让你的大夫指导你的盆底肌肉物理治疗，如在你的训练过程中用生物反馈训练。
三． 观察你吃的食物。
不管你相信与否，你的饮食对你的排尿次数影响很大。你喜爱的辛辣的食物可以刺激你的膀胱，引起尿频。含枸橼酸的水果和碳酸饮料也同样可刺激膀胱，导致尿频。如果这些食物及饮料使你很难控制你的尿急，尿频，那么你可能会避免或减少摄入这些膳食。包括以下:
1.辛辣食物
2.含枸橼酸水果（橙子，橘子，柠檬，菠萝，凤梨，酸橙，西柚，橙汁，橘子汁，及这些水果汁）
3.含碳酸饮料
4.含酒精饮料
5.含咖啡因饮料，如咖啡和茶叶
6.糖及人工甜味剂，糖精
7.巧克力
8.蜂蜜
9.番茄及番茄酱等制品。
10.膳食纤维摄入，防止便秘，便秘可加重尿急，尿频
11.保持健康体重，过重增加盆底肌肉压力，使尿频，尿急加重。
这也许还有更多食物可以刺激膀胱，导致突然尿急，尿频。保持记日记，如果你认为某些食物导致尿急，尿频，那么你可以避免吃，或少吃一点。对可疑的食物，也要小心，避免吃尤其是吃了以后你不确定能否找到厕所，（很多膀胱过度活动症的人出门时都准备了一份厕所地图，避免尿裤子等尴尬事件）。
四． 生物反馈训练
盆底肌肉锻炼可帮助你应付膀胱过度活动症。生物反馈训练可以提供信息让你知道，你的盆底肌肉是怎么帮助你控尿的，以及如何有效的控尿。和盆底治疗大夫一起协作，电极传感器贴在你的腹部和肛门或阴道附件位置的皮肤上。当你做盆底肌肉收缩及放松时，传感器可以感知这些电信号。同时你可以立即得到视觉或听觉反馈，来让你知道你是否锻炼的正确。那么，你就可以规划出怎么正确的收缩，放松，使盆底肌肉训练效果更好。
五． 做好准备
即使你注意了你的饮食，做了凯格尔运动，服用了治疗膀胱过度活动症的药物，这都不妨碍你做好准备，以防万一尿裤子。这里有一些提示可能能帮到你。
1. 计划好你上厕所的时间及次数，这样你就逐渐习惯了定时排尿，而不是总是在排尿。做好一份出行时厕所地图。
2. 外出时，带尿不湿，避免窘迫事件。
3. 考虑并确定一天喝多少水合适，减少饮水量时确定减少多少，是否对身体有害。
最后，需要时刻关注膀胱过度活动症的网上群体关怀的信息，获取一些新的药物及已经在实验的治疗方法。
Written By Jennifer Larson，CNN Health
Feel like you need to make a mad dash for the bathroom… again? You may have a condition known as overactive bladder (OAB). Overactive bladder causes a sudden and frequent urge to urinate, even if you don’t have a full bladder. Some people also have trouble maintaining control over their bladders, which can lead to embarrassing accidents.
You might feel resigned and chalk it up to aging, but it’s not just a normal part of aging, and you can do something about it. You can treat and learn to manage overactive bladder in order to minimize the disruptions to your life. Embracing a few overactive bladder tips may mean the difference between staying home and getting back out into the world.
The first step to managing overactive bladder is seeing a doctor, getting a diagnosis, and then working with your OAB specialist to find the right treatment path for you. That may entail a combination of strategies including medication, exercises, dietary changes, and other approaches.
Your doctor might suggest trying an anticholinergic medication, which can block a chemical that sends signals to your bladder to make it contract and release urine. This category of meds includes tolterodine (Detrol), oxybutynin (Ditropan, Oxytrol, or Gelnique), trospium (Sanctura), darifenacin (Enablex), solifenacin (Vesicare), and fesoterodine (Toviaz). Newer drugs called beta-3 adrenergic agonists can be helpful, too. These medications, including mirabegron (Myrbetriq) and vibegron (Gemtesa), relax the muscles of the bladder and increase bladder capacity. If those don’t work, there are other meds available and even botulinum toxin (Botox) injections for your bladder, which can help you maintain better control. If your first treatment doesn’t work, don’t be afraid to try something else. It’s also helpful to know that medications can take some time to work effectively, and you need to take them regularly to get the most benefit.
Just like exercise does your body good, certain kinds of exercise may help your bladder, too. The first is the Kegel exercise. Kegels are pelvic floor exercises that strengthen the muscles that support your bladder. You squeeze the muscles that you use to start or stop urinating and hold the squeeze for about five seconds, then release. Repeat until you have performed 10 contractions. Then you can build up to several sets of 10 per day.
While you’re strengthening your pelvic floor, you can also train your bladder. This type of exercise entails training yourself, actually. You’re learning to delay urinating when you first feel the urge to go. You do have to be able to contract your pelvic floor muscles to hold it in. It may be hard at first, but if you start with small delays, you can build up until you’re able to go several hours between trips to the toilet. Ask your doctor to direct you to a pelvic floor physical therapist, who can guide you through the process.
Believe it or not, your diet can make a big difference in how often you need to pee. Here’s why: your favorite spicy dishes can irritate your bladder and send it into action. So can citrus fruit and carbonated beverages. You might want to cut back or even possibly avoid those items if they make it a lot harder to control your bladder.
Other foods and beverages that might irritate your bladder include:
· Alcoholic beverages
· Caffeinated drinks, like coffee and tea
· Sugar and artificial sweeteners, including saccharin
· Chocolate
· Honey
· Tomatoes and tomato-based products.
There may even be more foods that provoke the sudden urge to go. Keep a diary, and as you identify them, you can make a note to avoid them or eat them only in moderation. You might also be conscious of avoiding foods that you know will irritate your bladder when you’re not sure you’ll be in easy reach of a bathroom.
Certain behavioral interventions can also be effective at helping you cope with overactive bladder. Biofeedback provides information about how your body works to help you learn how to make effective changes. Working with a pelvic floor therapist or doctor, electrical sensors are attached to your abdomen and near the anus or vagina. The sensors detect electrical signals coming from your pelvic floor muscles as you contract and flex those muscles. As you exercise those muscles, you’ll get immediate visual or auditory feedback to help you understand if you’re moving them correctly. Then you can figure out how and when to regulate your movements to make them more effective.
Even if you watch what you eat, practice your Kegel exercises, and take a medication to help you control your overactive bladder, it never hurts to be prepared, just in case. Here are a few tips that might help you:
· Schedule your toilet trips so your body will become accustomed to voiding at certain times–not all the time
· Wear absorbent pads to protect your clothing in the event of an accident
· Consider how much fluid you’re drinking and determine if there might be any benefit to cutting back
One more tip: try searching online for support groups for people with OAB. You might be able to learn some other road-tested strategies for managing overactive bladder from others who have the same condition.
