What Is Nocturia?
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WHAT IS NOCTURIA
Do you find yourself needing to pee multiple times per night? You may have a condition called nocturia. 1 in 3 adults over the age of 30 make at least two trips to the bathroom every night. And while the majority of those who are dealing with nocturia are usually over the age of 60, it can happen at any age.
If you are experiencing this problem, it is best to address it now as the occurrences of bathroom trips increase with age. Researchers have identified two major causes of nocturia:
- Nocturnal Polyuria – This occurs when there is an overproduction of urine at night. According to the International Continence Society, this type of nocturia is defined by a nighttime urine volume that is greater than 20-30% of the total 24 hour urine volume.
- Global Polyuria – A major cause of nocturia that consists of both day and nighttime urine overproduction.
A VIDEO INTRODUCTION TO NOCTURIA
Do you get up multiple times at night to go to the bathroom? That could be a real medical condition called Nocturia – click above to learn more about it.
Frequent nighttime urination isn’t something that you just have to live with. There are real, effective treatments available – click above to learn more.
CAUSES OF NOCTURIA
Due to obvious anatomical differences, men and women experience nocturia for different reasons. Women generally experience nocturia as a consequence of childbirth, menopause, and/or pelvic organ prolapse. In men, nocturia can be directly attributed to benign prostatic hyperplasia (BPH), also known as enlarged prostate.
Additional factors that can contribute to nocturia in both sexes include:
- Behavioral patterns – This is something you have conditioned your body to do as a routine
- Diuretic medications
- Overactive bladder treatment
- Excessive fluids before bedtime
- Diminished nocturnal bladder capacity – Urine production exceeds the bladder capacity causing the individual to be awakened in order to void.
- Fluid redistribution
POSSIBLE UNDERLYING CONDITIONS OF NOCTURIA
Nocturia, as described above, can be a result of excess fluids before bedtime, medications, alcohol, caffeine, reduced bladder capacity, or diuretic medications. Yet, while nocturia can occur because of these factors, sometimes it is a symptom of a greater problem.
Certain conditions can alter the way in which your body functions causing urine to be passed in the evening and during sleep. Such conditions include:
- Diabetes mellitus
- Diabetes insipidus
- High blood pressure
- Heart disease
- Congestive heart failure
- Vascular disease
- Restless leg syndrome
- Sleep disorders
WHAT ARE THE SYMPTOMS OF IBD?
The symptoms of IBD, as well as the severity of the symptoms, can vary for everyone.
Common symptoms of IBD include diarrhea or loose stools, blood in the stool, weight loss, fatigue, fever, abdominal pain (which can sometimes be severe), and even malnutrition. In addition, some people can develop IBD-associated arthritis, which can cause pain or discomfort in the joints and lower back pain.
Symptoms of IBD may go away for months, or sometimes even years at a time before reoccurring.
The pain felt with IBD can be different for everyone. Some people may feel pain in different areas of their abdomen, some may feel back pain, and others may even feel pain in their joints.
Patients with IBD often experience emotional symptoms, in addition to physical symptoms. Anxiety about when they may have an attack, worries about their appearance, and general frustration and depression around their inability to enjoy everyday activities can affect people with IBD. Learn more about the emotional challenges people with IBD face in this video.
NOCTURIA TREATMENT OPTIONS
- A physical examination
- Urinalysis and urine culture – These are different tests that determine the contents of the urine.
- Mattress Covers – A variety of products exist to protect the bed including vinyl, waterproof, and absorbing mattress covers, or even sheet protectors, which can make cleanup easier.
- Absorbent Briefs – These products are a form of modified underwear designed to absorb liquid, therefore preventing leakage. Both reusable and disposable products are available.
- Skincare Products – Many products exist to protect the skin from irritation and soreness that occur when a person experiences nocturnal enuresis. A range of soaps, lotions, and cleansing cloths exist for various skin types.
- Restriction of Fluid Intake – Naturally, limiting the intake of fluids in the evening results in a decreased amount of urine produced at night.
- Afternoon Naps – This can help reduce fluid build up by allowing liquid to be absorbed in the bloodstream. When awakening from a nap, you can use the bathroom and eliminate excess urine.
- Elevation of Legs – Like naps, elevating your legs helps redistribute fluids so it can be reabsorbed into the blood stream.
- Compression Stockings – Creating an effect similar to elevating your legs, these elastic stockings exert pressure against the leg while decreasing pressure on the veins. This allows fluids to be redistributed and reabsorbed into the bloodstream.
Different medicinal options exist to alleviate and even treat nocturia. These may be used alone or combined with some of the behavioral modifications listed above, which has been proven to be more effective.
A word of caution about medications: Used alone, studies have confirmed that the medication works only as long as it is taken. Once off the medication, relapses are quite common.
Anticholinergic medications are prescription medications that are effective for treating enuresis with detrusor overactivity, demonstrating success in 5-40% of cases. The main side effects with anticholinergic medications are dry mouth, dizziness, and blurred vision.
- Darifenacin – This medication relieves bladder spasms and treats overactive bladder.
- Oxybutynin – This medication relaxes the detrusor muscle of the bladder.
- Tolterodine – This medication is an antimuscarinic and functions much like oxybutynin.
- Trospium Chloride – This medication treats an unstable bladder by blocking cholinergic receptors that are found on muscle cells in the wall of the bladder. Once the receptors are blocked the bladder then can relax so overactivity does not occur.
- Solifenacin – This is a recently introduced anticholinergic that is a more selective antimuscarinic agent with fewer anticholinergic side-effects.
If this first line drug therapy is considered ineffective, one or more of the following may be prescribed.
- Desmopressin – By mimicking ADH or vasopressin, the kidney produces less urine.
- Imipramine – This medication boasts a 40% success rate but also has a fine line between an effective dose and toxic dose.
- Furosemide – This loop diuretic helps regulate urine production in the daytime in order to decrease urine production during sleep. Furosemide blocks ion flow in the kidneys, allowing urine production to be more controlled.
- Bumetanide – This loop diuretic assists in regulating urine production prior to sleep so waking during the nighttime does not occur. Bumetanide must be taken with caution and consultation with a healthcare professional prior to taking this medication is highly recommended.
Nocturia can be a debilitating problem for many people as it creates chronic sleep impairment. However, with proper management, motivation, and dedication this condition can be overcome for a better quality of life.
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