When you come to CTS for your physical therapy evaluation there is a good chance the physical therapist will ask about your fluid intake. Fluid type and amount is an important consideration in many pelvic floor conditions.
Many clients suffering from leakage, urgency, or pelvic pain decrease fluid intake in an effort to manage symptoms. Unfortunately, restricting fluid can exacerbate these issues.
Low fluid intake increases the concentration of the urine. This results in acidic urine which irritates the bladder lining resulting in exacerbation of leakage and urgency. Acidic urine can also result in sensitivity of the urethra and vaginal opening. In a more general sense, inadequate fluid intake can contribute to cognitive deficits, UTIs, kidney stones, and headaches. Drinking water with a meal mediates the increase in blood pressure that can occur with a salty meal.
As with most things, fluid intake is best done in moderation. Excessive fluid intake can result in increased urinary frequency. This can be problematic if the volume of urine with urge is so large that it starts to impact your ability to leave the house or engage in activities where you do not have access to a bathroom. Very high levels of fluid intake can result in low plasma sodium, or electrolyte imbalance, with a wide range of negative implications.
For most people, water should make up the majority of daily fluid intake. So where do caffeine and alcohol fall into the mix?
Caffeine is a diuretic. In most cases your body is still taking in fluid when you drink caffeine, but you are outputting more fluid than you otherwise would. In other words, drinking any beverage with caffeine does not carry the same ounce for ounce hydration benefit as water. Additionally, the acidity of the beverage or qualities such as tannins can decrease the bladder’s ability to expand and fill.
Alcohol blocks the signal to the kidneys to hold onto fluid that normally occurs to maintain proper hydration levels in the body. This leads to more fluid loss with alcohol intake. On top of this, alcohol has a relaxant effect on the musculature of the body. This may reduce the ability of the pelvic floor to contract at the right time to prevent leakage.
Everyone is different. Some are more impacted by caffeine, tannins, or acidity. These are all potential bladder irritants. Trial and error is important to rule out impact of irritants on bladder symptoms.
A good way to keep track of your results is through a bladder diary. A bladder diary allows you to systematically eliminate one potential irritant and track your urinary symptoms (frequency, urgency, and leakage) for a few days.
You are able to draw conclusions about type and amount of fluid intake and resultant urinary symptoms. In some cases the impact of these bladder irritants can be cumulative instead of immediate. Only after taking a break for a prolonged period are you able to see how this was really impacting your symptoms.
In general, the medical community recommends consuming 60-80 oz. of fluid a day.
Exercise, age, medications, and climate all impact the amount of fluid you should drink. CTS is here for you if you have questions about how much fluid or what type of fluid you should be drinking for your unique and wonderful body.