One of the many unfortunate consequences of disease progression, diabetic bladder occurs in individuals whose nerve endings in the digestive system have been compromised. Where a normally functioning bladder sends and receives signals about 4 – 6 times a day indicating it is full and needs to be emptied, a diabetic neurogenic bladder remains full, unable to complete the cycle of urination. This can mean that urine is held in the body or leaks uncontrollably. Either scenario is not only embarrassing, but life threatening.

Urine held in the body increases fluid volume, which is dangerous for the diabetic. Excess urine can back up into the kidneys and cause renal failure. When the body is incapable of voiding, soon thereafter other systems begin to rapidly shut down.  It is important to alert your doctor if you are having any problems urinating. There are several steps to take to diagnose and then aggressively treat diabetic bladder neuropathy.


Diabetic Neurogenic Bladder Control


“Going potty” is controlled through a series of nerve relays or conversations along the spinal cord between the sacral cord, the bladder, and a spot in the brain called the pons. Like a walkie talkie on a set channel, this communication can be disrupted by one end of the conversation switching to the wrong “frequency” (think of a spinal cord injury that breaks the signal) or too much static or chatter on the channel (such as excessive nerve ending damage at either point). What makes this tricky for the individual with advanced diabetes is that normally functioning pee signals are controlled by very slight changes in emotions as well as physiological needs like a full bladder. When there is progressed diabetes, there is almost always nerve damage. Since voiding the bladder is basically an act of nerves, anyone suffering any amount of neuropathy is a candidate for advancing to an uncontrolled bladder. All the fear and surprise of discovering other muscle groups incapable of moving have a direct impact on the functioning of the bladder. This is a fact even before neurogenic bladder condition has set in.

Typically, it takes about 10 years suffering with diabetes 2 before bladder neuropathy appears. For those who have never received a diagnosis of diabetes, problems with urination are likely the first sign that they have a disease that can be managed. It is important for people diagnosed with diabetes mellitus to track just about everything they put into their body, but also what comes out. Tracking how often you feel the need to pee and how many times you successfully manage to do it is the first step in treating the onset of diabetic neurogenic bladder. Once a chart has been developed, you will decide with your doctor specific ways to manage the problem.

In progressed cases, the filled bladder, distended and painful, often requires the insertion of a catheter to empty it manually.  Sometimes the nerve damage is so server that a a catheter must remain in place. If the bladder function returns intermittently, you have a chance to balance your system and renew your ability to control going to the bathroom.


Diabetic Bladder Neuropathy and Diet


Your bladder problems could be the result of a urinary tract infection or poor food choices. Proper diet, medication and hygiene could stop your potty problems. Acidic foods like citrus fruits (grapefruits, limes, lemons,  oranges, pineapple) irritate the bladder and increase the urge to urinate. Tomatoes, rich in lycopene for the eyes are so acidic and irritating that even consuming products made with tomatoes (yes, all those delicious sauces) can become a problem. While cranberries and undiluted cranberry juice can be an effective way to treat your urinary tract infection, if you have an overactive bladder, it is not a good idea to take this course of action. Excessive spices in your food preparation can irritate the bladder and onions might need to be removed altogether.

Interestingly, avoiding excessive consumption of artificial sweeteners, condiments, artificial flavors, preservatives, and additives like MSG, benzyl alcohol, and citric acid will radically improve your chances of gaining control over your bladder. It goes without saying that any beverage that is meant to stimulate your system is a no-no–coffee, teas, sodas, carbonated flavored waters–but all alcoholic beverages should be avoided as well. Keep both a food and pee diary and you will soon see which foods trigger an urge to go. While this may seem tedious, a surprise side effect of improving your bladder control may be an improved sex life. Bet you didn’t see that coming!


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