When you laugh so hard, tears run down your legs

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Maybe you’ve seen the sign that reads, “I laughed so hard tears ran down my leg!” And, perhaps you didn’t think it was funny because it happens to you, not only when you laugh but when you sneeze, cough, exercise, or lift something heavy.

If it happens once in a while, it’s common; when it happens, all the time, it’s called urinary incontinence. Not a disease, incontinence is a symptom of many conditions. And there are different types. The one above is called stress incontinence and happens when you leak urine when you exert pressure on your bladder.

Urge incontinence is when you have a sudden, intense urge to urinate, followed by an involuntary loss of urine. Overflow incontinence is when the body makes more urine than the bladder can hold resulting in urine constantly dribbling out. It can also happen when your bladder doesn’t empty out completely.

Functional incontinence is when a physical or mental impairment prevents you from getting to the toilet in time. Like not able to unbutton or unzip your pants quickly enough. And, not surprisingly, you can have a mix of more than one of these conditions.

For a look at the normal physiology, I’ll to defer to the Urology Care Foundation. “The brain and the bladder control urinary function. The bladder stores urine until you are ready to empty it. The muscles in the lower part of the pelvis hold the bladder in place. Typic-ally, the smooth muscle of the bladder is relaxed. This keeps the urine in the bladder.

“The neck (end) of the bladder is closed. The sphincter muscles are closed around the urethra. Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles contract, forcing the urine out through the urethra, the tube that carries urine from the body. The sphincters open up when the bladder contracts.”

Mayo Clinic tells us that urinary incontinence can be caused by “certain foods and medications that act as diuretics, stimulating your bladder and increasing your volume of urine. They include alcohol, caffeine, carbonated drinks, and sparkling water; artificial sweeteners; chocolate; chili peppers; foods that are high in spice, sugar or acid, especially citrus fruits; heart and blood pressure medications, sedatives, and muscle relaxants, and large doses of vitamin C.”

They also say that it can be caused by treatable medical conditions like urinary tract infections that can irritate the bladder and constipation. “The rectum is located near the bladder and shares many of the same nerves,” Mayo explains. “Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.”

Urinary incontinence can also be caused by physical problems or changes, including pregnancy, childbirth, aging, menopause, hysterectomy, enlarged prostate, prostate cancer, obstruction or neurological disorders. Oh yeah, it can happen to anyone, and it can be annoying, uncomfortable, and embarrassing.

So, your first step is to see your primary care provider. He or she may perform a few simple tests such as a urinalysis or a post-void residual measurement, which is when you urinate into a measuring container, then your bladder is checked with a catheter or ultrasound to see how much leftover urine is in there.

You may also be advised to record how much you drink, when and how much you urinate, whether you’ve had an urge to urinate and the number of incontinence episodes.

The National Institutes of Health gives us thirteen tips for a healthy bladder. They are 1. Drink enough fluids, especially water. That’s six to eight glasses of fluids each day, of which half should be just plain water. 2. Limit alcohol and caffeine. 3. Quit smoking. 4. Avoid constipation by eating plenty of high-fiber foods and being physically active.

5. Keep a healthy weight. 6. Exercise regularly. 7. Do pelvic floor exercise, also known as Kegel exercises, to help hold urine in the bladder. 8. Use the bathroom often and when needed, roughly every three to four hours, and 9. Take enough time to fully empty your bladder. 10. Be in a relaxed position while urinating. 11. Wipe from front to back. 12. Urinate after sex and 13. Wear cotton underwear and loose-fitting clothes.

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com.

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