WebMD Feature

By Kathleen Doheny

Reviewed By Louise Chang, MD

While there is no formal “urinary incontinence diet,” what you eat and drink can worsen your incontinence symptoms — particularly if you have urge incontinence, also called overactive bladder.

Most doctors advise people with urinary incontinence to avoid certain foods and drinks in their diets. But doctors also acknowledge that the same foods and beverages that bother one person may not bother another person at all. It’s important to personalize your urinary incontinence diet.

You can do that by trial-and-error: Eliminate the foods and beverages you suspect are causing problems, then reintroduce them one by one to see if you can tolerate small amounts.

Here are six common urinary incontinence diet culprits:
1. Excessive Water and Urinary Incontinence

If you don’t drink enough water, you can get dehydrated. But if you have incontinence and drink large quantities, that could also pose difficulties, says Jennifer Anger, MD, MPH, a urologist and assistant professor of urology at the University of California Los Angeles David Geffen School of Medicine.

“Drinking the often recommended six to eight glasses of water a day could be a problem,” she says. Eight 8-ounce glasses would total 64 ounces of fluids. She recommends limiting yourself to about a quart (32 ounces) or a quart and a half (48 ounces).

Managing fluids can help the symptoms of both stress and urge incontinence, says Amy Rosenman, MD, an assistant clinical professor of obstetrics and gynecology at the University of California Los Angeles David Geffen School of Medicine.

Stress incontinence is when you leak a bit of urine when there’s pressure on your bladder, such as when you cough or sneeze. Urge incontinence, also known as overactive bladder, is when you feel a sudden urge to urinate, and sometimes accidentally leak urine.
2. Alcoholic Beverages and Urinary Incontinence

If you have urge incontinence or mixed urinary incontinence (a combination of urge and stress), alcoholic beverages in your diet could be bad news, says Rosenman, the co-author of The Incontinence Solution.

“Alcohol has a direct effect on the bladder, reduces control and acts a bit as a diuretic so it causes dehydration,” she says.

“Alcohol interferes neurologically with the control you have over your bladder,” Rosenman tells WebMD. “It interferes with the neurological signals from the brain to the bladder [telling it when to go, when to hold urine, and so on]. If you have alcohol on board, there is less control over that signaling and you are more likely to have an accident.”

While some people with urinary incontinence cut alcohol out of their diet altogether, some can tolerate small quantities, she says. “Cut back as much as you can,” she advises. “Or eliminate alcohol for a couple weeks and then figure out how much you can tolerate [by re-introducing it gradually],” Rosenman says.

Rosenman remembers one patient who drank daily, despite incontinence problems. After Rosenman told her how alcohol affected her bladder control, the woman decided to abstain. “Her bladder got better,” she says.
3. Caffeine and Urinary Incontinence

As you are figuring out your personalized urinary incontinence diet, know that caffeine is a kind of “double whammy” for those with incontinence. “Caffeine stimulates the bladder on one hand, and it also acts as a diuretic,” says Rodney Appell, MD, a urologist and director of the Baylor Continence Center at Baylor College of Medicine, Houston.

It’s best, he says, to eliminate coffee and other caffeine sources completely from your diet when you have urinary incontinence.

Caffeine is in soft drinks, many teas, chocolate, and even — in small amounts — in decaf coffee.

But eliminating coffee (not to mention chocolate) can be difficult, Anger acknowledges. She tells her patients with urinary incontinence: “If you are a big coffee drinker, cut down to one or two cups a day.”

Also, drink most of your coffee in the morning so you don’t have to get up often at night to urinate. Avoid drinking coffee after 7 p.m. or so, Anger advises.
4. Spicy Foods and Urinary Incontinence

If you’ve got urge incontinence (overactive bladder), you may want to avoid in your diet spicy-hot foods such as Mexican or hot Chinese fare, chili peppers, chili, horseradish, and other highly spiced foods.

“In the same way caffeine can be an irritant, spicy foods are shown to be an irritant in the lining of the bladder,” says Christine Gerbstadt, MD, RD, a spokeswoman for the American Dietetic Association and a nutrition consultant in Sarasota, Fla., and Philadelphia.

Again, figuring out what spicy foods make your symptoms worse requires trial and error, she says, until you come up with your tailor-made urinary incontinence diet.
5. Acidic Foods and Urinary Incontinence

If you have urinary incontinence, it’s wise to avoid citrus foods, including orange juice, cranberry juice, and other citrus beverages, says Rosenman. Citrus foods and drinks are highly acidic and tend to irritate the bladder. Cranberry juice has a reputation for helping to clear up bladder infections, but it does not help with overactive bladder and urge incontinence, Rosenman says.
6. Carbonated Drinks and Urinary Incontinence

Even if carbonated drinks are not caffeinated, they may not have a place in your personalized urinary incontinence diet, Rosenman says.

“The carbon dioxide in the drink can irritate a sensitive bladder,” she says. And once the irritation sets in, you can have the urge of having to go, the typical symptom of urge incontinence.
How to Talk About Urinary Incontinence

Bringing up urinary incontinence during a routine doctor’s office visit can be embarrassing and difficult. But it’s important to start the conversation.

Rosenman suggests the straightforward approach. Try saying something like: ”I’m having some problems with my bladder.”

At that point, the doctor should begin asking you very specific questions, Rosenman says. He or she should ask, for instance, if you need to get up during the night to urinate, and if you leak and how often.

“If the doctor does not follow up with questions, ask for a referral,” she says.
The Link Between Weight and Urinary Incontinence

Whatever your best personalized urinary incontinence diet, be aware that keeping your weight at a healthy level can help, too. Several studies have found that if you are overweight, weight loss — even as little as 5% or 10% of your starting weight — can help reduce the symptoms of both urinary stress incontinence and urge incontinence.

In one study of 40 women with urinary incontinence, women who lost on average 35 pounds reduced their incontinence episodes by 60%, compared to just 15% among women who did not lose weight, according to a report in The Journal of Urology.

SOURCES: Amy Rosenman, MD, assistant clinical professor of obstetrics and gynecology, University of California Los Angeles David Geffen School of Medicine. Jennifer Anger, MD, MPH, assistant professor of urology, University of California Los Angeles David Geffen School of Medicine. Christine Gerbstadt, MD, RD, spokeswoman, American Dietetic Association; consultant based in Sarasota, Fla., and Philadelphia. Rodney Appell, MD, urologist; director, Baylor Continence Center, Baylor College of Medicine, Houston. Subak, L. The Journal of Urology, July 2005; vol 174; pp.190-195.

Reviewed by Louise Chang, MD on December 15, 2011