Dear readers, from the moment you wake up in the morning until you go to sleep at night, have you ever felt frustrated going in and out of the bathroom multiple times a day, thinking, “Why did I become like this?” The concepts of the urinary bladder’s ‘qi transformation’ action and the Soyangin ‘heat’ constitution in Donguibogam provide remarkable insights into understanding the complex mechanisms of urinary system diseases such as overactive bladder syndrome and urinary incontinence from a modern medical perspective.
Overactive bladder is characterized by an urge to urinate that comes too frequently, is difficult to hold, and in severe cases, leads to urine leakage. It is also often accompanied by nocturia that disrupts sleep at night. These symptoms are not simply problems of the urinary bladder muscle, but arise as a result of subtle interactions among our body’s complex nervous system, endocrine system, and pelvic floor muscle.
First, the urinary bladder is an organ that constantly communicates with the brain. When urine fills up, sensory receptors in the bladder wall send signals to the brain, and the brain interprets them to issue the command to go to the bathroom. However, if a problem occurs in this neurotransmission system, the brain receives a false signal that it is completely full, even though the urinary bladder has not filled sufficiently. In particular, psychological factors like stress or anxiety affect the autonomic nervous system and can make the urinary bladder more sensitive. We can interpret this as the ‘heat’ of the Soyangin constitution acting similarly to sympathetic hyperactivity caused by stress, triggering excessive contraction of the urinary bladder.
In women, the weakening of the tissues around the urinary bladder and the pelvic floor muscle after childbirth or upon entering menopause also has a major impact. When estrogen levels decrease, the urinary bladder and urethral mucosa thin out and lose elasticity, which can raise sensitivity to bladder irritation and trigger frequent urination or urinary urgency. Additionally, a weakened pelvic floor muscle fails to support the urinary bladder properly, which can lead to stress urinary incontinence where urine leaks upon increased intra-abdominal pressure such as during a cough or laughter.
Chronic inflammation, such as chronic cystitis or interstitial cystitis, can also irritate the bladder wall and cause these symptoms. The heat in the body emphasized by Donguibogam may refer not only to a simple rise in body temperature, but also to micro-inflammatory responses or an imbalance in the immune system. It is a situation where our body’s defense mechanisms are excessively activated, giving unnecessary irritation to the urinary bladder.
In conclusion, bladder issues do not arise simply because water overflows; they occur as complex factors intertwine, including malfunctions in the brain and nervous system regulating the bladder, hormonal imbalance, muscle weakness, and chronic inflammation. Just like the Soyangin wisdom in Donguibogam, restoring the overall balance and harmony of the body is the key to bladder health. Does this complex puzzle now seem a bit clearer?
