With empathy for your discomfort, let me explain in more detail how modern medicine understands this overactive bladder syndrome. Overactive bladder is not simply an issue of having a small urinary bladder or a weak urethra. The primary cause is the phenomenon where the detrusor muscle, the bladder muscle, contracts regardless of our will when the desire to urinate arises. It can be seen as a malfunction of the nervous system where signals indicating that the bladder is full are repeatedly sent to the brain even though the urinary bladder is not sufficiently filled.
The main causes include the following:
1. Nervous system issues: abnormalities can occur in the nerve pathways transmitting signals from the urinary bladder to the brain and from the brain to the urinary bladder. When there are neurological conditions such as stroke, Parkinson's disease, or multiple sclerosis, the ability to control the urinary bladder may decrease; however, those without such underlying diseases can also experience overactive bladder due to increased nerve sensitivity. Sensory nerves of the urinary bladder become overly activated, causing one to feel the urge to urinate even from small stimuli.
2. Excessive activity of the detrusor muscle: the detrusor muscle in the bladder wall must contract during urination, but in patients with overactive bladder, the detrusor muscle contracts on its own even when urine has not sufficiently accumulated, causing a strong desire to urinate. This can appear when an issue arises in the autonomic nervous system control of the urinary bladder.
3. Hormonal changes: overactive bladder symptoms are especially prone to appear in women after menopause. This is because as estrogen levels decrease, the mucosa of the urinary bladder and urethra thins, loses elasticity, and can also affect the function of the bladder muscle. Furthermore, the decreased secretion of antidiuretic hormone, which suppresses urine production at night, is also a major cause of nocturia.
4. Lifestyle and dietary habits: caffeine, alcohol, carbonated drinks, artificial sweeteners, and spicy foods can irritate the urinary bladder and worsen symptoms. Drinking too little water concentrates the urine and irritates the urinary bladder further; conversely, drinking too much water at once or having a habit of drinking water right before bed is also unfavorable.
5. Pelvic floor muscle dysfunction: pelvic floor muscles support the urinary bladder and urethra, playing an important role in holding urine. When these muscles weaken or become overly tense, it can negatively impact bladder function.
Thus, modern medicine views overactive bladder as a multifaceted condition involving multiple complex factors. Now you can understand that it is a problem difficult to solve merely by drinking a lot of water or simply holding it in.
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