If you’re reading this, you're probably no stranger to bladder leaks: one minute you’re sipping a cocktail and laughing with friends, the next you’re… oops! speed walking to the bathroom because you felt a sudden trickle — or a flood.

Even a small amount of leaking is considered a form of urinary incontinence and it’s incredibly common, impacting 55% of women between the ages of 15-64. It can occur for a variety of reasons including pelvic floor dysfunction, nerve damage, and hormone changes.

If you suspect that certain foods or drinks can make your bladder issues worse, you're spot on. Urinary incontinence can absolutely be exacerbated by dietary 'bladder irritants' — and limiting them can be a simple way to reduce leaking and other frustrating symptoms.

What are bladder irritants?

Bladder irritants are substances that can irritate your bladder and cause or worsen bladder symptoms. They're primarily things that you eat or drink, but may also include medications and vitamins.

Some common drinks and foods that are bladder irritants:

• Caffeine: Caffeine acts as a diuretic (a substance that increases urine production), so it can often be the culprit behind bladder leakage. Decaf options are better, but can still create plenty of irritation if you’re prone to more sensitivity. Unfortunately, caffeine is found in a lot of your daily favorites including tea, energy drinks, soda, chocolate, and of course coffee.
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• Alcohol: Alcohol is also a diuretic and is irritating to the bladder lining, contributing to more urine production and leakage potential. If you add a sugary mixture to your alcohol, it can be even more irritating to your bladder’s lining since it is also a bladder irritant, causing a ramp in your symptoms.
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• Sugar and artificial sweeteners: Cutting back on sugar and other sweeteners may help relieve bladder symptoms.
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• Acidic foods: Foods such as tomatoes, tomato-based products, and citrus fruits like limes, grapefruits, oranges, and cranberries can cause urine to become overly acidic and cause added bladder irritation.
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• Spicy food: Imagine what they do to your mouth. . . but in your bladder!
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• Fruit or fruit juices: Such as strawberry, apple, cantaloupe, peach, and pineapple.
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• Carbonated beverages: As CO2 can irritate the bladder lining, anything with carbonation is likely to cause an increase in urinary leakage. For example, sodas and that beloved La Croix may need to become occasional treats instead of everyday staples.
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• Dairy products: Primarily aged cheeses and sour cream.
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• Onions: The same veggie that can make your eyes water can also contribute to bladder irritation.
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A few other things that can irritate your bladder:

• Vitamins: Mainly Vitamin B & Vitamin C.

• Nicotine: Smoking contributes to disruptive bladder symptoms. Talk with your physician about a smoking cessation program that could help you out.
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• Allergy medicines that contain pseudoephedrine and ephedrine: These may irritate your bladder. Consider talking to your doctor to see if there is an alternative you can take.
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• High blood pressure medication: Some high blood pressure medications can act as a diuretic. Talk to your doctor if you think prescription medication may be contributing to urinary incontinence.

Why bladder irritants cause urinary leakage

The urinary system — which is made of your kidneys, bladder, and urethra — performs the vital process of filtering your blood. The vital nutrients, minerals, and water that your body needs to function and stay healthy is retained, and everything else is expelled in your urine. In other words, this process helps your body remove and get rid of all the excess junk and water that your body doesn't want or need from the things that you eat and drink.

Your bladder is a hollow organ made of smooth muscle and an inner mucosal lining. It holds urine until it's a convenient time for you to go or 'void.' While your bladder is slowly filling with urine, the muscle that surrounds it, called the detrusor muscle, remains relaxed so you can barely notice that your bladder is taking up. Then, when you are ready to void, the detrusor muscle contracts to help push the pee from your body. 

If your urine is full of irritating substances, then it may irritate the bladder lining, the detrusor, and the urethra — contributing to bladder leakage. 

Known bladder irritants do not affect everyone in the same way, or equally — for example, if you have Painful Bladder Syndrome/Interstitial Cystitis you may be more sensitive to bladder irritants — but if you are having bothersome bladder symptoms, it can be helpful to reflect on your diet for clues on what you may need to eliminate. 

In addition to urinary incontinence, bladder irritants may contribute to:

• Urinary urgency
• Bladder pain
• Urinary frequency
• A feeling of incomplete bladder emptying

How to Limit Bladder Irritants & Improve Urinary Incontinence

It may seem simple enough to ditch the random habanero pepper in your takeout or eat around the cantaloupe in your fruit salad, but what if your entire diet is made up of bladder irritants? Or what if you’re 100% sure you won’t get your kids to school on time if you don’t have a cup of coffee? 

Ease into eliminating bladder irritants with the following tips:

Start with a 10-day Experiment.

Commit to limiting bladder irritants for just 10 days. As your symptoms ease, add foods or drinks back into your diet one at a time — maybe start with your favorite so you don’t prolong the torture. If symptoms return when adding a specific food or drink back into your diet, it may be helpful to continue avoiding (or just limiting) those irritants for improved bladder symptoms.

Don’t avoid water to minimize your symptoms.

It may seem like the less water you drink, the less leakage is physiologically possible, but dehydration can actually increase the concentration of the bladder irritants, making your symptoms worse. Aim to drink about half your body weight (in ounces) of water each day. Try to avoid chugging it all down right before bed because you forgot during the day! Instead, try taking in small amounts several times throughout the day.

Cut back on smoking if you can.

Talk with your physician about a smoking cessation program that could help you out.

Remember, it is not all or nothing.

‍Eliminating irritants from your diet doesn’t work for everyone’s bladder leakage, and you may find greater success if you have the individualized guidance from your healthcare professional. They can work with you on better timing of the irritating foods and drinks or recommend avoiding irritants during PBS/IC flares, and will use these recommendations as part of a much more comprehensive treatment program to eliminate your leakage.

Swap in foods That calm an irritated bladder:

• Non-acidic fruits: Such as blueberries, watermelon, pears, and lemons
• Milk
• Potatoes
• Select herbal teas: Look for acid-free and decaffeinated versions of your favorites.
• Water: Non-carbonated
• White chocolate
• Lean protein: Such as fish, chicken breast (not the fried kind), and turkey breast
• Fiber-rich foods and whole grains: Eating plenty of fiber helps prevent constipation, which can help reduce urinary incontinence since constipated bowels can press on the bladder causing excess pressure.

Urinary Incontinence is Curable

If you are having new bladder pain and urinary incontinence, the first place to start is to check in with your physician. They will be able to help identify and treat any medical causes of your symptoms. Pelvic physical therapy should also always be considered when experiencing unwanted bladder symptoms, as it is a highly effective option in the treatment of bladder symptoms such as urinary incontinence.

In randomized controlled trials, between 44% and 69% of women cured their urinary incontinence through pelvic floor muscle training alone. 

This is inspiring evidence that simple lifestyle interventions alone — like altering your diet and improving the health of your pelvic floor — are enough to overcome urinary incontinence in many cases. 

If you’re tired of letting urinary incontinence dictate how you choose to live your life, and this information has you feeling empowered to take control of your pelvic health, reach out to schedule a free consultation with an expert pelvic floor physical therapist.