Bladder Irritants: What They Are & When to Avoid Them

This post was expanded and updated by Ashley Rawlins, PT, DPT, on Nov. 8th, 2023.

If you’re reading this, you know how uncomfortable bladder issues can be: one minute you’re sipping a cocktail and laughing with friends, the next you’re… uh-oh! running to the bathroom because you felt a trickle — or have to go so badly, you think you might actually pee your pants.

It’s easy to brush these symptoms off as no big deal, but they’re forms of urinary incontinence, an incredibly common condition impacting 55% of women between the ages of 15-64. Urinary incontinence can occur for a variety of reasons including pelvic floor dysfunction, nerve damage, and changes in your hormones. But did you know that certain foods and drinks can also contribute to bladder problems? They’re called bladder irritants and avoiding them can help reduce symptoms of urinary incontinence.

What are bladder irritants and how do they cause symptoms?

Bladder irritants are substances — primarily things that you eat and/or drink, but may also include medications or vitamins you have been prescribed or are taking over the counter — which can irritate your bladder, and cause or worsen bladder symptoms.

The urinary system — which includes your kidneys, bladder, and urethra — performs the vital process of filtering your blood. It retains the vital nutrients, minerals, and water that your body needs to function and stay healthy, and turns everything else that your body doesn't want in your bloodstream into liquid waste (aka urine).

As urine is collected, it sits in your bladder (a hollow organ made of smooth muscle with an inner mucosal lining) until it's a convenient time to void. The muscle that surrounds that bladder, the detrusor muscle, remains relaxed to allow for comfortable (almost unnoticeable) bladder filling, and then when you are ready to void, it contracts to help push the pee from your body.

However, when your urine is full of irritants, it has the potential to impact the bladder lining, detrusor, and the urethra — and contribute to bladder leakage.

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

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

Food & drinks that can irritate your bladder

Common bladder irritants include:

• 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 especially sensitive to caffeine. Unfortunately, caffeine is found in a lot of your daily favorites including tea, energy drinks, soda, chocolate, and of course coffee.
• 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 sugar is another bladder irritant.
• Sugar and artificial sweeteners - Yep, too much of the sweet stuff, even if it's fake, can interfere with healthy bladder function.
• 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.
• Spicy food: Imagine what they do to your mouth. . . but in your bladder!
• Fruits or juices: Such as strawberry, apple, cantaloupe, peach, and pineapple
• Carbonated beverages: CO2 can irritate the bladder lining, so anything with carbonation is likely to cause an increase in urinary leakage. For example, sodas and that beloved La Croix may need to be struck from your grocery list.
• Dairy products: Primarily aged cheeses and sour cream
• Onions: The veggies that can make your eyes water can also upset 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.
• 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.
• 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.

Bladder-friendly food & drinks to try instead

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. Some known bladder irritants may not irritate your bladder at all.

However, 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, and consider swapping out known irritants for less irritating (even soothing) options instead.

Check out the following bladder-friendly food and drinks that can be a good alternative:

• 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.

How to ditch bladder irritants from your diet

We get it — it probably feels easy to wrap your mind around ditching the random habanero in your takeout, or leaving the cantaloupe from your fruit salad in the bowl, 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 strategies:

• Avoid consuming bladder irritants for the next 10 days or so. 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 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.
• Smoking contributes to disruptive bladder symptoms too. Talk with your physician about a smoking cessation program that could help you out.
• Remember, it is not black and white. 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.

Can't avoid bladder irritants? Time to get creative

Now that you know what irritates your bladder, avoiding these food and drink items can help keep your bladder symptoms at bay. But, if coffee dates with your bestie, or toasting to celebrate the holidays & good times with your loved ones are not up for negotiation, you can get creative to outsmart your irritants (or to try and make them less irritating anyway!) Here are a few ways to try:

• Pick the least “irritating” version of the food or drink: Skip the sugary, extra strong espresso drink or fancy craft cocktail, for a lesser irritating version. An iced Americano (espresso with water over ice) would be a less concentrated option when compared to an iced cold brew for example. Or go for less sugar and spice and snag a Ranch Water instead of a spicy margarita. If your bladder is sensitive to fruits like pineapple, ask for a watermelon cocktail instead of a piña colada.
• Have less of what is bothering you: Consuming less of what bothers your bladder may help by creating a smaller aggravation in your symptoms. Opt for a short coffee instead of the usual grande, or ask the bartender to put your favorite beer in a smaller glass. Or splurge on your favorite (bladder irritating) cocktail and enjoy a guilt-free sip only at the toast!
• Add water (or ice) to dilute the irritant: As ice melts into your drink, it can help to dilute the impact of a bladder irritant —- even ask for the small ice instead of an ice sphere, as more will melt into your liquor this way. Or go European and add seltzer to your wine to create a Spritzer —- while this does add carbonation to your drink, it cuts the volume of wine in half. Also, have your tumbler of water handy, and keep up with your recommended daily water intake so you stay hydrated as your drink other things.

Urinary incontinence doesn’t have to disrupt your life

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 — 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.