Bladder Health for Older Adults
Everyone uses their bladder many times each day, but they may not know what to do to keep their bladder healthy.
Located in the lower abdomen, the bladder is a hollow organ, much like a balloon, that stores urine. It is part of the urinary system, which also includes the kidneys, ureters, and urethra. Urine contains wastes and extra fluid left over after the body takes what it needs from what we eat and drink.
As you get older, the bladder changes. The elastic bladder tissue may toughen and become less stretchy. A less stretchy bladder cannot hold as much urine as before and might make you go to the bathroom more often. The bladder wall and pelvic floor muscles may weaken, making it harder to empty the bladder fully and causing urine to leak.
Common Bladder Problems
Bladder problems are common and can disrupt day-to-day life. When people have bladder problems, they may avoid social settings and have a harder time getting tasks done at home or at work.
Common bladder problems include:
- Urinary tract infections (UTIs)—UTIs are the second most common type of infection in the body and can happen anywhere in the urinary system. More than half of women will have at least one UTI in their lifetime. Older women are more likely to get UTIs because the bladder muscles weaken and make it hard to fully empty the bladder. This causes urine to stay in the bladder. When urine stays in the bladder too long, it makes an infection more likely. Types of UTIs include:
- Bladder infection—This is the most common type of UTI, in which bacteria enter the bladder and cause symptoms such as strong and sudden urges to urinate.
- Kidney infection—Infections in the bladder can spread to the kidneys, which can lead to severe problems. When kidney infections occur frequently or last a long time, they may cause permanent damage to the kidneys.
- Urethra infection —A UTI can also develop in the urethra, but this is less common.
- Lower urinary tract symptoms (LUTS)—a group of symptoms such as trouble urinating, loss of bladder control, leaking urine, and frequent need to urinate. LUTS are caused by problems with the bladder, urethra, or pelvic floor muscles.
- Bladder cancer—Bladder cancer occurs in the lining of the bladder.
What Can Affect Bladder Health?
Many things can affect bladder health. You can’t control everything that affects bladder health, but there are many bladder health behaviors that you can control. Here are some things that may affect your bladder health.
- Constipation. Constipation can cause too much stool to build up in the colon, which can put pressure on the bladder and keep it from expanding the way it should.
- Diabetes. Diabetes can damage nerves around the bladder that help with control.
- Being overweight. People who are overweight may be at higher risk for leaking urine.
- Low physical activity. Physical activity can help prevent bladder problems, as well as constipation. It can also help you keep a healthy weight.
- Smoking. Bladder problems are more common among people who smoke. Smoking can also increase the risk for bladder cancer.
- Some medicines. Some medicines may make it more likely for your bladder to leak urine. For example, medicines that calm your nerves so you can sleep or relax may dull the nerves in the bladder, and you may not feel the urge to go to the bathroom.
- Alcohol. For many people, drinking alcohol can make bladder problems worse.
- Caffeine. Caffeine can bother the bladder and change how your bladder tells you when you need to urinate.
- Diet. Some people with bladder problems find that some foods and drinks, such as sodas, artificial sweeteners, spicy foods, citrus fruits and juices, and tomato-based foods, make the problem worse. People who have bladder problems may feel better when they don’t eat these foods and drinks.
- Pelvic Injury. Trauma—such as prostate surgery, childbirth, or sexual assault—can damage the muscles and nerves that help control the bladder.
Some activities can increase the risk of urinary tract infections, including:
- Having sex. Sexual activity can move bacteria from the bowel or vaginal cavity to the urethral opening. Urinating after sex lowers the risk of infection.
- Using a catheter to urinate. A catheter is a tube placed in the urethra and bladder to help empty the bladder. The catheter can make a direct path for bacteria to reach the bladder.
- Using certain types of birth control. Diaphragms can bring bacteria with them when they are placed. Spermicides (a birth control that kills sperm) may also make UTIs more likely.
Signs of a Bladder Problem
Everyone’s bladder behaves a little bit differently. But certain signs may mean a bladder problem. If you have signs of a bladder problem, talk with your healthcare provider.
Signs of a bladder problem can include:
- Inability to hold urine or leaking urine (called urinary incontinence)
- Needing to urinate eight or more times in one day
- Waking up many times at night to urinate
- Sudden and urgent need to urinate
- Pain or burning before, during, or after urinating
- Cloudy or bloody urine
- Passing only small amounts of urine after strong urges to urinate
- Trouble starting or having a weak stream while urinating
- Trouble emptying the bladder
Signs of Urinary Tract Infection
In some elderly people, mental changes and confusion may be the only signs of a UTI. Older adults with a UTI are more likely to be tired, shaky, and weak and have muscle aches and abdominal pain.
Symptoms of a UTI in the bladder may include:
- Cloudy, bloody, or foul-smelling urine
- Pain or burning during urination
- Strong and frequent need to urinate, even right after emptying the bladder
- A mild fever below 101°F in some people
If a UTI spreads to the kidneys, symptoms may include:
- Chills and shaking
- Night sweats
- Feeling tired or generally ill
- Fever above 101°F
- Pain in the side, back, or groin
- Flushed, warm, or reddened skin
- Mental changes or confusion
- Nausea and vomiting
- Very bad abdominal pain in some people
Some people may have bacteria in the bladder or urinary tract, but not feel any symptoms. If a urine test shows that you have bacteria in your urine, but you do not feel any symptoms, you may not need any treatment. Talk to your healthcare provider about whether antibiotics—the medications that treat UTIs—are needed.
When to See a Health Care Provider—and What to Expect
If you have any of the signs of a bladder problem or urinary tract infection, talk to your healthcare provider. Read advice on talking to your doctor about sensitive subjects, like bladder problems.
When you see your healthcare provider, he or she may perform the following tests to try to figure out what might be causing your bladder problem:
- Give you a physical exam to look for any health issues that may cause a bladder problem. For women, the physical exam may include a pelvic exam. For men, the physical exam may include a prostate exam, which is usually done with a rectal exam.
- Take a urine sample to check for a bladder (or urinary tract) infection.
- Examine the inside of your bladder using a cystoscope, a long, thin tube that slides up into the bladder through the urethra. This is usually done by a urinary specialist.
- Fill the bladder with warm fluid to check how much fluid your bladder can hold before leaking.
- Check a bladder scan using ultrasound to see if you are fully emptying your bladder with each void.
Treating Bladder Problems
Treatment for bladder problems may include behavioral and lifestyle changes, exercises, medicines, surgery, or a combination of these treatments and others. For more information on treatment and management of urinary incontinence, visit Urinary Incontinence in Older Adults.
Because most urinary tract infections are caused by bacteria, bacteria-fighting medications called antibiotics are the usual treatment for UTIs. The type of antibiotic and length of treatment depend on the patient’s history and the type of bacteria causing the infection. Drinking lots of fluids and urinating often may also speed healing. If needed, painkillers can relieve the pain of a UTI. A heating pad on the back or abdomen may also help.
For more information on bladder health, visit 13 Tips to Keep Your Bladder Healthy.
For More Information on Bladder Health
National Kidney and Urologic Diseases Information Clearinghouse
Updated: August 16, 2017