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Incontinence

03 December 2018

'I wet my bed after a few drinks' – alcohol and urinary incontinence

How strong is the link between alcohol and urinary incontinence? Can alcohol cause adult bed-wetting? Here's what you need to know.

Bed-wetting is a condition we associate with childhood. Waking up with soaked sheets is unpleasant and, quite frankly, embarrassing when you're an adult. But there are people who experience this after a few too many drinks the night before.

The National Association For Continence (NAFC) shares the story of Eric* (43) who woke up realising that he had wet his bed. He felt shocked and embarrassed and had no idea why this would happen to him as an adult.

Unfortunately, this wasn’t a once-off event – it happened a couple of times a month for a few months before he started analysing the situation. He then realised that there was a pattern – it seems that the bed-wetting occurred every time after he'd had a couple of beers while out playing poker. Eric is not a heavy drinker, but wanted the problem to stop. He switched to water and things started to improve.

This problem isn’t as shocking and uncommon as it sounds. Many people experience incontinence, and according to the NAFC, almost 5 million adult American experience bed-wetting. Since there is a lack of extensive research on the number of South Africans who suffer from urinary incontinence, let alone those who experience bed-wetting, we might not even be aware of the existence of such a problem. 

The condition is called nocturnal enuresis. While this type of involuntary passing of urine doesn’t fall under stress incontinence or urge incontinence (which occurs when there is pressure or a constant fullness of the bladder), it’s a form of incontinence that is triggered especially by alcohol consumption in adults.

The link between alcohol and your bladder

Alcohol doesn’t only contribute to the problem of nocturnal enuresis, but can also trigger urinary stress incontinence or urinary urge incontinence. Alcohol itself doesn’t cause incontinence, but it affects the bodily mechanisms which play a part in controlling the bladder.  

There are a couple of reasons why alcohol can trigger incontinence and potentially cause bed-wetting:

1. Alcohol suppresses the anti-diuretic hormone

This hormone signals the kidneys to stop producing more urine when the bladder is full. Alcohol limits the production of this hormone and your body starts producing more urine than it should, according to urologist Dr James Ulchaker from the Cleveland Clinic.

Involuntary urination occurs because you are sleeping too soundly to realise that you need to go to the toilet. 

2. Alcohol irritates the bladder

In people with urinary stress incontinence or urinary urge incontinence, alcoholic beverages can irritate the bladder, causing leakage.

The reason alcohol irritates the bladder is because of its diuretic effect. It draws water from the body, causing you to become dehydrated. Dehydration causes more concentrated urine, which causes irritation.

3. Alcohol affects the body’s ability to physically hold urine

The detrusor muscle, which forms part of the wall of the bladder, contracts and relaxes in order to empty out or hold urine. When the bladder becomes full too quickly, it loses its ability to control the detrusor muscle, causing distention of the bladder and subsequent leakage.

4. Alcohol causes fluids to build up faster

According to Dr Ulchaker, drinking a lot of alcohol can increase the amount of fluid in your bladder when you go to bed. If you are prone to incontinence under normal circumstances, alcohol will make it worse.

5. Caffeine also plays a role

When you drink alcoholic beverages that also contain caffeine (mixing spirits with certain soft drinks or energy drinks), you're aggravating an already overactive bladder.

Manage incontinence

Suffering from incontinence doesn’t mean you have to put your social life on hold. Here are things you can do to control your incontinence:

  • Limit how much you drink and allow plenty of time between your last drink and bedtime.
  • Avoid any sugary or caffeinated beverages which can irritate the bladder. 
  • Incorporate daily pelvic floor exercises in your routine.
  • Avoid drinking to the point of blacking out.
  • Set an alarm if you are worried about involuntary urination.
  • If you cut down on alcohol and the problem persists, see your doctor.

*Name has been changed to protect identity.

Image credit: iStock

 

Ask the Expert

Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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