Water consumption is something we hear a lot about. We all know water is essential for life, and being adequately hydrated has all sorts of physical and mental health benefits. For years, we had the recommendation of 8 eight-oz glasses of water each day, for a total of 64 ounces. More recently, we're told to try and drink half of our body weight in ounces (for some of us more than the old 64 oz recommendation, others less). However, with all the focus on how much we should drink each day, what has been lost is how we should be drinking water.

(Dealing with urinary urgency/frequency (having to go more than 6-8 times per day)? This is absolutely something that pelvic physical therapy can help address. Find a local Pelvic PT or schedule a remote consult with our team if you need help!)

The human body is a finely tuned machine, working to distribute water as efficiently as possible to the various organs and cells of the body. We all know that when we start to feel dehydrated, the body signals us to drink more by giving us the feeling of thirst. When we have more water than we need to operate, the body can also respond by flushing more water out to make sure the correct amount stays within the body.

While the voiding process is complex and depends on many different factors, research out of Canada has shown when we sip water regularly instead of gulping down larger amounts, urine excretion is 6 times lower! The body absorbs more of the water and stays hydrated, but it doesn't result in increased trips to the bathroom.

“When the absorption of water from the intestinal tract was retarded because it....was consumed slowly (sipping), a water diuresis did not occur, despite producing the same positive water balance”

Urinary Urgency and Frequency

Urinary urgency and frequency is a common symptom of pelvic floor dysfunction and of pelvic pain conditions like interstitial cystitis. Tight muscles within the pelvic floor irritate the nerves that run through the area. The brain can then interpret this as the urgent need to urinate. It can also be linked with pelvic pain, low back pain, painful intercourse, urinary incontinence, chronic UTIs and other pelvic health symptoms.

A 'normal' number of urinate is 4-6 times per day. Wondering if you really have to go when you feel the urge? You should have a stream that lasts for at least 10 seconds if the bladder really was full.

Many times patients will limit their water intake to try and reduce the number of trips they are forced to make to the bathroom. Using what we know about sipping water, it's possible to do a better job of staying hydrated while minimizing trips to the bathroom. Sipping water, rather than drinking a lot over a short period of time, seems to allow the body to efficiently process the water and hydrate, without the spike in urination we see with gulping water.

Who are We at PelvicSanity?

At PelvicSanity, it's our mission to support patients with pelvic pain and pelvic floor symptoms, regardless of where you live. We can help with:

• In-person treatment for those in Southern California at the PelvicSanity clinic

• Immersive Out-of-Town program for those able to travel

• Remote Consultations to get you expert 1:1 help, advice and an action plan

• Online patient courses on Interstitial Cystitis and Movement for Pelvic Health

• A Facebook support group for patients called Finding Pelvic Sanity.

Changing Bad Habits

Unfortunately, this is in contrast to how many of us drink water. We'll have a full glass with a meal or pause in our day to gulp down a water bottle, and then don't drink anything for several hours.

To combat these bad habits, you can start with a 32 oz water bottle. Fill it once in the morning, drinking it slowly. You should empty it by around 12-1pm. Then fill it up again, with the goal of emptying it again by the late afternoon or evening. That will get you a full 64 oz of water in the day without having to gulp down water or drinking a significant amount right before bed!

Other Bladder Health

While changing how you drink can be an easy and helpful tool, there are obviously other factors that greatly impact urinary urgency and frequency.

• Pelvic Floor Physical Therapy. When pelvic floor muscles are tight and strained they irritate the nerves within the pelvic floor. The brain often interprets this as the need to urinate, even if the bladder has just been emptied. By resolving the underlying pelvic floor dysfunction, pelvic PT can help resolve bladder issues.

• Avoid Bladder Irritants. Some food and drinks are known to be common bladder irritants. These can include alcohol, carbonated beverages, caffeine, artificial sweeteners, spicy foods, and citrus fruit. You can also use an elimination diet to help determine what unique food or drink triggers that you might have.

• Bladder Training. With urinary urgency and frequency, patients often become used to responding immediately to the need to use the bathroom. Bladder training works to re-educate the bladder, trying to increase the time between voidings.

Not finding a qualified professional in your area or need to create an action plan so you can improve? Schedule a remote consultation with the experts at PelvicSanity today!

Dr. Nicole Cozean is the founder of PelvicSanity Physical Therapy in Orange County, CA. PelvicSanity treats patients from all over the world with remote consultations and the Immersive Out of Town Program. She also runs Pelvic PT Rising, training other pelvic PTs to better serve patients.

Named Physical Therapist of the Year, Dr. Nicole is author of the award-winning book The Interstitial Cystitis Solution and the first PT to serve on the ICA Board of Directors, Her passion is helping those with pelvic health issues - regardless of where they live - find lasting relief.