In this episode of the GutFit Nutrition Podcast, we’re talking about the symptoms and impacts of Overactive Bladder (OAB), and link to IBS and digestive issues. This episode will empower you to take control with diet/lifestyle strategies and seek expert support, rather than simply living with it.
⏱️ Chapters:
- (0:00) – Introduction
- (1:46) – Introduction to the episode and focus on overactive bladder (OAB)
- (2:24) – Meet Callie K, the Bladder Dietitian and her personal story
- (5:00) – Callie’s journey from IC diagnosis to OAB and treatment challenges
- (7:25) – Signs and symptoms of overactive bladder
- (9:00) – Common root causes of OAB including pelvic floor and nervous system
- (12:00) – How chronic stress and nervous system dysregulation affect the bladder
- (15:00) – The gut-bladder connection and impact of IBS on urinary symptoms
- (16:45) – Nervous system regulation as a key to bladder symptom relief
- (20:56) – Overview of conventional OAB treatments and their limitations
- (24:01) – OAB in active individuals and runners with IBS
- (25:55) – Importance of proper hydration and common bladder irritants
- (29:01) – Harmful bladder habits to stop doing right now
- (32:07) – Dietary triggers for OAB and how to test sensitivities
- (38:34) – Callie’s top takeaways for improving bladder health
- (41:09) – How to connect with Callie K and learn more about her work
👤 Today’s Guest: Callie Krajcir, MS, RD
Callie Krajcir, MS, RD, The Bladder Dietitian®, is a Registered Dietitian and leading expert in bladder health. Living with interstitial cystitis (IC) her entire life and OAB during her college years has fueled her passion for helping others with IC, OAB and related conditions. Callie is the founder of Callie K Nutrition, the IC You Podcast, and social media platforms (@callieknutrition) that have empowered hundreds to find relief from bladder pain, urgency, and frequency through practical diet and lifestyle changes. She also serves as Vice Chair of the Board of Directors for the Interstitial Cystitis Association, advocating for awareness and better care for those living with IC.
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📌 Book: When the Body Says No by Gabor Mate
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
A lot of people think that if you drink less, you will have to
pee less. That is not true as a myth when
you are not hydrated. So let's say you're dehydrated,
your urine is more concentrated.So if you think your urine is,
it consists of all of the waste products that your body is
(00:20):
trying to get out. We don't really want it sitting
in our bladder for that long. But when you are dehydrated,
your urine is more concentrated.And if your bladder wall is a
bit irritated for whatever reason, it might be sensitive to
those toxins that are in your urine.
Or for example, if you are consuming like bladder irritants
(00:41):
like caffeine or alcohol or spicy foods or tomatoes, like
those are kind of the top water irritants that can trigger some
symptoms, especially if your bladder wall is already, you
know, a bit aggravated. Welcome to the Gut Fit Nutrition
Podcast, the show where we dive deep into the world of gut
(01:03):
health, nutrition, and fitness to help you unlock your best
self from the inside out. I'm your host, Lee Morado, a
registered dietitian, gut healthexpert, long distance runner,
and movement enthusiast on a mission to empower you with
science backed whole body strategies to fuel your body,
heal your gut, and thrive in your active life.
Whether you're here to finally break free from IBS and
(01:24):
digestive symptoms, optimize your fitness performance, or
learn how to support your gut health with natural strategies,
you're in the right place. Each week, we'll explore topics
like conquering digestive symptoms, building a gut
friendly lifestyle, enhancing endurance and strength
performance, and more. So grab a cup of your favorite
gut friendly tea and settle in because we're about to get gut
(01:45):
fit together. Today's episode is 1 I know many
of you have been waiting for, especially if you've ever found
yourself constantly scanning forthe nearest bathroom, cutting
workouts short, or struggling tostay hydrated without triggering
the urge to pee. Yet again, we're talking about
overactive bladder, or OABA, condition that affects millions
yet is often misunderstood or brushed off as just something to
(02:07):
deal with. But OAB is more than a minor
inconvenience. It can have a significant impact
on your quality of life, your confidence, your workouts, and
even your digestive health. So if you've been silently
wondering, is this normal or canI actually do something about
this, this episode is for you. I'm thrilled to be joined by
Cali K MSRD, also known as the Bladder Dietitian.
(02:30):
Cali is a registered dietitian and one of the leading voices in
bladder health education and support.
She's the founder of Cali K Nutrition, host of the ICU
podcast, and a tireless advocatefor those living with conditions
like interstitial cystitis and overactive bladder.
Let's get into it. Super excited to have you on
today. I think this is a really
(02:52):
important talk. I've gotten actually some
requests for chat around overactive bladder.
So I'm happy to have you on because I know you're the the
expert in this topic. The expert, thank you.
I'm so excited to talk about allthings bladder.
Yeah, for sure. I guess just to start off and
give listeners some background around you.
(03:14):
I'm sure probably quite a few people are listening or already
familiar with you, but for thosewho aren't, just tell us a bit
more about yourself, where you're located, how you help
people, and who you help. Yes.
So I am Callie Kreicher. I am located about an hour
outside of Philadelphia in the United States.
(03:35):
I am a bladder dietitian, so youprobably didn't know that we
existed, and that's because I'm the first person that is like
actually specializing in bladderhealth.
The conditions that I help people with include interstocial
cystitis and overactive bladder and some overlapping conditions
(03:55):
as well. And I am an IC and an OAB
patient. I struggled with bladder pain
for the 1st 25 years of my life.I am now totally pain free.
And I also struggled with OAB during my college years and I
was able to also completely overcome that.
And I pee normally now. And yeah, I'm basically helping
(04:18):
people get relief like I have through lifestyle changes.
And, you know, we're just reallyfocused on the hope element of
living with these chronic conditions.
And I just really like to help people understand that you can
overcome these symptoms, you canlive a normal life.
(04:39):
And yeah, that's kind of the gist of it.
Yeah, for sure. Do you work mainly with women or
work with like all? Yeah, I just work with women.
I am currently developing a selfstudy option for my program that
men can do so that is going to launch in a couple of weeks.
(05:01):
Cool, awesome. And I guess for yourself, like
when you first started dealing with the the symptoms of those
conditions, like how did you sort of find yourself, I guess
maybe trying to reach out for support medical community and
sort of navigating like the condition in the early stages?
Yeah, so like I said, bladder pain since I was a kid.
(05:22):
So that was really tough for me,navigating that because no one
around me was talking about their bladder or they were
struggling, always going to the toilet.
And so I kind of just suffered in silence until I was 18.
I ended up getting diagnosed with ICI, had this procedure
done, called a hydro distention,where they essentially put you
(05:43):
under anesthesia and they blow your bladder up and they stretch
it. And after that procedure, I
developed, developed frequent urinary frequency and urgency.
So I felt like I had to pee all the time.
I was going every 20 minutes, you know, I could, I was living
on the toilet and it really affected my life.
Those were my college years, unfortunately.
(06:04):
And there was just a ton going on.
I was playing volleyball in college, I was studying, I was
eating different foods, doing different social events,
drinking alcohol. So there was a lot going on, and
I got the OAB diagnosis kind of easily because I already had
that IC diagnosis and a lot of people do just get diagnosed
(06:27):
with both. And yeah, after that I started
my treatment journey. Happy to elaborate on that, but
I'm going to stop there. In case, you know, that's
helpful. Yeah.
And I can imagine too like just with all the things that you
want to be doing in university, like for one, being in class and
being able to like sit through the lecture, but also like
(06:48):
engaging in like extracurriculars, playing
sports, like those are all things that you need to be
present for. And you can't be running to the
washroom every 20 minutes I. Remember I, I think it was
either biology or anatomy class and just thinking like I just
went to the bathroom 10 minutes ago.
I cannot go to the bathroom again even though I feel like my
(07:09):
bladder is going to explode because I'm so afraid that
people were going to judge me and be like, why is this girl
like leaving or going to the bathroom so much?
So it was definitely a mind gamein addition to the physical
symptoms. Yeah, definitely.
It's just breaking down overactive bladder OAB, Like
what how do you know that it is something you're dealing with
(07:32):
versus just like needing to pee a lot because you're, you know,
you drink a lot of fluids and coffee.
It's like, what's sort of the the difference there?
No, that's a good question. So I mean, the average person
urinates like 6 to 8 times per day.
That's what's considered normal.And then zero to 1 times at
(07:52):
night. And so I mean, like you said,
like there are if you're over hydrated or you're hydrating
well like that may be a little bit more.
But if you're getting to the point where it's getting in the
way of you living your life and you feeling it excessive like
that is the point where you may want to get connected with a
urologist or urogynecologist. But like the common symptoms of
(08:14):
overactive bladder are that sudden intense urge to urinate,
feeling you have to pee all the time.
Maybe you just went and then youstand up and you already feel
like you have to go again. Waking up multiple times at
night. We call that nocturia.
And then some people experience incontinence, usually urge
incontinence, which means you might leak urine before you go
(08:36):
to the bathroom. And there's also stress
incontinence, which just means like when you feel stressed,
when that that symptom arises. So those are like the common
symptoms of OAB. Yeah.
And do you feel like it's something that just happens like
in isolation or is it sort of like a secondary, you know,
result of of sort of a bigger 'cause like pelvic floor
(09:00):
dysfunction or, you know, other?Overlapping with a lot of
conditions like pelvic floor dysfunction, like I see like
IBS, you know, chronic fatigue, autoimmune conditions, things
like that. And yeah, we're, I'm sure we're
going to talk about like root causes, things like that.
But the most common root cause, what is causing these symptoms
(09:25):
in my clients is it's regulated nervous system, which usually is
triggering pelvic floor dysfunction as well.
So it's kind of like this dominoeffect.
OK. That's interesting.
Actually leading into that, can you break down sort of the
common root causes of of overactive bladder?
Yeah, for sure. So we don't have any like set in
(09:45):
stone. These are known causes outside
of like neurological conditions like Ms. Parkinson's, spinal
cord issues that can lead directly to OAB symptoms.
But for a lot of people, there'sno physical cause.
And so some, well actually pelvic floor dysfunction can be
a physical 'cause I shouldn't say that, but yeah, pelvic floor
dysfunction is a common 1. So if your pelvic floor muscles
(10:08):
are really tight or they can be loose, usually I see people's
being tight or dysfunctional, they're not working properly.
That can cause more pressure on your bladder and that urge to
urinate the nervous system dysfunction.
So if you're, if you are stuck in a state of fight or flight,
like that is going to trigger, it could trigger a variety of
(10:32):
physical symptoms, but for people with IE that's going to
trigger the bladder symptoms. Interesting.
So that's a topic we can definitely dive into.
I, I really love talking about that.
You know, there's, there's hormone issues that some people
can experience where maybe they have like a like estrogen
(10:54):
atrophy and they may experience an increase in their urinary
symptoms. A lot of the times we'll see
pain with that. But I think there are people
that don't have pain. You know, there could be, there
could be some other things, but I would say those are the top
couple. OK.
And so when you say nervous system dysregulation, like what?
(11:17):
Yeah, what does that, what does that mean?
And what's like what, what is the cause of that?
I guess most, most people. Great.
Question. Yeah.
So where do we start with this? So your nervous system is meant
to protect you from threats. We have this.
We have a couple different nervous system states that we go
(11:38):
through just as humans. We are wired to have a state of
rest and digest. We have fight or flight, we have
freeze. And so when there is some sort
of threat, whether that is like a lion is chasing you, whether
that is a car accident or something normal like a meeting
that you have at work or like a fight that you have with a
(11:59):
friend or a family member. Like that can also be viewed as
a threat or as some sort of stress.
And our nervous systems are meant to go through this stress
response where, you know, we go into that fight or flight
response and there's a lot of different things that happen in
your body. It pumps out these stress
hormones that get you ready to either fight something or run
(12:20):
away from it. And that can lead to your
digestion slowing down, you know, different changes, like
your breathing gets shallow, your blood pressure increases,
things like that. And there's also a freeze
response, but I'm going to kind of skip it to keep this on the
(12:40):
shorter side. So we're meant to, once that
threat goes away, go back into that rest and digest slash
safety state where everything iscalm.
Our breathing goes back to beingvery deep and we have like no
tension in our body. We don't have any sort of threat
and we just feel calm and safe. That's where we're supposed to
(13:02):
end up. But people with chronic symptoms
like OABICIBS, whatever that maybe, you're getting stuck in that
chronic stress state, which means, you know, that's where
you start to see digestive issues.
That's where you start to see urinary issues.
Maybe you have chronic pain. I see a lot of people coming to
(13:25):
me who have developed these characteristic traits that are
things like perfectionism, people pleasing, always needing
to be in control, rumination, having a sense of urgency to
figure out what's wrong with youor just like get stuff done as
soon as possible. And these, I've come to learn,
(13:47):
are our bodies way of hoping andadapting to stress and trauma.
So I feel like I just talked a whole lot, but did that make
sense? Yeah, no, that definitely did
make sense. I think with stress, like even,
you know, it's not something that we can avoid entirely.
(14:07):
And like stress is actually can be a positive thing because like
you said it, it like motivates us to react and like our body
sort of gets resources ready. And like in certain
circumstances, like preparing for a test or you know, even
athletes at a competition, like it gets you ready, it gets you
excited to actually perform better.
(14:29):
But if we're always sort of reacting in the like fight or
flight response to everything and every little stressor.
And then maybe we don't have time to sort of come down
between those events and get back into the rest and digest
and sort of have better mechanisms of maybe, you know,
being more resilient to the stress and coping with it.
That's when sort of it can 'cause you know, our body and
(14:50):
nervous system to go off track and then result in sort of these
these conditions like overactivebladder.
And yeah, with IBS too, because of the gut brain connection, I
guess with with IBS, we say likewe talk a lot about the gut
brain axis, I guess is there, I haven't heard it yet, but is
there a bladder brain? I've seen, but I'm sure we can
(15:13):
and we can assume that there's something there.
I mean, yeah, I think there is abig connection, especially
between the gut and the bladder.I mean, for me personally, when
my IBS flares up, my bladder will also flare up.
It's the most annoying thing in the world.
But it's like this is a total stress response that is my #1
trigger. I only ever have a little bit of
(15:35):
symptoms as a result of some sort of like big stress in life.
And I'm on that nervous system regulation journey.
But yeah, it's definitely all connected.
Usually there is some sort of pelvic floor dysfunction
involved. And yeah, I mean, I, I truly
believe that the root of bladderconditions, at least the, the
(15:56):
OAB and I see, I believe it is that that nervous system and
teaching it that it is safe, that there is threat.
And the clients that I work with, who we, we work on these
practices, nervous system regulation practices, their
symptoms. I have people who get relief
within a couple of weeks. It is it, it's honestly mind
(16:20):
blowing. But at the same time, like it's
not surprising once you really get educated on it.
And I just it, it's, it's amazing how how powerful that
work is. Yeah, definitely, definitely.
I know. Even.
I guess I should ask, have you read the book When the Body Says
No? Like.
(16:40):
No, OK. Books on this topic, I just have
not gotten to that one yet. Yeah, Yeah.
So that one, I think it was published like early 2000s, but
the idea behind it is that sort of like being in a state of
emotional repression where maybeyou for a lot of people like
maybe grew up in like a controlling family or always
(17:02):
sort of had to be on your best behavior.
Or sort of like were the parent like as a child and didn't
really have like supportive family relationship.
That then can sort of lead to like, you know, internal stress
in older life and maybe a lack of happy boundaries or sort of
lack like self-care mechanisms. And then in turn, that sort of
creates that, like internal stress and can cause the immune
(17:24):
system to sort of like go out ofwhack or go off track and can
result in like different sort ofdisease states.
So I think it kind of leads backto what you said about the
nervous system regulation. And probably for some people,
maybe it's like a little bit easier to fix through sort of
daily practices, but then other people maybe need to work
through things a little bit deeper, like therapy or sort of
(17:48):
that like, yeah, yeah. Deeper practice.
But it's very interesting, like,yeah.
Yeah, I I've been digging into some of the resources.
I recently read the Pain Reprocessing Therapy workbook.
It is phenomenal. Even if you don't have pain, you
can substitute whatever symptom you're experiencing for the word
pain and not. We did book club in my program
(18:13):
on that. Everyone loved it.
It helped so many people. Another good one is the Bot or
not that one. Well The Body Keeps the Score is
really good, but I was thinking of The Way Out by Alan Gordon is
another good one. Yeah, yeah.
So is that kind of the concept of just like the words and the
vocabulary that you use? Yes.
(18:33):
Yeah, it is. Yeah.
Yeah, I like the, I think it wasTony Robbins who developed it.
But the concept of transformational vocabulary, so
just catching like the words that you use and a lot of us
just tend to default to like inflammatory words like
frustrated or anxious or pain ordepressed.
But even just trying to swap those words for maybe less, less
(18:57):
inflammatory words, like you're feeling challenged and instead
of frustrated or your body's working through something
instead of feeling pain, like even just that can actually help
your nervous system to calm downa little bit.
So even just like the way that we talk about our body and the
way we talk about our symptoms can can make a difference.
It's, it's crazy how complex it is.
And I think that's one thing that maybe the sort of
(19:20):
conventional medical system doesn't fully focus on is sort
of that real impact of like the mind and, and emotional and
mental stress and how it really can impact like development of
disease and then also our ability to like manage.
Right. It's hard because when you go to
a doctor, they might mention like, hey, how's your stress?
And it's like we don't really realize how impactful that is.
(19:45):
You may not feel stressed, but alot of us on a day-to-day basis,
like our baseline is super high.We're just used to the go, go,
go of day-to-day life. And you know, for me, I didn't
really take stress seriously. Back when I was going through
all my treatment journey and everything, I was dead set on
(20:07):
the idea that there would be some sort of medication or
medical treatment that was goingto cure my symptoms.
And spoiled clerk. They did not.
I tried everything offered to me.
No relief was given and it a lotof the things made me worse
because they were invasive and Iwas a very sensitive person
(20:30):
physically and mentally. But yeah, I didn't get relief
until I really started focusing on, OK, what is at the root of
the problem? OK, it's my nerve, stomach, my
pelvic floor. Let's get those things
addressed. And after that, it only took a
couple months for me to get relief.
It was crazy after suffering forover 2 decades.
And just sort of getting to the actual root of what was
(20:52):
contributing. Yeah.
What are the what are sort of the typical like medical
treatments that would be prescribed for OAB?
For OAB on pelvic floor, physical therapy is a big one.
OK, that, I mean, I can't say enough good things about it.
I would definitely if you have bladder symptoms like get into
(21:13):
be evaluated by a PT if you havethe means.
Yeah, for sure. You know, you obviously want to
rule out infection. Just wanted to say that just in
case. We want to make sure that that's
that's not in existence. There are some medications you
can try. There's things like Myrbetriq,
Jemtessa, amitriptyline, couple things, but it's all going to be
(21:34):
trial and error. There is, you could do bladder
training, you could try like thethe stem, like the nerve
stimulation, they're Botox injections that you can get in
your bladder. But obviously that is a bit
risky because some people develop retention and they have,
(21:54):
they can't pee on their own. They have to catheterize
themselves. And so a lot of it does come
with risks. Definitely.
So I guess, like, do you typically suggest, I think I
know the answer, but to sort of work on maybe that nervous
system regulation getting a bit more into what's contributing to
(22:14):
the OAB versus trying like thesemedications or sort of these
more invasive therapies? Yeah, I mean, I don't like to
tell people what to do. We have to be careful with that.
But I always frame it like if I were to be diagnosed with OAB
again, if I could go back and doit again, I would focus on my
nervous system first. I would adjust my pelvic floor
(22:36):
at pelvic floor PT right away and I would make sure I'm doing
just the normal things like staying hydrated and, you know,
seeing if I have any sort of diet irritants, which we could
talk about that, but that's kindof where I would start.
Yeah, that makes sense for sure.And I want to say no judgement
if anybody tries medications andall that stuff I just mentioned,
(22:58):
I did it. So absolutely no judgement
there. Some of this stuff does work for
people, but for me it didn't. So it sounds like there's a lot,
there's a lot of avenues to explore and I think it's worth
it, like working with the right treatment team.
So I think based on what you're saying, probably if someone
could build like their perfect treatment team for OAB, there
(23:20):
would be sleep dietitian specializing in bladder health,
pelvic floor therapist and I guess a urologist is sort of
your medical specialist. Would you add anything or?
Ologist. I found more success as a woman
with a urogynecologist, but you never know.
(23:41):
A urologist could get the job done and then like men, would
see them. Yeah.
Is that a common specialty? I I don't.
Know, yeah, it's fairly common here.
I don't know about in Canada if you guys have that.
I don't. I don't know if I've ever even
heard that term. Maybe it's just because you're
not really in this niche, but who knows.
Yeah, Yeah. OK.
Interesting. So they obviously do a
(24:03):
combination of gynecology and urology.
Yeah, that's awesome. Yeah.
I guess we can talk a little bitmore around the link between IBS
or sort of digestive conditions and bladder issues.
I know I see it a lot with my IBS clients, like some who are
(24:24):
very active, like I have some runners with gut issues or IBS
and something that they complainabout is like frequent need to
pee on their runs, which is not fun.
And then I have some clients whoaren't as active, but obviously
working to like get get your bowels moving and support your
bowel health. Part of that is hydration, but
it could be difficult when they're needing to like pee
(24:46):
pretty frequently. And that kind of works against
people are sort of a barrier to staying well hydrated.
So yeah, if you want to maybe walk us through a little bit
more about what what the connection is between sort of
the gut and the bladder. Yeah, yeah, I think we brushed
on it a little bit. I mean, I think there is some
Oregon crosstalk going on. I I do see a lot of overlap with
(25:11):
digestive issues and bladder issues and not, not a fun
combination. I mean, I told you I have, I've
had both things going on and it's it's just a lot.
And you know, you really just got to find what is what is
causing this. Is it a stress issue?
Is it a pelvic floor issue? Is it something else?
(25:31):
But I know you mentioned hydration.
That is something I really want to emphasize here.
A lot of people think that if you drink less, you will have to
pee less. Yeah.
That is not true as a myth when you are not hydrated.
So let's say you're dehydrated, your urine is more concentrated.
So if you think your urine is, it consists of all of the waste
(25:54):
products that your body's tryingto get out.
We don't really want it sitting in our bladder for that long.
And sorry, my train of thought just went down a whole other
Ave. but that's a great thing. Gotta bring it back.
What was I saying before in the beginning?
Oh my God. Yeah, we're going through the
(26:14):
gut, gut bladder connection. Sorry, yes.
So when you are dehydrated, yoururine is more concentrated.
And if your bladder wall is a bit irritated for whatever
reason, it might be sensitive tothose toxins that are in your
urine. Or for example, if you are
consuming like bladder irritantslike caffeine or alcohol or
(26:41):
spicy foods or tomatoes, like those are kind of the top water
irritants that can trigger some symptoms, especially if your
bladder wall is already, you know, a bit aggravated.
So we need to have hydration. We need, I, I usually tell
people because everyone's hydration needs are different.
(27:01):
If you're working out, it's going to be more.
If you live in a hot climate andyou're sweating more, you're
going to need more. If you're on certain
medications, might need more. And yeah, there's a lot of
different factors there. So just generally I tell people,
shoot for the 8 glasses, the 64 ounces, you know, give or take.
And once you're hydrated, that is where you can start working
(27:27):
on things like bladder training and like rewiring that
connection between your bladder and your brain that is kind of
miscommunicating at that point because a lot of people with
those symptoms of frequency and urgency, like they're only
peeing a little bit usually. And that's because the bladder
has somehow gotten trained to alert your brain that it's time
(27:48):
to go before it's actually readyto go.
So there's a lot of different things that you can do, but
hydration is like the number onefirst step I would start up.
Yeah, definitely. Yeah.
I like that you address that myth because I've definitely had
new clients who are like, I can only drink five cups a day,
otherwise I have to pee all the time and I can't go more than
(28:08):
that. But to your point, like being
dehydrated actually will make the symptoms worse.
So it's not going to work against you.
As for me, typically I'll like if someone is struggling with
overactive bladder, I generally just reinforce like trying to
start drinking and hydrating early in the morning and sort of
sipping through the day. So you're spreading out that
(28:29):
fluid intake usually suggest maybe tapering it off like by
dinner time. And then if they have something
after dinner, like a little bit of herbal tea that they sip on.
I know sometimes just trying to be mindful of caffeine, citrus
juices, alcohol, sort of the bigtriggers and then trying not to
(28:51):
I guess always pee like just in case.
So that's what I recommend. But is there anything else that
you maybe suggest for your clients or anything you'd add to
that for like? It's funny, I like an hour ago
on certain bladder habits to stop doing and peeing in case
was one of them. Yes, yes.
So yeah, in case is essentially training your bladder to go when
(29:13):
it is a little bit too early. And there are certain times when
peeing just in case is OK. That is after sex, before bed,
when you wake up in the morning and if you're going on like a
car or a plane ride longer than an hour and a half to chew up
towers where you know there's not going to be any sort of
bathroom. So peeing just in case is 1.
Pushing to pee, that is recipe for disaster.
(29:38):
If you're having issues where you can't pee unless you're
pushing, go to the pelvic floor physical therapist.
Another one is rushing to the toilet.
So if you are like, hustling to the toilet and like, you feel
like you're going to pee your pants, you're kind of retraining
your brain and your bladder to not really work together.
(29:59):
It's telling yourself that your bladder's in charge and not your
brain. So you really need to work on
calmly walking to the bathroom if you have that urge.
And then another big one that women are usually guilty of is
hovering over the toilet. This is OK.
Mean like if you're using a pelvic or sorry, a public
(30:22):
toilet. Yes.
And you're like. Squatting so you're not sitting.
Correct. Yes, once in a while.
This is a You're out like your. Kids, It's like a nasty toilet
though, and you don't want to. Sit.
Exactly yes, exactly. Just don't make it a habit
because you know there's some risks there.
Your pelvic floor like really can't relax like it should yeah
(30:44):
have an increased risk of of having some urine leftover,
which could increase your risk of UTI.
You can risk prolapse. There's some things that if this
is habitual, it can increase your risk of certain things.
So I know that public toilet seats can be nasty, so use your
best judgment. But for me, I just, I take the
(31:05):
toilet paper, I wipe it and thenI put another layer on and then
I sit down. It's just so much easier to sit
down. So yeah, those are some of the
the bladder habits that I would recommend.
OK. Is that a common thing for I?
I don't think it's something that I've done, but I'd like to
hover over the toilet. Is that like a way to work your
(31:26):
glute muscles a little bit more or I'm wondering why that's
common? Most of the women in my life,
like I know a lot of people do this and yeah, I don't know.
If this is a society. Difference.
I mean, I know when I went to like Europe, some of the places
didn't even have toilet seats. And I'm like, how are you
supposed to do this? Yes, well, maybe.
(31:49):
In those cultures it's a little different, but I don't know.
Who knows? I don't know what their race is
of overactive bladder and pelvicdysfunction or interesting.
OK. Yeah.
So yeah, I think that's really, really helpful.
Anything else you'd add to like the dietary triggers?
(32:12):
Yeah, to be mindful of? It sounds like it's not really
the big like sort of maybe contributor for most people, but
yeah, for people who maybe diet is contributing.
What would you add to that list?Right.
So I mean, just for the average human, like drinks that contain
caffeine are going to make you pee more.
It's just a are we drinking these things in moderation, like
(32:35):
the coffee, the the tea, things like that.
And I will say that most of the people that I work with aren't
diet sensitive. But for those people who are,
it's usually a symptom of another underlying condition
like we talked about before. And once they address those
conditions, diet activity usually goes away, OK?
(33:00):
That doesn't mean like if somebody went crazy and drank a
bunch of alcohol that they're going to have like totally
normal urine output. Like, no, no, everything was not
arrange it. But I would say if you are at
the beginning of your journey orif you're in a flare up, you may
want to be mindful of consuming some of the things I've been
talking about, the alcohol, the coffee, the like if you're like
(33:24):
a black tea drinker, that's one.Carbonated beverages can can be
bothersome for some people. The foods we're looking at
citrus, citrus products, juices like you said, tomatoes, tomato
products, spicy foods, things like that.
Yeah, those are like the top offenders usually.
(33:46):
But again, don't assume you're diet sensitive.
If you want to know for sure, you can do an elimination diet
where you remove these items fora couple of weeks and then you
test them back in one at a time to determine if you are
sensitive to it. But I will say, if you are
sensitive to something, that doesn't mean it's going to be
like that forever. Like I said, you can overcome
(34:09):
this as your symptoms decrease. Similar with IBS too, because a
lot of the like the food intolerances are then sort of
driven by the gut brain connection and something's going
on where the like the nerves andthe gut are hypersensitive,
which is not always due to like the food itself.
Like it can be a microbiome imbalance or nervous system
(34:31):
dysregulation. And then people maybe are more
sensitive to things like bot maps or different food groups,
but oftentimes are they getting to more of the root of the
issue, like working on the nervous system and even
rebalancing the microbiome, thenthey can better tolerate those
foods. So I think that's a good point
as well. Like often food intolerances are
just aren't just like the only part of the picture.
(34:53):
Like there's usually a deeper level going on, which I think is
nice for a lot of people to heartoo, because most people don't
want to have to cut out or be more restrictive around food.
So I think that was a good one to to highlight as.
High on that hill. Definitely around caffeine.
I have two follow up questions to that.
(35:16):
The first one, is it just the like the caffeine content or is
it the the tannins in coffee andblack tea that can increase
urgency or is it both? It it's usually the caffeine.
There are some theories about the just the acid content in
those beverages. We're not sure if the acid is
playing a role. Yeah.
(35:38):
You know, when you eat somethinglike a, if you have like lemon
juice, like it goes in as an acid, but your body digests it
and it ends up being it's like alkaline and you digest it.
So it's, the research isn't solid in terms of tannins.
I don't know. I haven't seen any research on
that specifically. But it's possible that there's
(35:58):
something out there I might needto go look.
OK, Yeah. And then the other question was
around coffee. I know it's been sort of like
debated and we've gone back and forth, but the last I sort of
looked at the research around like coffee and needing to pee
was that if you're like sort of caffeine adapted like you're
someone who's in habitual coffeedrinker, it doesn't make you
(36:19):
have to pee as much as someone who like only drinks coffee once
in a while or is like a newer coffee drinker.
I don't know any any thoughts onthat or?
That recently, but I'm just thinking of myself like I, I
feel like I'm a consistent coffee drinker and I still
notice like an increase to pee after I drink my coffee, but
(36:40):
it's nothing like it's just a small difference in my heart and
like if I hadn't drank coffee. So personally, like just a
little bit of a difference for me.
But in terms of the research, I haven't seen anything recently
on that. Yeah, OK.
I feel like it's, yeah, I know for me I always like because I
(37:02):
have like half a liter when I wake up and then I work out and
I'll have like another liter of fluids and then I have coffee
and like we'll have to be a few times in the morning.
But I think it's just a combination of like fluids plus
coffee. I don't know if it'd be any
different if I didn't have coffee, but maybe.
Be an interesting experiment. You might feel really bad.
(37:26):
Oh, and the other one around, I guess IBS and the like the
bladder connection, I know too when someone maybe struggles
more with Constipation or like IBSC.
So they often get the colon or the rectums like full of stool
literally that it like sort of presses on the bladder because
they share like the same space. So I guess even back to like the
(37:48):
dietary part of it, if maybe someone's not eating the right
balance of fiber types or enoughfoods to sort of keep their
bowels regular, then that may also like sort of worsen the,
the OAB symptoms. Is that right?
Yep, Yep. Constipation is a pretty common
(38:09):
trigger. And just like you said that you
need to address the diet component of that in addition to
like the hydration and the movement and all of that stuff.
But yeah, yeah, that is a prettycommon thing.
Yeah. So even in that case, not so
much maybe what they're eating, but maybe what they're not
getting enough of, right to keepsort of things regular.
(38:29):
Cool. Yeah, I think we went through
quite a lot. I guess just to maybe take
things home, what would sort of be maybe two or three takeaways
for someone wanting to improve their bladder health function?
Where would they? Would they get started?
I'm speaking to people with bladder symptoms.
(38:52):
You want to elaborate? I'm just, I mean, it's going to
be a little different for peoplethat just are normal and have no
bladder symptoms. They pee normally.
Like for those people I feel like maintain good hydration
and, you know, consume bladder irritants in moderation on yeah,
(39:16):
I mean just just basics for them.
And then for people with bladdersymptoms, I mean, if you, if you
think there's something wrong, you know, go see a urologist or
urogynecologist, possibly get into pelvic PT, figure out if
that's contributing. But I would say like if you're
listening and you have OAB or you think you have OAB, just
(39:37):
understand that there is hope that you can get relief.
There may not be a ton on the Internet about like what we're
talking about and how to get relief, but I think the
information is coming out. I mean, I'm posting everywhere
on social media like what I'm learning through working with my
clients. And you know, there, there just
(39:58):
is. There is hope.
And you really need to start with your mindset.
You need to believe that you canget better because if you don't,
you probably won't. So I mean, those are my words of
wisdom. Yeah, for sure.
I think it's like it's the same with with IBS or other
conditions too. Like there's a lot of sort of,
we'll just use the term like cookie cutter information online
(40:20):
like Web MD, Healthline, like all sort of the basic stuff that
you've probably heard or been told.
But I think it's a different thing with maybe you work with
an expert or someone who specializes in this, who sees it
all the time and is sort of likeworked with many people in this
condition and is able to sort ofhelp you look like a bit deeper
(40:40):
and really get to like more of the, the strategies that are
going to give you results ratherthan sort of the, the
foundational things. That's not to say like the
foundational stuff can't help. But I think for a lot of people
probably with this and with IBS to like it can be quite complex
and usually need more than just sort of the the basics online
for most people. Definitely, yeah.
(41:05):
Yeah, so I guess just to end things off, how can people get
in touch with you and how can listeners learn more?
You know, go follow me on socialmedia, like on Instagram and
tech talk at Cali K Nutrition. I have a podcast of my own.
It's called ICU. We focus on both IC and OAB and
(41:26):
bladder health on there. I'm sure we can link that in the
show notes. And then, yeah, I mean, those
are the best places to connect with me.
Cool, awesome. I will.
Yeah. I'll link those in the show
notes. We did talk a lot about the
pelvic floor support. So I actually have a future
episode coming out on pelvic floor therapy.
(41:46):
So I'll link to that below because super important, both
with IBS and with OIB for sure. All right, well, thanks, Kelly
so much. It's been a great conversation.
And I'm sure there's probably a lot of light bulb moments for
listeners today. So thanks for coming on.
You're welcome. Thanks for having me.
(42:06):
That's a wrap for today's episode.
Thank you so much for listening and being a part of our
community here. If the Gut Fit Nutrition podcast
is giving you value, helped yourdigestion and fitness, made you
rethink how you approach your gut health, consider leaving a
review on Apple, Spotify, or wherever you're getting your
podcasts. If you have questions for my
listener Q&A episodes, you can submit them as a comment on this
(42:29):
episode or send me an e-mail at lee@leemorado.com.
For more digestible IBS gut health and fitness tips, be sure
to follow me on Instagram at LeeMorado under score Rd. and to
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freebie, visit gotfitnutrition.com.
Thanks for tuning in. We'll be in touch soon.
A lot of people think that if you drink less, you will have to
pee less. That is not true as a myth when
you are not hydrated. So let's say you're dehydrated,
your urine is more concentrated.So if you think your urine is,
it consists of all of the waste products that your body is
(00:20):
trying to get out. We don't really want it sitting
in our bladder for that long. But when you are dehydrated,
your urine is more concentrated.And if your bladder wall is a
bit irritated for whatever reason, it might be sensitive to
those toxins that are in your urine.
Or for example, if you are consuming like bladder irritants
(00:41):
like caffeine or alcohol or spicy foods or tomatoes, like
those are kind of the top water irritants that can trigger some
symptoms, especially if your bladder wall is already, you
know, a bit aggravated. Welcome to the Gut Fit Nutrition
Podcast, the show where we dive deep into the world of gut
(01:03):
health, nutrition, and fitness to help you unlock your best
self from the inside out. I'm your host, Lee Morado, a
registered dietitian, gut healthexpert, long distance runner,
and movement enthusiast on a mission to empower you with
science backed whole body strategies to fuel your body,
heal your gut, and thrive in your active life.
Whether you're here to finally break free from IBS and
(01:24):
digestive symptoms, optimize your fitness performance, or
learn how to support your gut health with natural strategies,
you're in the right place. Each week, we'll explore topics
like conquering digestive symptoms, building a gut
friendly lifestyle, enhancing endurance and strength
performance, and more. So grab a cup of your favorite
gut friendly tea and settle in because we're about to get gut
(01:45):
fit together. Today's episode is 1 I know many
of you have been waiting for, especially if you've ever found
yourself constantly scanning forthe nearest bathroom, cutting
workouts short, or struggling tostay hydrated without triggering
the urge to pee. Yet again, we're talking about
overactive bladder, or OABA, condition that affects millions
yet is often misunderstood or brushed off as just something to
(02:07):
deal with. But OAB is more than a minor
inconvenience. It can have a significant impact
on your quality of life, your confidence, your workouts, and
even your digestive health. So if you've been silently
wondering, is this normal or canI actually do something about
this, this episode is for you. I'm thrilled to be joined by
Cali K MSRD, also known as the Bladder Dietitian.
(02:30):
Cali is a registered dietitian and one of the leading voices in
bladder health education and support.
She's the founder of Cali K Nutrition, host of the ICU
podcast, and a tireless advocatefor those living with conditions
like interstitial cystitis and overactive bladder.
Let's get into it. Super excited to have you on
today. I think this is a really
(02:52):
important talk. I've gotten actually some
requests for chat around overactive bladder.
So I'm happy to have you on because I know you're the the
expert in this topic. The expert, thank you.
I'm so excited to talk about allthings bladder.
Yeah, for sure. I guess just to start off and
give listeners some background around you.
(03:14):
I'm sure probably quite a few people are listening or already
familiar with you, but for thosewho aren't, just tell us a bit
more about yourself, where you're located, how you help
people, and who you help. Yes.
So I am Callie Kreicher. I am located about an hour
outside of Philadelphia in the United States.
(03:35):
I am a bladder dietitian, so youprobably didn't know that we
existed, and that's because I'm the first person that is like
actually specializing in bladderhealth.
The conditions that I help people with include interstocial
cystitis and overactive bladder and some overlapping conditions
(03:55):
as well. And I am an IC and an OAB
patient. I struggled with bladder pain
for the 1st 25 years of my life.I am now totally pain free.
And I also struggled with OAB during my college years and I
was able to also completely overcome that.
And I pee normally now. And yeah, I'm basically helping
(04:18):
people get relief like I have through lifestyle changes.
And, you know, we're just reallyfocused on the hope element of
living with these chronic conditions.
And I just really like to help people understand that you can
overcome these symptoms, you canlive a normal life.
(04:39):
And yeah, that's kind of the gist of it.
Yeah, for sure. Do you work mainly with women or
work with like all? Yeah, I just work with women.
I am currently developing a selfstudy option for my program that
men can do so that is going to launch in a couple of weeks.
(05:01):
Cool, awesome. And I guess for yourself, like
when you first started dealing with the the symptoms of those
conditions, like how did you sort of find yourself, I guess
maybe trying to reach out for support medical community and
sort of navigating like the condition in the early stages?
Yeah, so like I said, bladder pain since I was a kid.
(05:22):
So that was really tough for me,navigating that because no one
around me was talking about their bladder or they were
struggling, always going to the toilet.
And so I kind of just suffered in silence until I was 18.
I ended up getting diagnosed with ICI, had this procedure
done, called a hydro distention,where they essentially put you
(05:43):
under anesthesia and they blow your bladder up and they stretch
it. And after that procedure, I
developed, developed frequent urinary frequency and urgency.
So I felt like I had to pee all the time.
I was going every 20 minutes, you know, I could, I was living
on the toilet and it really affected my life.
Those were my college years, unfortunately.
(06:04):
And there was just a ton going on.
I was playing volleyball in college, I was studying, I was
eating different foods, doing different social events,
drinking alcohol. So there was a lot going on, and
I got the OAB diagnosis kind of easily because I already had
that IC diagnosis and a lot of people do just get diagnosed
(06:27):
with both. And yeah, after that I started
my treatment journey. Happy to elaborate on that, but
I'm going to stop there. In case, you know, that's
helpful. Yeah.
And I can imagine too like just with all the things that you
want to be doing in university, like for one, being in class and
being able to like sit through the lecture, but also like
(06:48):
engaging in like extracurriculars, playing
sports, like those are all things that you need to be
present for. And you can't be running to the
washroom every 20 minutes I. Remember I, I think it was
either biology or anatomy class and just thinking like I just
went to the bathroom 10 minutes ago.
I cannot go to the bathroom again even though I feel like my
(07:09):
bladder is going to explode because I'm so afraid that
people were going to judge me and be like, why is this girl
like leaving or going to the bathroom so much?
So it was definitely a mind gamein addition to the physical
symptoms. Yeah, definitely.
It's just breaking down overactive bladder OAB, Like
what how do you know that it is something you're dealing with
(07:32):
versus just like needing to pee a lot because you're, you know,
you drink a lot of fluids and coffee.
It's like, what's sort of the the difference there?
No, that's a good question. So I mean, the average person
urinates like 6 to 8 times per day.
That's what's considered normal.And then zero to 1 times at
(07:52):
night. And so I mean, like you said,
like there are if you're over hydrated or you're hydrating
well like that may be a little bit more.
But if you're getting to the point where it's getting in the
way of you living your life and you feeling it excessive like
that is the point where you may want to get connected with a
urologist or urogynecologist. But like the common symptoms of
(08:14):
overactive bladder are that sudden intense urge to urinate,
feeling you have to pee all the time.
Maybe you just went and then youstand up and you already feel
like you have to go again. Waking up multiple times at
night. We call that nocturia.
And then some people experience incontinence, usually urge
incontinence, which means you might leak urine before you go
(08:36):
to the bathroom. And there's also stress
incontinence, which just means like when you feel stressed,
when that that symptom arises. So those are like the common
symptoms of OAB. Yeah.
And do you feel like it's something that just happens like
in isolation or is it sort of like a secondary, you know,
result of of sort of a bigger 'cause like pelvic floor
(09:00):
dysfunction or, you know, other?Overlapping with a lot of
conditions like pelvic floor dysfunction, like I see like
IBS, you know, chronic fatigue, autoimmune conditions, things
like that. And yeah, we're, I'm sure we're
going to talk about like root causes, things like that.
But the most common root cause, what is causing these symptoms
(09:25):
in my clients is it's regulated nervous system, which usually is
triggering pelvic floor dysfunction as well.
So it's kind of like this dominoeffect.
OK. That's interesting.
Actually leading into that, can you break down sort of the
common root causes of of overactive bladder?
Yeah, for sure. So we don't have any like set in
(09:45):
stone. These are known causes outside
of like neurological conditions like Ms. Parkinson's, spinal
cord issues that can lead directly to OAB symptoms.
But for a lot of people, there'sno physical cause.
And so some, well actually pelvic floor dysfunction can be
a physical 'cause I shouldn't say that, but yeah, pelvic floor
dysfunction is a common 1. So if your pelvic floor muscles
(10:08):
are really tight or they can be loose, usually I see people's
being tight or dysfunctional, they're not working properly.
That can cause more pressure on your bladder and that urge to
urinate the nervous system dysfunction.
So if you're, if you are stuck in a state of fight or flight,
like that is going to trigger, it could trigger a variety of
(10:32):
physical symptoms, but for people with IE that's going to
trigger the bladder symptoms. Interesting.
So that's a topic we can definitely dive into.
I, I really love talking about that.
You know, there's, there's hormone issues that some people
can experience where maybe they have like a like estrogen
(10:54):
atrophy and they may experience an increase in their urinary
symptoms. A lot of the times we'll see
pain with that. But I think there are people
that don't have pain. You know, there could be, there
could be some other things, but I would say those are the top
couple. OK.
And so when you say nervous system dysregulation, like what?
(11:17):
Yeah, what does that, what does that mean?
And what's like what, what is the cause of that?
I guess most, most people. Great.
Question. Yeah.
So where do we start with this? So your nervous system is meant
to protect you from threats. We have this.
We have a couple different nervous system states that we go
(11:38):
through just as humans. We are wired to have a state of
rest and digest. We have fight or flight, we have
freeze. And so when there is some sort
of threat, whether that is like a lion is chasing you, whether
that is a car accident or something normal like a meeting
that you have at work or like a fight that you have with a
(11:59):
friend or a family member. Like that can also be viewed as
a threat or as some sort of stress.
And our nervous systems are meant to go through this stress
response where, you know, we go into that fight or flight
response and there's a lot of different things that happen in
your body. It pumps out these stress
hormones that get you ready to either fight something or run
(12:20):
away from it. And that can lead to your
digestion slowing down, you know, different changes, like
your breathing gets shallow, your blood pressure increases,
things like that. And there's also a freeze
response, but I'm going to kind of skip it to keep this on the
(12:40):
shorter side. So we're meant to, once that
threat goes away, go back into that rest and digest slash
safety state where everything iscalm.
Our breathing goes back to beingvery deep and we have like no
tension in our body. We don't have any sort of threat
and we just feel calm and safe. That's where we're supposed to
(13:02):
end up. But people with chronic symptoms
like OABICIBS, whatever that maybe, you're getting stuck in that
chronic stress state, which means, you know, that's where
you start to see digestive issues.
That's where you start to see urinary issues.
Maybe you have chronic pain. I see a lot of people coming to
(13:25):
me who have developed these characteristic traits that are
things like perfectionism, people pleasing, always needing
to be in control, rumination, having a sense of urgency to
figure out what's wrong with youor just like get stuff done as
soon as possible. And these, I've come to learn,
(13:47):
are our bodies way of hoping andadapting to stress and trauma.
So I feel like I just talked a whole lot, but did that make
sense? Yeah, no, that definitely did
make sense. I think with stress, like even,
you know, it's not something that we can avoid entirely.
(14:07):
And like stress is actually can be a positive thing because like
you said it, it like motivates us to react and like our body
sort of gets resources ready. And like in certain
circumstances, like preparing for a test or you know, even
athletes at a competition, like it gets you ready, it gets you
excited to actually perform better.
(14:29):
But if we're always sort of reacting in the like fight or
flight response to everything and every little stressor.
And then maybe we don't have time to sort of come down
between those events and get back into the rest and digest
and sort of have better mechanisms of maybe, you know,
being more resilient to the stress and coping with it.
That's when sort of it can 'cause you know, our body and
(14:50):
nervous system to go off track and then result in sort of these
these conditions like overactivebladder.
And yeah, with IBS too, because of the gut brain connection, I
guess with with IBS, we say likewe talk a lot about the gut
brain axis, I guess is there, I haven't heard it yet, but is
there a bladder brain? I've seen, but I'm sure we can
(15:13):
and we can assume that there's something there.
I mean, yeah, I think there is abig connection, especially
between the gut and the bladder.I mean, for me personally, when
my IBS flares up, my bladder will also flare up.
It's the most annoying thing in the world.
But it's like this is a total stress response that is my #1
trigger. I only ever have a little bit of
(15:35):
symptoms as a result of some sort of like big stress in life.
And I'm on that nervous system regulation journey.
But yeah, it's definitely all connected.
Usually there is some sort of pelvic floor dysfunction
involved. And yeah, I mean, I, I truly
believe that the root of bladderconditions, at least the, the
(15:56):
OAB and I see, I believe it is that that nervous system and
teaching it that it is safe, that there is threat.
And the clients that I work with, who we, we work on these
practices, nervous system regulation practices, their
symptoms. I have people who get relief
within a couple of weeks. It is it, it's honestly mind
(16:20):
blowing. But at the same time, like it's
not surprising once you really get educated on it.
And I just it, it's, it's amazing how how powerful that
work is. Yeah, definitely, definitely.
I know. Even.
I guess I should ask, have you read the book When the Body Says
No? Like.
(16:40):
No, OK. Books on this topic, I just have
not gotten to that one yet. Yeah, Yeah.
So that one, I think it was published like early 2000s, but
the idea behind it is that sort of like being in a state of
emotional repression where maybeyou for a lot of people like
maybe grew up in like a controlling family or always
(17:02):
sort of had to be on your best behavior.
Or sort of like were the parent like as a child and didn't
really have like supportive family relationship.
That then can sort of lead to like, you know, internal stress
in older life and maybe a lack of happy boundaries or sort of
lack like self-care mechanisms. And then in turn, that sort of
creates that, like internal stress and can cause the immune
(17:24):
system to sort of like go out ofwhack or go off track and can
result in like different sort ofdisease states.
So I think it kind of leads backto what you said about the
nervous system regulation. And probably for some people,
maybe it's like a little bit easier to fix through sort of
daily practices, but then other people maybe need to work
through things a little bit deeper, like therapy or sort of
(17:48):
that like, yeah, yeah. Deeper practice.
But it's very interesting, like,yeah.
Yeah, I I've been digging into some of the resources.
I recently read the Pain Reprocessing Therapy workbook.
It is phenomenal. Even if you don't have pain, you
can substitute whatever symptom you're experiencing for the word
pain and not. We did book club in my program
(18:13):
on that. Everyone loved it.
It helped so many people. Another good one is the Bot or
not that one. Well The Body Keeps the Score is
really good, but I was thinking of The Way Out by Alan Gordon is
another good one. Yeah, yeah.
So is that kind of the concept of just like the words and the
vocabulary that you use? Yes.
(18:33):
Yeah, it is. Yeah.
Yeah, I like the, I think it wasTony Robbins who developed it.
But the concept of transformational vocabulary, so
just catching like the words that you use and a lot of us
just tend to default to like inflammatory words like
frustrated or anxious or pain ordepressed.
But even just trying to swap those words for maybe less, less
(18:57):
inflammatory words, like you're feeling challenged and instead
of frustrated or your body's working through something
instead of feeling pain, like even just that can actually help
your nervous system to calm downa little bit.
So even just like the way that we talk about our body and the
way we talk about our symptoms can can make a difference.
It's, it's crazy how complex it is.
And I think that's one thing that maybe the sort of
(19:20):
conventional medical system doesn't fully focus on is sort
of that real impact of like the mind and, and emotional and
mental stress and how it really can impact like development of
disease and then also our ability to like manage.
Right. It's hard because when you go to
a doctor, they might mention like, hey, how's your stress?
And it's like we don't really realize how impactful that is.
(19:45):
You may not feel stressed, but alot of us on a day-to-day basis,
like our baseline is super high.We're just used to the go, go,
go of day-to-day life. And you know, for me, I didn't
really take stress seriously. Back when I was going through
all my treatment journey and everything, I was dead set on
(20:07):
the idea that there would be some sort of medication or
medical treatment that was goingto cure my symptoms.
And spoiled clerk. They did not.
I tried everything offered to me.
No relief was given and it a lotof the things made me worse
because they were invasive and Iwas a very sensitive person
(20:30):
physically and mentally. But yeah, I didn't get relief
until I really started focusing on, OK, what is at the root of
the problem? OK, it's my nerve, stomach, my
pelvic floor. Let's get those things
addressed. And after that, it only took a
couple months for me to get relief.
It was crazy after suffering forover 2 decades.
And just sort of getting to the actual root of what was
(20:52):
contributing. Yeah.
What are the what are sort of the typical like medical
treatments that would be prescribed for OAB?
For OAB on pelvic floor, physical therapy is a big one.
OK, that, I mean, I can't say enough good things about it.
I would definitely if you have bladder symptoms like get into
(21:13):
be evaluated by a PT if you havethe means.
Yeah, for sure. You know, you obviously want to
rule out infection. Just wanted to say that just in
case. We want to make sure that that's
that's not in existence. There are some medications you
can try. There's things like Myrbetriq,
Jemtessa, amitriptyline, couple things, but it's all going to be
(21:34):
trial and error. There is, you could do bladder
training, you could try like thethe stem, like the nerve
stimulation, they're Botox injections that you can get in
your bladder. But obviously that is a bit
risky because some people develop retention and they have,
(21:54):
they can't pee on their own. They have to catheterize
themselves. And so a lot of it does come
with risks. Definitely.
So I guess, like, do you typically suggest, I think I
know the answer, but to sort of work on maybe that nervous
system regulation getting a bit more into what's contributing to
(22:14):
the OAB versus trying like thesemedications or sort of these
more invasive therapies? Yeah, I mean, I don't like to
tell people what to do. We have to be careful with that.
But I always frame it like if I were to be diagnosed with OAB
again, if I could go back and doit again, I would focus on my
nervous system first. I would adjust my pelvic floor
(22:36):
at pelvic floor PT right away and I would make sure I'm doing
just the normal things like staying hydrated and, you know,
seeing if I have any sort of diet irritants, which we could
talk about that, but that's kindof where I would start.
Yeah, that makes sense for sure.And I want to say no judgement
if anybody tries medications andall that stuff I just mentioned,
(22:58):
I did it. So absolutely no judgement
there. Some of this stuff does work for
people, but for me it didn't. So it sounds like there's a lot,
there's a lot of avenues to explore and I think it's worth
it, like working with the right treatment team.
So I think based on what you're saying, probably if someone
could build like their perfect treatment team for OAB, there
(23:20):
would be sleep dietitian specializing in bladder health,
pelvic floor therapist and I guess a urologist is sort of
your medical specialist. Would you add anything or?
Ologist. I found more success as a woman
with a urogynecologist, but you never know.
(23:41):
A urologist could get the job done and then like men, would
see them. Yeah.
Is that a common specialty? I I don't.
Know, yeah, it's fairly common here.
I don't know about in Canada if you guys have that.
I don't. I don't know if I've ever even
heard that term. Maybe it's just because you're
not really in this niche, but who knows.
Yeah, Yeah. OK.
Interesting. So they obviously do a
(24:03):
combination of gynecology and urology.
Yeah, that's awesome. Yeah.
I guess we can talk a little bitmore around the link between IBS
or sort of digestive conditions and bladder issues.
I know I see it a lot with my IBS clients, like some who are
(24:24):
very active, like I have some runners with gut issues or IBS
and something that they complainabout is like frequent need to
pee on their runs, which is not fun.
And then I have some clients whoaren't as active, but obviously
working to like get get your bowels moving and support your
bowel health. Part of that is hydration, but
it could be difficult when they're needing to like pee
(24:46):
pretty frequently. And that kind of works against
people are sort of a barrier to staying well hydrated.
So yeah, if you want to maybe walk us through a little bit
more about what what the connection is between sort of
the gut and the bladder. Yeah, yeah, I think we brushed
on it a little bit. I mean, I think there is some
Oregon crosstalk going on. I I do see a lot of overlap with
(25:11):
digestive issues and bladder issues and not, not a fun
combination. I mean, I told you I have, I've
had both things going on and it's it's just a lot.
And you know, you really just got to find what is what is
causing this. Is it a stress issue?
Is it a pelvic floor issue? Is it something else?
(25:31):
But I know you mentioned hydration.
That is something I really want to emphasize here.
A lot of people think that if you drink less, you will have to
pee less. Yeah.
That is not true as a myth when you are not hydrated.
So let's say you're dehydrated, your urine is more concentrated.
So if you think your urine is, it consists of all of the waste
(25:54):
products that your body's tryingto get out.
We don't really want it sitting in our bladder for that long.
And sorry, my train of thought just went down a whole other
Ave. but that's a great thing. Gotta bring it back.
What was I saying before in the beginning?
Oh my God. Yeah, we're going through the
(26:14):
gut, gut bladder connection. Sorry, yes.
So when you are dehydrated, yoururine is more concentrated.
And if your bladder wall is a bit irritated for whatever
reason, it might be sensitive tothose toxins that are in your
urine. Or for example, if you are
consuming like bladder irritantslike caffeine or alcohol or
(26:41):
spicy foods or tomatoes, like those are kind of the top water
irritants that can trigger some symptoms, especially if your
bladder wall is already, you know, a bit aggravated.
So we need to have hydration. We need, I, I usually tell
people because everyone's hydration needs are different.
(27:01):
If you're working out, it's going to be more.
If you live in a hot climate andyou're sweating more, you're
going to need more. If you're on certain
medications, might need more. And yeah, there's a lot of
different factors there. So just generally I tell people,
shoot for the 8 glasses, the 64 ounces, you know, give or take.
And once you're hydrated, that is where you can start working
(27:27):
on things like bladder training and like rewiring that
connection between your bladder and your brain that is kind of
miscommunicating at that point because a lot of people with
those symptoms of frequency and urgency, like they're only
peeing a little bit usually. And that's because the bladder
has somehow gotten trained to alert your brain that it's time
(27:48):
to go before it's actually readyto go.
So there's a lot of different things that you can do, but
hydration is like the number onefirst step I would start up.
Yeah, definitely. Yeah.
I like that you address that myth because I've definitely had
new clients who are like, I can only drink five cups a day,
otherwise I have to pee all the time and I can't go more than
(28:08):
that. But to your point, like being
dehydrated actually will make the symptoms worse.
So it's not going to work against you.
As for me, typically I'll like if someone is struggling with
overactive bladder, I generally just reinforce like trying to
start drinking and hydrating early in the morning and sort of
sipping through the day. So you're spreading out that
(28:29):
fluid intake usually suggest maybe tapering it off like by
dinner time. And then if they have something
after dinner, like a little bit of herbal tea that they sip on.
I know sometimes just trying to be mindful of caffeine, citrus
juices, alcohol, sort of the bigtriggers and then trying not to
(28:51):
I guess always pee like just in case.
So that's what I recommend. But is there anything else that
you maybe suggest for your clients or anything you'd add to
that for like? It's funny, I like an hour ago
on certain bladder habits to stop doing and peeing in case
was one of them. Yes, yes.
So yeah, in case is essentially training your bladder to go when
(29:13):
it is a little bit too early. And there are certain times when
peeing just in case is OK. That is after sex, before bed,
when you wake up in the morning and if you're going on like a
car or a plane ride longer than an hour and a half to chew up
towers where you know there's not going to be any sort of
bathroom. So peeing just in case is 1.
Pushing to pee, that is recipe for disaster.
(29:38):
If you're having issues where you can't pee unless you're
pushing, go to the pelvic floor physical therapist.
Another one is rushing to the toilet.
So if you are like, hustling to the toilet and like, you feel
like you're going to pee your pants, you're kind of retraining
your brain and your bladder to not really work together.
(29:59):
It's telling yourself that your bladder's in charge and not your
brain. So you really need to work on
calmly walking to the bathroom if you have that urge.
And then another big one that women are usually guilty of is
hovering over the toilet. This is OK.
Mean like if you're using a pelvic or sorry, a public
(30:22):
toilet. Yes.
And you're like. Squatting so you're not sitting.
Correct. Yes, once in a while.
This is a You're out like your. Kids, It's like a nasty toilet
though, and you don't want to. Sit.
Exactly yes, exactly. Just don't make it a habit
because you know there's some risks there.
Your pelvic floor like really can't relax like it should yeah
(30:44):
have an increased risk of of having some urine leftover,
which could increase your risk of UTI.
You can risk prolapse. There's some things that if this
is habitual, it can increase your risk of certain things.
So I know that public toilet seats can be nasty, so use your
best judgment. But for me, I just, I take the
(31:05):
toilet paper, I wipe it and thenI put another layer on and then
I sit down. It's just so much easier to sit
down. So yeah, those are some of the
the bladder habits that I would recommend.
OK. Is that a common thing for I?
I don't think it's something that I've done, but I'd like to
hover over the toilet. Is that like a way to work your
(31:26):
glute muscles a little bit more or I'm wondering why that's
common? Most of the women in my life,
like I know a lot of people do this and yeah, I don't know.
If this is a society. Difference.
I mean, I know when I went to like Europe, some of the places
didn't even have toilet seats. And I'm like, how are you
supposed to do this? Yes, well, maybe.
(31:49):
In those cultures it's a little different, but I don't know.
Who knows? I don't know what their race is
of overactive bladder and pelvicdysfunction or interesting.
OK. Yeah.
So yeah, I think that's really, really helpful.
Anything else you'd add to like the dietary triggers?
(32:12):
Yeah, to be mindful of? It sounds like it's not really
the big like sort of maybe contributor for most people, but
yeah, for people who maybe diet is contributing.
What would you add to that list?Right.
So I mean, just for the average human, like drinks that contain
caffeine are going to make you pee more.
It's just a are we drinking these things in moderation, like
(32:35):
the coffee, the the tea, things like that.
And I will say that most of the people that I work with aren't
diet sensitive. But for those people who are,
it's usually a symptom of another underlying condition
like we talked about before. And once they address those
conditions, diet activity usually goes away, OK?
(33:00):
That doesn't mean like if somebody went crazy and drank a
bunch of alcohol that they're going to have like totally
normal urine output. Like, no, no, everything was not
arrange it. But I would say if you are at
the beginning of your journey orif you're in a flare up, you may
want to be mindful of consuming some of the things I've been
talking about, the alcohol, the coffee, the like if you're like
(33:24):
a black tea drinker, that's one.Carbonated beverages can can be
bothersome for some people. The foods we're looking at
citrus, citrus products, juices like you said, tomatoes, tomato
products, spicy foods, things like that.
Yeah, those are like the top offenders usually.
(33:46):
But again, don't assume you're diet sensitive.
If you want to know for sure, you can do an elimination diet
where you remove these items fora couple of weeks and then you
test them back in one at a time to determine if you are
sensitive to it. But I will say, if you are
sensitive to something, that doesn't mean it's going to be
like that forever. Like I said, you can overcome
(34:09):
this as your symptoms decrease. Similar with IBS too, because a
lot of the like the food intolerances are then sort of
driven by the gut brain connection and something's going
on where the like the nerves andthe gut are hypersensitive,
which is not always due to like the food itself.
Like it can be a microbiome imbalance or nervous system
(34:31):
dysregulation. And then people maybe are more
sensitive to things like bot maps or different food groups,
but oftentimes are they getting to more of the root of the
issue, like working on the nervous system and even
rebalancing the microbiome, thenthey can better tolerate those
foods. So I think that's a good point
as well. Like often food intolerances are
just aren't just like the only part of the picture.
(34:53):
Like there's usually a deeper level going on, which I think is
nice for a lot of people to heartoo, because most people don't
want to have to cut out or be more restrictive around food.
So I think that was a good one to to highlight as.
High on that hill. Definitely around caffeine.
I have two follow up questions to that.
(35:16):
The first one, is it just the like the caffeine content or is
it the the tannins in coffee andblack tea that can increase
urgency or is it both? It it's usually the caffeine.
There are some theories about the just the acid content in
those beverages. We're not sure if the acid is
playing a role. Yeah.
(35:38):
You know, when you eat somethinglike a, if you have like lemon
juice, like it goes in as an acid, but your body digests it
and it ends up being it's like alkaline and you digest it.
So it's, the research isn't solid in terms of tannins.
I don't know. I haven't seen any research on
that specifically. But it's possible that there's
(35:58):
something out there I might needto go look.
OK, Yeah. And then the other question was
around coffee. I know it's been sort of like
debated and we've gone back and forth, but the last I sort of
looked at the research around like coffee and needing to pee
was that if you're like sort of caffeine adapted like you're
someone who's in habitual coffeedrinker, it doesn't make you
(36:19):
have to pee as much as someone who like only drinks coffee once
in a while or is like a newer coffee drinker.
I don't know any any thoughts onthat or?
That recently, but I'm just thinking of myself like I, I
feel like I'm a consistent coffee drinker and I still
notice like an increase to pee after I drink my coffee, but
(36:40):
it's nothing like it's just a small difference in my heart and
like if I hadn't drank coffee. So personally, like just a
little bit of a difference for me.
But in terms of the research, I haven't seen anything recently
on that. Yeah, OK.
I feel like it's, yeah, I know for me I always like because I
(37:02):
have like half a liter when I wake up and then I work out and
I'll have like another liter of fluids and then I have coffee
and like we'll have to be a few times in the morning.
But I think it's just a combination of like fluids plus
coffee. I don't know if it'd be any
different if I didn't have coffee, but maybe.
Be an interesting experiment. You might feel really bad.
(37:26):
Oh, and the other one around, I guess IBS and the like the
bladder connection, I know too when someone maybe struggles
more with Constipation or like IBSC.
So they often get the colon or the rectums like full of stool
literally that it like sort of presses on the bladder because
they share like the same space. So I guess even back to like the
(37:48):
dietary part of it, if maybe someone's not eating the right
balance of fiber types or enoughfoods to sort of keep their
bowels regular, then that may also like sort of worsen the,
the OAB symptoms. Is that right?
Yep, Yep. Constipation is a pretty common
(38:09):
trigger. And just like you said that you
need to address the diet component of that in addition to
like the hydration and the movement and all of that stuff.
But yeah, yeah, that is a prettycommon thing.
Yeah. So even in that case, not so
much maybe what they're eating, but maybe what they're not
getting enough of, right to keepsort of things regular.
(38:29):
Cool. Yeah, I think we went through
quite a lot. I guess just to maybe take
things home, what would sort of be maybe two or three takeaways
for someone wanting to improve their bladder health function?
Where would they? Would they get started?
I'm speaking to people with bladder symptoms.
(38:52):
You want to elaborate? I'm just, I mean, it's going to
be a little different for peoplethat just are normal and have no
bladder symptoms. They pee normally.
Like for those people I feel like maintain good hydration
and, you know, consume bladder irritants in moderation on yeah,
(39:16):
I mean just just basics for them.
And then for people with bladdersymptoms, I mean, if you, if you
think there's something wrong, you know, go see a urologist or
urogynecologist, possibly get into pelvic PT, figure out if
that's contributing. But I would say like if you're
listening and you have OAB or you think you have OAB, just
(39:37):
understand that there is hope that you can get relief.
There may not be a ton on the Internet about like what we're
talking about and how to get relief, but I think the
information is coming out. I mean, I'm posting everywhere
on social media like what I'm learning through working with my
clients. And you know, there, there just
(39:58):
is. There is hope.
And you really need to start with your mindset.
You need to believe that you canget better because if you don't,
you probably won't. So I mean, those are my words of
wisdom. Yeah, for sure.
I think it's like it's the same with with IBS or other
conditions too. Like there's a lot of sort of,
we'll just use the term like cookie cutter information online
(40:20):
like Web MD, Healthline, like all sort of the basic stuff that
you've probably heard or been told.
But I think it's a different thing with maybe you work with
an expert or someone who specializes in this, who sees it
all the time and is sort of likeworked with many people in this
condition and is able to sort ofhelp you look like a bit deeper
(40:40):
and really get to like more of the, the strategies that are
going to give you results ratherthan sort of the, the
foundational things. That's not to say like the
foundational stuff can't help. But I think for a lot of people
probably with this and with IBS to like it can be quite complex
and usually need more than just sort of the the basics online
for most people. Definitely, yeah.
(41:05):
Yeah, so I guess just to end things off, how can people get
in touch with you and how can listeners learn more?
You know, go follow me on socialmedia, like on Instagram and
tech talk at Cali K Nutrition. I have a podcast of my own.
It's called ICU. We focus on both IC and OAB and
(41:26):
bladder health on there. I'm sure we can link that in the
show notes. And then, yeah, I mean, those
are the best places to connect with me.
Cool, awesome. I will.
Yeah. I'll link those in the show
notes. We did talk a lot about the
pelvic floor support. So I actually have a future
episode coming out on pelvic floor therapy.
(41:46):
So I'll link to that below because super important, both
with IBS and with OIB for sure. All right, well, thanks, Kelly
so much. It's been a great conversation.
And I'm sure there's probably a lot of light bulb moments for
listeners today. So thanks for coming on.
You're welcome. Thanks for having me.
(42:06):
That's a wrap for today's episode.
Thank you so much for listening and being a part of our
community here. If the Gut Fit Nutrition podcast
is giving you value, helped yourdigestion and fitness, made you
rethink how you approach your gut health, consider leaving a
review on Apple, Spotify, or wherever you're getting your
podcasts. If you have questions for my
listener Q&A episodes, you can submit them as a comment on this
(42:29):
episode or send me an e-mail at lee@leemorado.com.
For more digestible IBS gut health and fitness tips, be sure
to follow me on Instagram at LeeMorado under score Rd. and to
apply for coaching, shop the resource suite or grab a
freebie, visit gotfitnutrition.com.
Thanks for tuning in. We'll be in touch soon.
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