Optimising Bladder and Bowel Health Through Diet and Hydration

The following article offers Healthcare Professionals general dietary advice to provide for their patient experiencing bladder and bowel issues.

(These recommendations should be applied after a thorough continence assessment and used alongside specialist interventions as part of a comprehensive care plan).

The Role of Hydration in Managing Bladder and Bowel Dysfunction

Hydration is essential for kidney, bladder and bowel health. However, individuals will often minimise the amount of fluid they consume, especially if they have bladder control problems. This in turn means that urine production decreases, enabling bacteria in the bladder to reproduce, increasing the risk of urinary infections. In addition, concentrated urine is highly irritating to the lining of the bladder, causing the bladder to spasm. Spasms exacerbate urinary urgency, frequency, and episodes of incontinence.

The effects of dehydration on the bowel are equally as problematic. If the body lacks sufficient fluid to function as it should, the large intestine absorbs fluid from the stool, making stools harder and more difficult to pass. The resulting constipation then has secondary effects on bladder function and capacity as they share the same space in the pelvic region.

Daily fluid recommendations to provide to your patient

Assesing your patients urine before recommending a new diet and fluid plan

Pale yellow urine colour is a good indicator of hydration; deviations from this may be a sign to increase (if urine is dark yellow) or decrease (if urine is clear) fluid intake.

If drinking is an issue for your patient, hydration can also be supplemented with recommending and altering your patients comprehensive care plan to include fluid-based foods, for example

• Soups
• Stews
• Yoghurt
• Watermelon
• Grapes
• Jelly
• Custard

While fluid intake is very important for bladder and bowel health, there are certain fluids which should be avoided. For example, alcohol, caffeine, carbonated drinks, milk and more highly acidic juices.

What are the effects of alcohol consumption in patients experience poor bladder or bowel function?

• Alcohol affects the bladder by stimulating the bladder muscle, causing urgency and frequency. It also inhibits the release of antidiuretic hormone ²
• Alcohol is no better for the gut. It can lead to disturbances in intestinal absorption, bacterial overgrowth, and mucosal damage, often contributing to diarrhoea and other non-specific abdominal complaints³

What are the effects of caffeine consumption in any patient experiencing poor bladder or bowel function?

• Caffeine causes the bladder muscle to spasm, leading to urgency, frequency, and possible incontinence. Caffeine has a similar effect on the colon, increasing colonic motility in as little as 4 minutes after ingestion ⁴.
• For individuals with heightened sensitivity, particularly those with irritable bowel syndrome (IBS), caffeine can have significant effects on bowel continence.
• Caffeine can be found in tea, coffee, energy drinks, cocoa, cola, and some medications. While guidelines on caffeine intake are scarce, recent studies suggest a daily consumption of less than 100mg improves bladder symptoms ⁵.

What are the effects on bladder and bowel health from carbonated drinks, acidic juices and milk?

• Carbonated drinks, and highly acidic juices including orange, grapefruit, pineapple, and tomato juice can cause symptoms of bladder overactivity.
• Acid-based drinks are also best avoided if you have gut problems, such as IBS.
• Milk is another drink that can exacerbate bladder irritation in individuals with overactive bladder symptoms, and potentially cause constipation with excessive consumption, or diarrhoea in the case of lactose intolerance or inflammatory bowel disease (IBD) ⁶.

What are the safe fluid alternatives to advise your patient to consume to support bladder and bowel function?

• Water is preferable for promoting and maintaining bladder and bowel health.
• Cranberry juice can reduce incidence of cystitis and urinary tract infection⁶, although caution should be taken if you have a patient who has IBS, hiatus hernia, or who are taking certain medications that interact with cranberry juice.
• Herbal teas are a good alternative for hydration. Chamomile tea can reduce symptoms of cystitis and relieve wind.
• Ginger and peppermint teas relieve wind, and liquorice tea can alleviate constipation in individuals also⁶.

Dietary Advice to provide your patient as a Healthcare Professional for optimal bowel function:

What are the benefits of fibre?

• Fibre produces healthy and well-formed stools.
• Stimulates colonic motility.
• Produces satiety.
• Promotes the growth of beneficial bacteria in the gut.

Fibre Recommendations for Patients with Bladder or Bowel Dysfunction

• Current recommendations suggest an intake of 30g of fibre a day⁸. Fibre rich foods include wholegrains, fruit, vegetables (especially cruciferous vegetables), beans/peas/pulses, nuts, and seeds.

When you have a patient with a condition requiring a low-fibre diet:

While fibre is very good for bowel health in most people, there are certain conditions when a low-fibre diet may be advised. These include IBS, IBD, diverticulitis, bowel obstruction or narrowing, pre- and post- bowel surgery, and if people have a stoma (ileostomy/colostomy) with a high amount of output.

A dietician or medical specialist may recommend a low fibre, or ‘low residue’ diet to help with the management of these conditions.

Other Dietary Triggers to Avoid

• Acidic foods – as mentioned above, acidic fluids can impact on bladder and bowel function. Likewise, acidic foods can worsen symptoms of bladder overactivity and inflammatory bowel conditions. Some examples of acidic foods include citrus fruits, tomato-based products, and vinegar.
• Spicy food –for certain people spicy food can irritate the bladder, causing symptoms of overactivity. Similarly, spicy food can trigger rapid digestion and bowel irritation, leading to diarrhoea and painful bowel motions ⁹. Spicy foods can be particularly problematic for people with bowel conditions, such as IBD and IBS, worsening their symptoms.
• Processed foods – these types of foods often contain artificial ingredients, such as flavouring, preservatives, and artificial sweeteners. These can exacerbate bladder irritation, contribute to long term digestive issues like IBS/IBD, alter the gut microbiome, and cause either constipation or diarrhoea¹⁰.  Minimising intake of processed foods and opting for whole, unprocessed foods can improve bladder, bowel, and overall health and wellbeing.

Supporting the Microbiome: The Role of Prebiotics and Probiotics

Certain foods help ‘good bacteria’ to flourish in the gut and urinary tract, collectively known as the microbiome. These good bacteria help:

• Fight infections
• Support immune system regulation
• Prevent inflammation
• Promote gut health
• Reduce the risk of certain bladder and bowel disorders¹¹.

To promote good bacteria in your patient, it is required that they implement a diet that includes fibre, prebiotics, and probiotics.

Some examples of foods containing prebiotics and probiotics are:

• Prebiotic foods – onions, garlic, banana, artichokes, leeks, and oats.
• Probiotic foods – fermented foods like yoghurt, kefir, sauerkraut, kimchi and tempeh¹².

Tailoring Recommendations to the Individual Patient

It’s important to keep in mind that dietary and fluid recommendations are general and may not apply to everyone in the same way.

Everyone is unique, and the most effective way to understand what improves or worsens bladder and bowel symptoms is by maintaining a detailed bladder and bowel diary directly with your patient.

Tracking food and fluid intake along with bathroom habits over a 3-to-7-day period can help pinpoint specific triggers.

If there is a known or suspected intolerance or bowel condition, consulting with medical specialists and allied health professionals is essential—they can provide a more tailored and specific dietary plan to suit individual needs.