Dr Flo, my wife passes urine after every one hour, but in small quantities. The frequency of urination increases when it is cold, and the situation is worse when she takes liquids. She went for a diabetes test last month, but it was negative. What might she be ailing from? Denice
The frequency of passing urine increases when there is an increase in fluid intake. It also increases during the cold season because the amount of sweat reduces.
Passing urine frequently for a prolonged duration, without any identifiable cause may be due to interstitial cystitis. This is a condition where there is persistent inflammation, or there are ulcers, in the bladder wall.
This makes the bladder sensitive, and you may not be able to hold a lot of urine. It may also be painful to pass urine.
It may also be due to an overactive bladder. This means that the bladder wall muscles contract more than usual, making one feel like passing urine more frequently. This may be due to a nerve problem, or obesity.
It would be good for your wife to be seen by a urologist to have several tests like urinalysis, cystoscopy and cystometry, and an ultrasound scan done.
She also needs bladder retraining, by gradually increasing the intervals between urinating over three months.
She can also benefit from Kegel exercises to strengthen her pelvic muscles. This is done by contracting the pelvic muscles as though stopping the flow of urine. To identify these specific muscles, stop urine mid-flow when urinating. Contract these muscles for about 10 seconds, 10 times in one set, six to 10 sets in a day.
She can also take 1.5 litres of fluid during the day, but limit fluid intake after 6pm to avoid waking up at night to pass urine. She should also avoid fluid intake when going on a long journey or if she will be away from a washroom.
It also helps to avoid alcohol and caffeine, spicy foods and acidic foods like citrus fruits and tomatoes.
Also avoid constipation by taking a high-fibre diet because constipation worsens an overactive bladder. Maintaining a healthy weight and physical exercise can also help.
A doctor can also prescribe medications like oxybutinine or imipramine to manage an overactive bladder.
Dr Flo, my chest burns at night and I am not able to sleep until it cools down. This has become so frequent that I am starting to get worried. Please help. Beatrice
The burning pain in the chest that comes mostly at night and cools off on its own is most likely due to irritation in the oesophagus or food pipe, which passes through the chest from the mouth to the stomach.
The pain in the chest can be caused by inflammation of the oesophagus (oesophagitis), hyperacidity and reflux and oesophageal strictures, which are caused by scarring of the lining of the oesophagus.
In addition to the pain, you might also have heartburn, discomfort or pain when swallowing, nausea and/or vomiting, bloating and upper abdominal pain.
You can get a stool test, barium tests and endoscopy to diagnose the problem. After that, you may be given medication to reduce the amount of acid your stomach makes and to reduce what comes back up the oesophagus (reflux).
You may also get medicine to neutralise the acid, medicine to protect the lining of the stomach, and antibiotics if you have an infection. You may need to be on this medicine for a long time.
In some people, the disease may take long to treat, or it may keep coming back. This may be because the muscle between the oesophagus and the stomach (oesophageal sphincter) is weak, or your stomach produces a lot of acid, either because of genetics, or because it is triggered by stress or anxiety. It may also be due to having other problems like inflammatory bowel disease, other infections, liver or kidney disease, or even stomach cancer.
To reduce or prevent the symptoms, avoid alcohol and smoking; avoid some painkillers like ibuprofen, aspirin and diclofenac, and avoid long-term use of steroids.
Do not skip meals and avoid acidic foods and drinks. Eat dinner two to three hours before going to bed and avoid eating heavy meals in the evening.
Also, stay upright between the time you have dinner and when you got to sleep.
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