Bladder & Bowel Urgency: Why Do I Suddenly Need to Go?
Feeling like you need to find a toilet right now can be stressful, especially when it starts affecting where you go, how long you can travel or whether you feel comfortable being away from a bathroom.
Bladder and bowel urgency describes a sudden, strong need to urinate or open your bowels that can be difficult to delay.
For some people, urgency occurs without leakage. For others, the urge can become so strong that they experience urinary or bowel leakage before reaching the toilet.
There are many reasons urgency can develop, and understanding what is contributing to your symptoms is an important part of working out how best to manage them.
What Is Bladder Urgency?
Bladder urgency is a sudden and difficult-to-delay need to urinate.
You may experience:
A strong urge to find a toilet immediately
Going to the toilet frequently
Difficulty delaying urination
Urine leakage on the way to the toilet
Waking during the night to urinate
Going to the toilet “just in case”
Feeling anxious when you don't know where the nearest toilet is
Some people also notice particular triggers, such as arriving home, putting the key in the front door, hearing running water or getting into the shower.
What Is Bowel Urgency?
Bowel urgency is a sudden or strong need to open your bowels that can be difficult to delay.
You may experience:
Needing to find a toilet quickly
Difficulty holding on once the urge begins
Frequent bowel motions
Loose or unpredictable bowel motions
Bowel leakage or soiling
Anxiety about being somewhere without easy toilet access
Bowel urgency can have a number of causes, including changes in stool consistency, gastrointestinal conditions, bowel habits and pelvic floor function.
Why Am I Going to the Toilet So Often?
There isn't one “normal” number of toilet visits that applies to everyone.
How often you need to go can be influenced by how much and what you're drinking or eating, medications, bladder or bowel conditions and your individual habits.
Sometimes people experiencing urgency begin going to the toilet more frequently to prevent the urge from happening.
For example, you might start going before leaving home, before driving somewhere, when you arrive somewhere, before exercising and again whenever you see a toilet — even when you don't actually have a strong need to go.
These “just in case” habits can be worth discussing as part of a broader assessment of your bladder or bowel symptoms.
Why Does My Bladder Suddenly Become Urgent When I Get Home?
This is something many people experience.
You may have been able to comfortably delay going to the toilet while driving home, only for the urge to suddenly become much stronger when you pull into the driveway or put your key in the door.
Over time, the bladder and nervous system can develop associations between certain situations and going to the toilet.
That doesn't mean the urgency is “in your head”. Instead, it highlights that bladder control involves communication between the bladder, pelvic floor, nervous system and brain, rather than simply how full your bladder is.
Does Urgency Mean I Have a Weak Pelvic Floor?
Not necessarily.
Your pelvic floor contributes to bladder and bowel control, but urgency doesn't automatically mean your pelvic floor muscles need strengthening.
For some people, strength may be relevant. For others, pelvic floor coordination, muscle tension, breathing, bladder or bowel habits and the ability to respond to an urge may be more important.
This is why simply doing more pelvic floor squeezes isn't always the answer.
Can a Tight Pelvic Floor Contribute to Urgency?
Pelvic floor muscle overactivity or difficulty relaxing the pelvic floor can be associated with some bladder and bowel symptoms.
The pelvic floor needs to do more than contract. It also needs to relax, coordinate and respond appropriately during bladder and bowel function.
If pelvic floor dysfunction is suspected, an individual assessment can help determine whether strength, tension, coordination or other factors may be relevant to your symptoms.
Can Stress or Anxiety Make Urgency Worse?
The bladder and bowel are closely connected with the nervous system, and some people notice their symptoms change during periods of stress or anxiety.
You may have experienced this yourself — needing to urinate more frequently when nervous or suddenly needing to open your bowels before an important event.
This doesn't mean your symptoms are purely psychological. Stress can be one of several factors influencing bladder and bowel function.
What Can Cause Bladder & Bowel Urgency?
There are many possible contributors, including:
Bladder or bowel habits
Pelvic floor dysfunction
Constipation
Loose or frequent bowel motions
Irritable bowel syndrome (IBS) and other gastrointestinal conditions
Pregnancy and childbirth
Perimenopause and menopause
Diet and fluid intake
Caffeine and other bladder irritants for some people
Some medications
Stress and anxiety
Urinary tract infections
Neurological or other medical conditions
Because urgency can have different causes, assessment should focus on why you are experiencing the symptom, rather than treating urgency as one condition with one solution.
Can You Retrain an Urgent Bladder?
Bladder retraining may form part of management for some people experiencing urgency or frequency.
This doesn't simply mean “hold on for as long as possible.”
Depending on your presentation, bladder retraining may involve gradually changing toileting habits, learning strategies to respond to an urge and working towards more comfortable bladder intervals.
The appropriate approach depends on your individual symptoms and should take into account other factors such as pain, infection, bladder emptying and medical conditions.
How Can Pelvic Health Care Help With Urgency?
A pelvic health assessment can explore your bladder and bowel symptoms, toileting habits and pelvic floor function to identify factors that may be contributing.
Depending on your presentation, management may include:
Bladder or bowel retraining
Urge-management strategies
Pelvic floor rehabilitation
Pelvic floor relaxation or coordination
Education around bladder and bowel habits
Toileting and bowel-emptying strategies
Breathing and pressure management
Discussion around fluid and relevant lifestyle habits
Referral to your GP, dietitian or another healthcare professional where appropriate
Sometimes we may also ask you to complete a bladder or bowel diary, as this can provide useful information about your individual patterns and symptoms.
When Should I Seek Help for Bladder or Bowel Urgency?
If you're planning your day around toilet access, going much more frequently than you used to, struggling to delay an urge or experiencing bladder or bowel leakage, it's worth discussing your symptoms with a healthcare professional.
You also don't need to wait until urgency results in incontinence before seeking help.
New or significant changes in bladder or bowel function, blood in your urine or stool, difficulty emptying your bladder, recurrent urinary tract infections, unexplained weight loss, severe pain or other concerning symptoms should be discussed with your GP or medical team.
Pelvic Health Care in Healesville & the Yarra Valley
At Yarra Valley Women's Health, our pelvic health osteopaths provide individualised assessment and management for bladder and bowel concerns including urgency, frequency, incontinence and pelvic floor dysfunction.
Our aim is to help you understand why your symptoms may be occurring and provide you with the knowledge and strategies to feel more confident managing your pelvic health.