An intense discussion withDr. Gutta Srinivas, Urologin, Star Hospital. Issued in the public interest to raise awareness and improve the quality of life.

URINE PRODUCTION AND FLUID INGESTION WHAT IS NORMAL AND WHAT IS A WARNING SIGN (1)What is considered "increased frequency" in regards to urination?

When a person urinates more than eight times in 24 hours, this is considered increased frequency in terms of urination or urination.

What is the recommended "normal" water/fluid intake and how does this affect urination?

Water/fluid intake varies from person to person and also from various environmental factors.

Some people hear the person by what they hear on TV or in their articles

What liquids other than water can cause "frequent urination"?

Some people who are addicted to tea and coffee and drink ten or more cups a day are prone to frequent urination. Tea and coffee stimulate the bladder and induce diuresis (frequent urination). Smoking has a similar effect on the bladder.

Westerners tend to drink large amounts of Coca-Cola and Pepsi (liters) a day, which also have a significant diuretic effect on the bladder and can increase urination.

Can we change this pattern of "frequent urination"?

Yes of course!! You can completely control the frequency of urination by changing your habits, eliminating excess tea, coffee, cola and similar sugary drinks, quitting smoking, etc.

Are there other factors that affect urination?

Another factor that determines how often we visit the bathroom is the weather. For example, people in hot, humid coastal areas tend to lose water through sweat. When they travel to areas that aren't as hot or humid, they tend to urinate more frequently. Likewise, in summer, the frequency of urination decreases due to the heat, while in winter, trips to the bathroom are more frequent. This is due to cold weather, strong winds and cool breezes that encourage the bladder to urinate more frequently.

Does age affect urination frequency or does it lead to urination problems?

There are some urinary/pee problems that come with age. An enlarged prostate is one such condition in men.

When the prostate enlarges, the bladder changes. Thus, we see that the pressure remains the same regardless of the amount of urine in the bladder. Normally, the bladder only sends a signal to the brain that it needs to be emptied when it is full. With an enlarged prostate, the smooth, uninterrupted flow of urine through the urethra is blocked. Prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra, the "tube" through which urine leaves the body. When the urethra narrows, the bladder has to contract more forcefully to push urine through the body. Over time, the bladder muscle can gradually become stronger, thicker and overly sensitive and will begin to contract with even small amounts of urine, causing you to urinate more frequently. Eventually, the bladder muscle cannot overcome the action of the narrowed urethra, so urine remains in the bladder and is not completely emptied. Sometimes this problem is caused by bladder stones.

Do neurological issues also play a role in bladder function/urination?

Some neurological problems also contribute to frequent or infrequent urination. For the urinary system to function properly, muscles and nerves must work together to keep urine in the bladder and release it at the right time. Nerves carry messages from the bladder to the brain to tell when the bladder is full. They also carry messages from the brain to the bladder, telling the muscles to contract or relax. A nerve problem can affect bladder control when the nerves that carry messages between the brain and the bladder are not working properly. This can lead to:

• Overactive bladder: When damaged nerves send signals to the bladder at the wrong time, causing its muscles to contract without warning, frequent urination (eight or more times a day and two or more at night); urinary urgency (a strong and sudden need to urinate immediately) and urge incontinence (leakage of urine after a strong and sudden urge to urinate).

• Poor sphincter control: Sphincters surround the urethra and keep it closed to keep urine in the bladder. When the nerves to the sphincters are damaged, the muscles can relax and leak or become tense when you try to urinate.

• Urinary retention: For some people, nerve damage means that the bladder muscles aren't getting the message that it's time to urinate or are too weak to completely empty the bladder. When the bladder becomes too full, urine can back up and the increased pressure can damage the kidneys. Also, urinating for a long time can lead to kidney or bladder infections. Urinary retention can also lead to overflow incontinence.

Do you need a test if you urinate more than usual?

While it may seem like a trivial problem, if you suddenly and inexplicably urinate frequently, you should have it checked out.

How much water should we drink a day?

How much water the human body needs depends on the weather and climate. A normal person needs 1½ to 2 liters of urine per day, so a minimum intake of 2 liters of water per day is required. The minimum amount of liquid at any age is 2 liters plus 500 ml (half a liter) of food. About 500 ml evaporates when breathing and sweating.

However, people with heart, liver and kidney problems are advised by their doctor to limit their water intake to just one liter a day.

Are there any health issues that require increased water intake?

Yes, some people have repeated UTIs (urinary tract infections). It is essential that they drink more water so that the bacteria are eliminated. During an infection, thousands of bacteria need to be flushed out of the bladder, and water is an essential part of that process.

When people are prone to kidney stones, doctors advise them to drink more water. Kidney stones occur when the urine contains more crystal-forming substances, such as calcium, oxalate, and uric acid, which fail to dilute the fluid in the urine. At the same time, urine may lack substances that prevent the union of these crystals, creating an ideal environment for the formation of kidney stones.

Some people's bodies tend to absorb excess calcium. In other cases, uric acid from meat is trapped in the system and stones form. The body has to excrete these either through the intestines or through the urine. If people have or are likely to have kidney stones, they should aim for a urinary output of 3 liters, in which case they need to consume 3½ liters of water in cold weather. When it's hot, they need to drink 5 liters of water to guarantee 3 liters of urine. Thus, we see that temperature and meteorological/climatic conditions determine the amount of water needed.

What do you think is the main cause of bladder problems in India and how can we control it?

Essentially, the leading cause of bladder problems in India is the westernization of the diet: eating fast/processed foods; Drink soft drinks available in the market and eat non-vegetarian food. There is a common misconception that avoiding tomatoes and spinach is the answer to keeping gallstones at bay, but this is not the case. Non-vegetarians should limit meat consumption to twice a week, avoiding soft drinks like Coca-Cola, as they also contribute to stone formation. Polished rice is also associated with a high risk of stone formation, so it is advisable to eat brown rice and other fiber-rich foods.

Any advice for people prone to kidney stones?

• Drink four liters of water during the day. (This is calculated based on Hyderabad weather conditions)

• Avoid drinking water before bed

• Drink half a liter of water in the morning

• Drink 150-200 ml of water every hour and take a little more after meals.

• Drink some water if you wake up at night to urinate.

• Distribute your water intake to keep your body hydrated.

• Continuous flow of fluid through the kidneys is essential to prevent kidney stones from forming.

• Watch your salt intake. Do not add extra salt at the table and avoid pickles etc.

• Eat more fiber-rich foods like fruits and vegetables.

• Tomatoes have nothing to do with the formation of kidney stones. They are good for you as they contain lycopene which has anti-cancer properties.

• Spinach is also healthy and does not contribute to the formation of kidney stones.

• Get regular check-ups to make sure you don't have kidney stones.

Schedule an appointment:Dr. Gutta Srinivas, Urologin, Star Hospital

URINE PRODUCTION AND FLUID INGESTION WHAT IS NORMAL AND WHAT IS A WARNING SIGN (2)Disclaimer:Welthi.com does not guarantee specific results as a result of the procedures mentioned herein, and results may vary from person to person.keep reading

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