Lifestyle advice

Alongside bladder training and pelvic floor muscle training, lifestyle interventions that can be recommended include:

• Weight loss (if BMI over 30)
• Caffeine reduction – this includes restricting coffee, tea and ‘cola’
• Fluid management including timing of fluid intake in relation to bedtime. Fluids should be restricted in the evening (especially caffeinated drinks and alcohol). Age UK recommends having six to eight drinks per day (200ml each). All hot and cold drinks count so keeping a chart on the fridge to keep track can be useful. If needing to urinate during the night is a problem, drinking less before going to bed can help. Different sources give conflicting advice about this, ranging from not drinking after 6pm to not drinking more than one hour before bedtime. Patients should be advised to experiment in order to find out what works for them, remembering to avoid caffeine later in the day. Alcohol may also aggravate incontinence, particularly at night, so should also be avoided.
• Adjust timing of medicines. Time intake of diuretics (take them six hours before bedtime)
• Reduction of physical exertion (e.g. lifting)
• Smoking cessation
• Resolution of chronic constipation and prevention of recurrence.

Signposting

• Patients can be signposted to useful information on the NHS or Age UK websites
• For those people who are less internet savvy, information leaflets may help – and materials can be printed from the NHS or Age UK websites
• Bladder and Bowel UK also provides leaflets that can be printed off for the patient.