Dear Doctor, I can’t say that I have always had this problem but I can’t remember when it started either. At work, I drink a lot of coffee. Actually sometimes I drink about 5 mugs! However, I never have the urge to use the bathroom and can even go a whole day without urinating.

But the second I get home, I find myself visiting the bathroom every five minutes. The strangest part is that when I go to pee, my bladder feels like it is on the verge of bursting yet I urinated just minutes before. What causes this? It is really starting to worry me.

Rose A, Gaculiro

Dear Rose,

You have not mentioned your age or any other associated problems like pain during urination, sense of incomplete voiding, history of taking any drugs before, e.t.c.  The frequency of urination is confined to waking hours or even during night thus disturbing sleep; this information could also be useful in determining the cause for the frequency of urination.

Usually in a young woman, frequency of urination occurs due to infection of the urinary bladder. Here along with frequency of urination one usually has urgency, i.e. strong desire to pass urine, pain during urination, sense of incomplete evacuation like within five minutes of passing urine there will be an urge again. 

Fever may be present with severe infection.  Common toilets like at work places, blood loss during menstruation, pregnancy and delivery are some of the factors that make a woman more prone to develop cystitis, i.e. bladder infection.

Conditions like diabetes mellitus, diabetes insipidus, and drinks like tea, coffee, sodas, pineapple and citrus fruits like oranges, can all lead to increased frequency of urination. 

Drugs used to treat high blood pressure and or salt and water retention also lead to this problem.

In an elderly person, cancer of the bladder or overactive bladder (due to muscular or neurological damage to bladder) can result in frequent urination.

Maybe you are too busy to go to the toilet during working hours and the bladder has been conditioned so as not to empty during working hours. But it keeps on filling and gets stretched out. This itself is not healthy as putting the bladder stretched out for long hours tends to weaken the bladder sphincter (valve that closes the bladder) resulting in incontinence of urine as age advances.  

Back home as you are relaxed, the bladder may empty all the contained urine in maybe one or two times. But frequent urination after this needs to be evaluated.

Get your urine sample examined for infection. It should be the urine passed first thing in the morning and the sample should be collected after discarding a few drops (mid morning urine sample). If the result is positive it can be treated by taking a complete course of a suitable antibiotic.  Also, get blood glucose levels tested to assess for diabetes .

Withholding fluids will not help as the resultant concentrated urine will irritate the bladder leading to more frequent urination. But you can restrict coffee or take beverages with low caffeine. Too much of coffee is not healthy also for the body.

Try going to the toilet every two hours or so in daytime. This will expel urine in whatever quantity held in the bladder and also expel any infectious microbes. Keep good perineal hygiene during menstruation.

All these measures can help solve the problem.

Dr. Rachna Pande is a Specialist in Internal Medicine at Ruhengeri Hospital