7 Reasons You Need The Toilet Every 40 Minutes All Day
You already cut the coffee. You already cut the water. You are still counting bathrooms between meetings, and number six explains why none of it worked.
I am a urologist, and most of what gets written about bladders is written about the night.
The patients who bother me most have a daytime problem. They are still working. They are somewhere between forty-five and sixty. And their day is organised, quietly and completely, around where the bathrooms are — the seat on the aisle, the one at the end of the row, the excuse ready before the meeting starts.
What makes it worse than the night version is that it is witnessed. Nobody sees you get up at two in the morning. Everybody sees you leave the room for the third time before lunch, and by about the fourth month you are spending real energy on whether they have noticed.
Seven reasons. Five of them are things you have already tried to fix yourself, which is why you are still going every forty minutes. The sixth is the one that is never checked.
You Already Cut Your Water Down, And It Did Not Work
This is nearly always the first thing anybody tries, and it is the first thing I have to undo.
It is a reasonable theory — less in, less out. In practice the person who drinks less does not go less. They go the same number of times with less in the bladder each time, because what is driving the trip is not volume.
And the urine they do make is more concentrated, which is more irritating against the bladder wall, which brings the next signal on sooner. So the afternoon is worse than the morning on exactly the days they drank least, and the conclusion drawn is that it is getting worse on its own.
You Go “Just In Case” Before Everything
Before the meeting. Before the drive. Before you leave the house, and again before you leave the office. Not because you need to — because you might need to later and there might not be one.
This is the single most common thing I see and it is doing more than anybody realises. A bladder learns what volume to raise the alarm at, and it learns it from how full it usually is when you empty it. Empty at a third full, four or five extra times a day, every day for two years, and the alarm moves. It starts arriving at a third.
So the strategy that was protecting you from being caught out has gradually become the reason you get caught out. You did not weaken anything. You taught it, very consistently, and it learned.
You Are Counting Coffee And Tea As Water
Four hot drinks between nine and three is unremarkable in an office and it is most of what a lot of people put in all day.
Caffeine at that volume makes the kidneys produce more while you are putting in less plain fluid, which is a bad pairing. It is also directly irritating to a bladder lining that is already sensitive, which is the part people miss — this is not only about how much liquid arrives, it is about what it does to the tissue when it gets there.
I am not telling you to give it up. I am telling you it is not the water you have been counting it as.
You Never Actually Finish, So You Are Back Twenty Minutes Later
Ask someone how many times they go and they will tell you eight. Ask how many of those were a proper emptying and the number drops.
A lot of daytime frequency is not eight separate fillings. It is four, each of them interrupted — you go, you stop early because you are in a hurry or because the flow stalls, and twenty minutes later you are back for the rest of it.
That pattern also means there is nearly always something left sitting in there, and what is left is the most concentrated part of it, resting against the wall until the next lot arrives on top.
If you have already tried the four things above — and most people reading this have tried all four — then the reason it has not shifted is not on that list. It is number six.
See The Three-Step ProgramYou Have Started Planning The Day Around The Bathrooms
You know which floor has the quiet one. You take the aisle seat. You arrive early enough to go before it starts, and you sit near the door.
I am not going to pretend that planning is the cause of anything. It is a sensible response to a real problem, and I would do the same.
The reason it is on the list is that it is the point where this stops being a bladder problem and becomes a life problem, and it is also the point where most people stop mentioning it to anybody. The planning works well enough to make it invisible, and invisible problems do not get looked at for another four years.
Nobody Has Ever Looked At What Is Sitting On Your Bladder Wall
Everything above is a habit. This is the physical thing underneath them, and it is the reason the habits have not fixed it.
A healthy bladder wall is pink, wet and smooth, and it stretches — that is its whole job. It fills, the wall gives, and somewhere near capacity it sends a signal.
Put a scope into someone who has been going every forty minutes for years and there is a pale, gritty, chalk-coloured film on that wall, laid down in layers and stuck to the tissue. Mineral salts and acid crystals that came out of your own urine and settled there.
Coated tissue does not stretch. A wall that cannot stretch cannot tell the difference between a third full and full, so it sends the signal at a third — which is why the urgency is completely convincing and there is almost nothing there when you get up. Your bladder is not weak and it is not overactive. It is coated, and it is reporting what it can feel.
You Have Been Told It Is Stress, Or Hormones, Or Your Age
This is the one that makes me angry, and not at the patient.
A person who is going every forty minutes at fifty-two and mentions it gets one of three answers. Stress. Hormones. Age. All three are plausible, all three are unfalsifiable in a ten-minute appointment, and all three end the conversation, which is the thing they have in common.
Notice what none of them are. None of them is a description of anything physically happening in the bladder. You cannot act on any of them, which is how somebody ends up managing this for six years without once being told what is actually on the wall.
So — What Actually Takes The Deposit Off?
Once you know the wall is coated, the question changes. It stops being how do I hold on until the end of the meeting and becomes how do I get the surface back.
Three separate jobs, in order. Stop new deposit adhering. Loosen what has already bonded to the tissue. Settle the irritated lining underneath so it stretches again and stops calling full at a third.
Do the third alone and you have quietened a wall that is still coated. Do the first alone and you have stopped it getting worse while the afternoon is exactly what it was.
“Most of the bladders I scope are not weak. They are coated. We have spent thirty years treating the signal and almost none of it looking at what the signal is coming off.”
— Dr. Alan Reeves, MD
Here is the sequence, and what each part is actually doing.
CranShield™
Proanthocyanidins at extract strength rather than juice strength, so new mineral and acid deposit has far less to hold on to. Astragalus is here because a lining that is already irritated lays down more, faster.
Sedraclear™
Chanca Piedra translates out of the Spanish as stone breaker, which is what it has been used for along the Amazon for as long as anyone has written it down. Its job here is the crystalline deposit sitting on the wall — loosening the bond so it lifts and leaves in the ordinary way, at the ordinary volume.
UrsiCalm™
Under the deposit is tissue that has been irritated for years and is reporting full long before it is. This is the part that decides whether the day feels different, because a calm lining stretches, and a lining that stretches stops raising the alarm at a third of a bladder.
Every one of those is available on its own, and most of them are cheap. That is not the difficulty. The difficulty is that the three steps have to happen in order and at weights that do something — stop the deposit, lift the deposit, settle the tissue under it — and buying nine bottles to do that is how people give up in week three.
The formulation my team put together is called Rensa. Two capsules, once a day, all three steps at the weights above. It is not a diuretic and it is not a water pill. It is not designed to make you go more. It is designed to take the deposit off the wall so the wall stops reporting full when it isn't.