Incontinence or Frequent Urination
Urinary incontinence is the involuntary loss of urine. There are many potential causes of incontinence, including physical and functional factors. In Chinese medicine, incontinence is often seen as a result of weakness in the body's vital energy and a failure to properly metabolize fluids. This can lead to a lack of control over the body's lower orifices and weakened muscles in the pelvic region. Incontinence may also be caused by imbalances in other organs, such as the kidneys or spleen, and by a variety of other factors, including heat, irritability, and physical pressure on the bladder. In some cases, incontinence may be a result of inadequate nourishment and support for the organs involved in urination.
External damp-heat invasion often presents as an acute episode, with the pathogen typically entering the body through the tai yang Bladder channel, the leg yin channels, or the local collaterals. However, repeated episodes of damp-heat invasion, especially when treated with harsh, cold medications or antibiotics, can result in a lingering damp-heat pathogen in the Bladder. This is often due to a underlying Kidney deficiency that allows for repeated invasion. When damp-heat becomes persistent, the heat component tends to decrease, with dampness becoming the dominant factor.
Eating a diet that is high in sugar and alcohol can lead to the buildup of damp-heat in the body. This can cause a depletion of yin, which can lead to a weakness in the Spleen. A cold, raw diet or a restrictive or inadequate diet can also weaken the Spleen and damage yang qi. When the Spleen is weak, it can drain the Kidneys to support its yang function, leading to a deficiency in Kidney yang and making the body vulnerable to external pathogens. A weak Spleen can also produce dampness, which can combine with any heat in the body to create damp-heat. This can lead to a deficiency in Lung qi, which can cause chronic cough and incontinence. Additionally, certain medications can also contribute to urinary frequency and incontinence.
Feeling frustrated, angry, resentful, or emotionally repressed can disrupt the flow of Liver qi, which can affect the circulation of Bladder qi. This, combined with chronic Liver qi constraint, heat, and Spleen deficiency, can lead to incontinence and enuresis. Prolonged fearfulness and anxiety, such as that experienced by an abused child or after a sudden and intense shock or trauma, can disrupt the Heart-Kidney axis. This can lead to an imbalance between water and fire in the body, resulting in fire flaring out of control and affecting the Small Intestine via the Heart connection. The combination of Heart and Kidney pathology can amplify the irritating effects of heat on the Bladder and weaken the lower yin orifices.
Excessive physical activity can gradually drain Kidney yang, leading to weakness in the Kidneys. This weakness can also be inherited or develop from chronic illness, prolonged exposure to cold conditions, or excessive reproductive activity. In younger people, Kidney qi can be weakened without affecting Kidney yang, so cold symptoms may not be present. Kidney yin can be damaged by febrile diseases, overwork (particularly while under stress), lack of sleep, use of recreational drugs, aging, and excessive sexual activity.
Treatment for incontinence may involve a combination of pelvic floor exercises, bladder training, and addressing any contributing factors. One common pattern, Kidney and Spleen deficiency, can respond well to treatment, though it may take several months to see sustained results. Even in cases where the outlook is not as promising, treatment can still be worth pursuing as surprising responses have been observed in the past. Bladder training programs, which involve toning and strengthening the pelvic floor muscles and desensitizing the detrusor muscle, can be particularly effective for chronic deficiency patterns. To perform the exercise, the person should contract the muscles used to stop the flow of urine for five seconds, then relax for five seconds. The length of the contraction and the amount of rest can be gradually increased over time, with the goal of completing three sets of ten contractions each day. Delaying urination when the urge is felt can also be helpful, as can keeping a diary and limiting diuretic drinks. Relaxation techniques may be useful for managing strong urges.