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Potential Bladder Irritants and Overactive Bladder Symptoms: A Systematic Review.
Barbara Ha1, Yoolim Seo2, Ashlee M Weaver3
1From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Urogynecology (Philadelphia, Pa.)
|March 19, 2025
Summary
This review found no consistent evidence linking common bladder irritants like alcohol or artificial sweeteners to overactive bladder symptoms. Further research is needed to clarify their role in managing this condition.
Area of Science:
- Urology
- Dietary Science
- Evidence-Based Medicine
Background:
- Behavioral modification, including avoiding bladder irritants, is a primary management strategy for overactive bladder (OAB).
- The precise role of specific dietary irritants in OAB remains unclear, necessitating further research as highlighted by the 2017 International Consultation on Incontinence.
Purpose of the Study:
- To systematically review and evaluate the existing peer-reviewed literature.
- To examine the association between six potential bladder irritants and OAB symptoms.
- To synthesize findings on alcohol, spicy foods, chocolate, artificial sweeteners, caffeinated/carbonated/citrus beverages, and high-acid foods in relation to OAB.
Main Methods:
- A systematic literature search was conducted across MEDLINE, EMBASE, and SCOPUS databases.
- An adapted patient-intervention-comparison-outcome framework guided the review.
- Risk of bias was assessed using the Risk of Bias in Non-randomized Studies-of Exposures tool; the study is registered with PROSPERO (CRD42023466251).
Main Results:
- Fifty-one articles were reviewed, focusing on alcohol (34), spicy foods (1), chocolate (3), artificial sweeteners (5), beverages (27), and high-acid foods (2).
- Outcomes assessed included OAB, urgency incontinence, urinary urgency, frequency, and nocturia.
- Observed associations between these irritants and OAB symptoms were mixed and inconsistent, with moderate risk of bias in 23 publications.
Conclusions:
- This systematic review did not find consistent evidence to support an association between the investigated bladder irritants and overactive bladder symptoms.
- The current body of evidence is insufficient to definitively link specific dietary components to OAB symptom exacerbation.
- Further high-quality research is warranted to elucidate the potential impact of these irritants on OAB.
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