• Emily Reul, PT, DPT

Bladder Diary

Updated: Mar 25

Hello friends! This week’s topic is bladder diaries. If you’re thinking of your bladder sitting down and writing, “Dear Diary” with pages full of secrets, that’s not exactly what we are talking about. A bladder diary is a daily record of your bladder and bowel activity.


No bladder story is the same, so a bladder diary can help give you (and your providers) a glimpse into how your bladder is functioning and how it reacts to certain food and drinks. Your therapist can help you interpret the information you record in your bladder diary to help develop treatments to improve your symptoms. A bladder diary can also be a very helpful tool when doing bladder retraining for urge incontinence (or overactive bladder). To learn more about urge incontinence, check out our blog here.


HOW TO USE A BLADDER DIARY

There are tons of different bladder diary templates you can use, but they all follow the same concepts. They simply measure what goes into your body (like food and drinks—including how much and what type) as well as what comes out of your body (pee, poop, and leaks). You will write each of these items down at the times that they happen during the day.


When measuring output, there are several things you may want to write down:

  • How much urine comes out (you can count the number of seconds, or to truly be accurate you can use a urine hat to collect and measure)

  • How strong of an urge you felt when you went to the bathroom

  • The amount of leaking you have (often measured as light, moderate, or heavy)

  • What you were doing when you leaked (e.g. Jumping, sneezing, laughing, etc.)

  • The type of poop using the Bristol Stool Scale



Some other things you may want to write on your bladder diary are pain or abdominal discomfort or the number and size of pads you are using each day.


WHEN IS THE BEST TIME TO WRITE A BLADDER DIARY

While there is no perfect answer to this question, try to write a bladder diary for 2 or 3 consecutive days. Doing a bladder diary takes commitment but it can be so beneficial for getting more insight about your symptoms. If you are going on vacation, this may not be the best time to write your diary as you may have a hard time completing it—I mean, who wants to be writing a bladder diary when you are relaxing on the beach? It may be best to pick a few “normal” days in which you are following your daily routine.


HOW TO INTERPRET YOUR BLADDER DIARY

Looking at your bladder diary after you’ve finished it can help you to recognize and understand your symptoms better. For example, you may realize that you only go to the bathroom or have leaking at night (nocturia or nocturnal enuresis) on the night when you consume liquids before bed. Learn more about nocturnal enuresis here. You may also realize that the urge to go to the bathroom is stronger when you haven’t been drinking enough liquids. You might learn that you have to pee more often if you aren’t pooping regularly. There is an endless list of possibilities, but your provider can help you look at your bladder diary and recognize any of these patterns.


Here is a list of some of the things we commonly look for:

  • Overloading fluids at night

  • Urinating too often (i.e. every 20-30 min)

  • Not drinking enough liquids

  • Increase in urgency or leaking aft