Dr Fiona Wu, Senior Consultant Urologist and Medical Director at Aare Urocare (a member of Beyond Medical Group), was featured in Lianhe Zaobao by 李亦筠 on 19 May 2026, to share insights on how constipation may be the hidden cause behind common urinary problems, including urinary incontinence and urinary tract infections.
Frequent urination, urinary tract infections (UTIs), and urinary incontinence may all be signs of constipation. Many patients do not immediately recognise the connection between their bowel habits and urinary symptoms. In clinical practice, it is not uncommon to encounter patients who seek help for urinary problems, only to discover that constipation is the underlying trigger. Dr Fiona also advises patients to adjust their diet and lifestyle to help soften stools and relieve bladder pressure.
How Constipation Affects the Bladder
When the bowel is unable to empty completely, residual stool accumulates and creates pressure within the pelvic cavity. This excess pressure can worsen urinary leakage, particularly in individuals with a weaker pelvic floor. Additionally, a full bowel can compress the bladder and disrupt its normal function, making it harder to hold or fully empty urine.
Long-term straining during bowel movements gradually weakens the pelvic floor muscles, leading to urinary incontinence. Persistent pressure can also cause pelvic organ prolapse, further compounding leakage and difficulty urinating.
Constipation can also alter the gut microbiome. When harmful bacteria proliferate in the intestinal environment, they may migrate to the urinary tract and trigger UTIs. In general, constipation can simultaneously affect both urine storage and voiding, contributing to leakage, infections, and a cascade of related urinary symptoms.
Lifestyle Changes to Manage Symptoms
Constipation is closely tied to everyday habits. Key measures include increasing dietary fibre through fruits, vegetables, and wholegrains; maintaining adequate hydration; and establishing a regular routine for physical activity. These approaches help soften stools, reduce the frequency of straining, and ease pressure on the bladder. In many cases, improving bowel habits can simultaneously alleviate urinary symptoms.
Simple dietary choices to support bowel health include:
- Breakfast: Oats paired with fruits such as bananas, berries, or papaya; or wholegrain toast with avocado or nut butter
- Lunch: Brown rice or wholegrain noodles with leafy greens, legumes, or a salad with chickpeas or edamame
- Dinner: Broccoli, carrots, and green leafy vegetables; wholegrains in the meal; add legumes such as lentils or beans
- Snacks: Fruits, nuts, seeds, or vegetable-based sides
- Hydration: Drinking sufficient water is equally important. Adequate fluid intake supports fibre in promoting regular bowel movements
Protein intake is also important. Meeting daily protein requirements through fish, chicken, eggs, tofu, soy-based products, or dairy helps maintain overall nutritional balance.
Treating Both the Bowel and the Bladder
Dr Fiona emphasises that even when lifestyle changes are made, if constipation persists and urinary symptoms such as leakage, recurrent UTIs, or difficulty voiding continue, patients should seek medical attention promptly. Delayed consultation is common because patients tend to view bowel and bladder symptoms as separate concerns.
Many people focus on the bladder problem while overlooking the root cause in the bowel. It is important to evaluate bladder and bowel function together as part of a comprehensive assessment, as the two are closely interconnected. This evaluation may include a detailed history of urination and bowel habits, a physical examination, urine tests, and further investigations where necessary.
Bladder symptoms do not always stem from the bladder itself. The cause may well lie in the bowel. Addressing only one aspect while overlooking the other may lead to incomplete treatment outcomes.
This article was originally published in Lianhe Zaobao.