(Top photo: Shane Augustus, via)
Now, I don't know about you boozy cats out there in Whereversville, but me: I like to piss when I'm drinking. I say "like", but what I mean is urination at the pub is usually a panicky emergency that takes place with alarming frequency. The worst thing is when you have that final I'm-going-home piss, but it's not actually the final one – far from – so you spend the next hour on the tube or bus or cab ride almost delirious with desperation, clutching seats, trying not to move as your swollen bladder bounces around in your pelvis like a fat dog on a netted trampoline.
If there's one phrase you'll here with the most regularity when it comes to this topic, it's likely: "The problem is: beer just goes right through me."
But does it actually?
Richard Viney is a Consultant Urological Surgeon and a Senior Lecturer in Urology at University Hospitals Birmingham. I asked him why my pint addiction is also making me want to piss my pants all the time. "It is volume on top of everything else," he says. "If you were matching pints with teetotallers drinking pints of water, the beer drinker would still be visiting the toilet more frequently."
So what does alcohol do to the bladder?
"Alcohol itself is a diuretic, which means that the kidneys themselves put out more water," says Viney. "The more alcohol you put in, the more urine you produce per volume of alcohol. Secondly, it will increase heart rate and push blood pressure up, which will also drive urine output, so having beers or any alcohol will increase urine output, which will have an impact on the bladder. Alcohol will have a direct impact on the bladder as well, because it is an irritant and the bladder will want to empty more frequently."
However, according to Rizwan Ahmed – a member of the London Urology Associates – it's not the same for everyone. "The effect of alcohol on the bladder is variable for some individuals, especially females," he says. "For them it has more of an effect, but for the majority it will have at least some effect, varying from an increase in urine frequency to a state where someone who drinks alcohol has to go to the toilet almost immediately. It will just run through their body. The course of increased urinary production is in relation to one of the hormones in the body."
"If you are a cigarette smoker, cigarettes are massively irritant to the bladder."
So our delicious al-kee-hol has things in it that create water in our poor, stretched out bladders. But is this only relevant for beer and the exorbitant amount of it that we drink? Or does it apply across the board?
"It depends on the type of alcohol you are drinking," says Viney. "If you're drinking beer, then beer is bringing various things to the table as well. If you're having a night on the beers versus a night on the whiskeys, gram for gram you are going to be peeing more with the beer, purely because of the volume element to it."
So maybe there is some truth to the old beery adage, after all – if only because you drink more of it, and more quickly, than you would other types of alcohol. But what about the other aspects of your typical night out? The cigarette smoking, the drink mixing?
"If you are a cigarette smoker, cigarettes are massively irritant to the bladder," says Viney. "The cigarettes are driving heart rate up, but the nicotine is also a massive bladder irritant, and it is pro-malignant, so bladder cancer comes from smoking and passive smoking. When we see bladder cancer in dogs they have all come out of smoking households. The other thing, of course, is mixers – fruit juices can change the PH of your urine, and that can be a bladder irritant. Also, if you like your party drugs, like ketamine, it is a hugely destructive drug for your bladder."
So we know why your bladder fills to burst, but what about the horrendous discomfort that goes along with it? When I over-eat, which is a daily occurrence, I feel full and maybe a bit queasy, but never close to the eye-popping horror of needing desperately to piss.
"Without going too far into the biology," says Viney, "there are two ways in which your body is controlled neurologically. There is what's called the somatic nervous system, which is controlled and you are consciously aware of all that stuff – like if you want to touch your nose with your finger, you are in complete control of that process, but there is a whole lot of other stuff which goes on in your body that is controlled by your brain without you ever being consciously aware of it, like your heart beating, like your lungs breathing, like sweating… and these things happen automatically. The bladder is a funny structure because it is part somatic and part autonomic, and it is a battle between the two: between your conscious control – not wanting you to wet yourself in an awkward point in time – but it is your bladder's desire to get rid of waste fluid."
So there you have it: booze makes your kidneys produce more fluid, filling up your bladder. Pints of lager stretch you out even more, because you're drinking more of them in quick succession than you would spirits, and so you need to piss more.
Mind you, technically beer doesn't go "through you" quicker than any other type of alcohol. So next time someone makes that complaint, remind them that they are wrong.
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