Bladder dysfunction in alcohol rehab

Evidence based addiction treatment research suggests that alcohol-induced bladder dysfunction is not uncommon in alcohol rehab. However, the mechanisms are not clear. Researchers from The University of Tokushima Graduate School in Japan report on the case of symptomatic abdominal distension due to urinary retention after alcohol withdrawal (Iga et. al., 2005).

The patient was a 48-year-old Japanese woman, married with three children. She began drinking occasionally after college. At age 38 she experienced panic disorder and sought professional help. From age 42 to 48 she gradually increased the amount of alcohol she consumed until the alcohol abuse became severe at age 48, when she was admitted to the psychiatry department at the University. The patient ate regular meals and took vitamins after admission. Two days after admission she showed typical symptoms of alcohol withdrawal. About 10 days after admission, her abdomen was extremely distended but soft and non-tender and an ultrasound suggested that urinary retention was the cause of the distention. Further, a urodynamic study showed a decrease in bladder sensation. The patient was diagnosed with neurogenic bladder with autonomic dysfunction, secondary to alcoholic neuropathy. Alcoholic neuropathy refers to any nerve damage as a result of excessive consumption of alcohol; alcoholic neuropathy commonly presents as numbness in the arms or legs. In this case, excessive alcohol use causes nerve damage in the bladder, which resulted in urinary retention and abdominal distension.

The patient was taught how to insert a urethral catheter, which she had to use 3 to 4 times a day. The patient improved some over the months but still must use the catheter once a day.

Notably, the urinary retention in this patient did not begin until after alcohol withdrawal. The authors point out that “alcohol withdrawal is associated with the onset of other alcoholic neuropathies such as peripheral polyneuropathy and Korsakoff’s syndrome.”

In this case, the patient exhibited no symptoms or signs of thiamine deficiency or alcoholic myelopathy nor did the patient show signs of bladder obstruction or use of medication that might cause urinary retention. Thus, the authors diagnosed her with urinary retention due to bladder dysfunction by alcoholic neuropathy.

“Recent experimental researches suggest that ethanol withdrawal causes neurotoxicity and inhibits neuronal recovery processes in rat organotypic hippocampal cultures, and that alcoholic neurodegeneration occurs through multiple mechanisms during intoxication and withdrawal,” the authors conclude. “The findings in our case suggest that neurogenic bladder due to alcoholic neuropathy could be precipitated by alcohol withdrawal.”

Other cases of alcohol-induced bladder dysfunction have been reported. Alcohol treatment providers in alcohol rehab programs should be aware that abdominal distention could be due to urinary retention caused by alcoholic neuropathy.

Bladder dysfunction is one of the many adverse effects of alcohol abuse. As the problem persists, the effects can worsen unless an individual decides to take action. A self- empowering approach deals with the overall wellness physically, psychologically, and spiritually. We work with wellness providers, dieticians, and nutritionists to ensure that all of our clients get their needs met in all areas. Sleep, exercise, and nutrition are three major focuses in recovery.

Iga J-I, Taniguchi T, Ohmori T. Acute abdominal distension secondary to urinary retention in a patient after alcohol withdrawal. Alcohol and Alcoholism. 2005; 40(1): 86-87.

http://alcalc.oxfordjournals.org/cgi/content/full/40/1/86