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Imperative urges

 
, medical expert
Last reviewed: 07.06.2024
 
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Imperative urges, also known as imperative manifestations or imperative symptoms, are strong, intrusive, inescapable thoughts, urges, or actions that enter a person's mind and can cause discomfort and anxiety. These thoughts or urges compel the person to perform certain actions, even if they are illogical or inconsistent with the person's desires or values.

Imperative urges are one of the hallmarks of a number of mental disorders, such as:

  1. Oxessive-compulsive disorder (OCD): In OCD, the patient experiences intrusive thoughts (oxxes) that cause anxiety, and the patient feels the need to perform ritualized actions or compulsions to relieve this anxiety. For example, making sure the door is closed several times in a row or washing hands repeatedly.
  2. Ticdisorder: Tics are imperative movements or sounds that the patient cannot restrain. Tics can be motor (movements) or vocal (sounds).
  3. Anxiety Disorder: In a number of anxiety disorders, compulsive urges may occur due to the experience of anxiety and the need to perform certain actions to relieve anxiety.
  4. Body perception disorder (dysmorphophobia): People with this disorder may have obsessive thoughts about real or imagined defects in their appearance and a desire to correct them through surgery.

Imperative urges can significantly affect a person's quality of life and may require psychotherapy and/or medication depending on their nature and severity.

Causes of the urges

Urge urges can have different causes, depending on the context and where they occur. The following are some of the possible causes of urges:

  1. Urge tourinate:

    • Irritable bladder syndrome (IBBS): This condition is characterized by frequent and urgent urination, a feeling of bladder overflow, and lower abdominal pain.
    • Urethritis: Inflammation of the urethra can cause urgency to urinate and burning when urinating.
  2. Imperative urges to defecate:

    • Irritable bowel syndrome (IBS): This is a functional bowel disorder that can cause frequent and imperative urges to defecate, as well as abdominal pain, constipation or diarrhea.
    • Colon Diseases: Inflammatory boweldisease, polyps or cancer can cause urges.
  3. Imperative urges in other contexts:

    • Ticdisorder: Tics are imperative movements or sounds that the patient cannot restrain.
    • Rapid voiding syndrome: Urgent and unavoidable urges to defecate immediately after eating may be associated with this syndrome.
    • Imperative urges in psychiatric or neurological conditions: Some psychiatric or neurological disorders, such as Tourette's syndrome or obsessive-compulsive disorder, can cause imperative urges in various forms.
  4. Urge duringmedical procedures: Urge may occur during medical procedures such as cystoscopy, colonoscopy, or urodynamic testing.
  5. Pharmacologic causes: Some medications can cause urges as a side effect.
  6. Psychological and stress factors: Emotional stress or psychological problems can also cause urges.

It is important to remember that the exact cause of imperative urges can only be determined after consulting with a doctor and conducting the necessary tests and examinations.

Symptoms of the urges

This symptom can occur due to various diseases or conditions related to the urinary system or nervous system. Symptoms of urges may include:

  1. Strong urge to urinate: Patients describe an excessive and urgent urge to urinate that occurs suddenly and cannot be delayed.
  2. Frequent visits to the toilet: Patients may have to go to the toilet excessively often, even if the urination is minor.
  3. Pain or discomfort when urinating: Sometimes symptoms of urges may be accompanied by pain or discomfort when urinating.
  4. Midnight urges: Patients may wake up during the night with an urgent desire to visit the toilet.

Symptoms of imperative urges can result from a variety of conditions such as:

  • Overactive bladder syndrome (OABS): This condition is characterized by overactive bladder and urinary involuntariness.
  • Cystitis: Inflammation of the bladder mucosa can cause urgency and pain when urinating.
  • Urinary tract infections: Bacterial infections of the urinary tract can cause symptoms of urgency.
  • Neurological diseases: Someneurological diseases, such as Parkinson's disease or stroke, can affect urinary control and cause urges.

Imperative urges to urinate

These are strong, unstoppable urges or urges to urinate that may occur suddenly and cause an urgent need to go to the toilet. These urges can be associated with various medical conditions and can cause discomfort and anxiety.

The most common cause of imperative urge to urinate is a urogenital disorder such as:

  1. Irritable bladder syndrome (IBBS): This condition is characterized by frequent and urgent urination, a feeling of bladder overflow and is often accompanied by lower abdominal pain.
  2. Cystitis: Inflammation of the bladder can cause frequent and urgent urges to urinate, as well as lower abdominal pain and burning when urinating.
  3. Urolithiasis: The presence of uroliths can cause frequent and urgent urges to urinate, especially when stones have passed through the urinary tract.
  4. Urethritis: Inflammation of the urethra may be accompanied by a sense of urgency when urinating and burning.
  5. Low-volume bladder (small bladder): In some people, the bladder may have a low volume, which can lead to more frequent and urgent urges to urinate.
  6. Urogenital infections: Genitourinary infections can cause bladder irritation and urges.
  7. Other medical conditions: Urge to urinate may also be associated with diseases of the nervous system or other medical problems.

Imperative urges to defecate

These are strong, inescapable urges or urges to defecate (fecal secretion) that come on suddenly and create an urgent need to visit the toilet. These urges can be triggered by a variety of medical conditions and may be accompanied by diarrhea, abdominal pain, or other symptoms.

The most common causes of imperative urges to defecate are the following conditions and diseases:

  1. Irritable bowel syndrome (IBS): This is a functional bowel disorder that can cause frequent and imperative urges to defecate, as well as abdominal pain, constipation or diarrhea.
  2. Colorectal disease: Various colorectal diseases such as inflammatory bowel disease (including Crohn's disease and ulcerative colitis), polyps, or cancer can cause urges to defecate.
  3. Rapid voiding syndrome: This condition is characterized by urgent and unstoppable urges to defecate immediately after eating.
  4. Excessive consumption of caffeine or specific foods: Caffeine and certain foods can irritate the intestines and cause urges to defecate in some people.
  5. Functional constipation: Some people with constipation may experience intermittent bowel overflow, which causes strong imperative urges to accumulate stool.
  6. Other medical conditions: Imperative urges to defecate may also be associated with neurologic or functional disorders.

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Treatment of the urges

Treatment for imperative urges depends on the underlying cause of this condition. If you experience imperative urges to urinate, defecate, or in other contexts, it is important to see a doctor or specialist to get an accurate diagnosis and develop the best treatment plan. Here are some of the possible treatments that may be utilized depending on the diagnosis:

  1. Treatment of the underlying condition: If urges are associated with other medical conditions such as irritable bladder syndrome, inflammatory bowel disease, or other medical conditions, treating the underlying condition may help reduce urges.
  2. Medication: Your doctor may prescribe medications to reduce symptoms and control urges. Examples include antispasmodics, antidiarrheals, urologic or gastroenterologic medications, etc.
  3. Physical therapy and rehabilitation: Physical therapy, biofeedback, and other rehabilitation techniques can help manage urges and improve bladder or bowel muscle control.
  4. Psychotherapy and Cognitive Behavioral Therapy (CBT): These methods may be useful in treating urges related to psychological aspects or anxiety.
  5. Diet and lifestyle changes: In some cases,dietary changes, eliminating irritating foods, controlling fluid intake, or managing stress can help reduce symptoms.
  6. Medical procedures and surgery: In some cases, medical procedures such as botulinum therapy (botulinum toxin injections) or surgery may be needed to improve urge control.
  7. Pharmacotherapy: In some cases, medications that affect the nervous system to reduce urges may be prescribed.

Literature

Lopatkin, N. A. Urology: National Guide. Brief edition / Edited by N. A. Lopatkin - Moscow : GEOTAR-Media, 2013.

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