Managing Bowel Problems With Ms
It is important that you prioritise your emotional wellbeing when you have MS, as losing motivation or feeling low can cause constipation. If you feel upset, embarrassed or stressed by MS bowel problems this can also exacerbate the problem. The mind-body connection is powerful.
Managing bowel problems with MS is key in taking back control over your body and not letting it stop you from enjoying life to the fullest.
Its not easy to approach a professional about bowel issues, but your doctor, neurologist or continence advisor will be able to help. If you combine this advice with positive lifestyle changes with the OMS 7-Step Recovery Program you will be improving other MS symptoms as well.
How Does Ms Affect The Urinary System
Multiple sclerosis can affect the urinary system in a number of ways. One of the most common problems is that people with MS feel the urge to urinate more often than normal.
This can be due to the MS lesions causing damage to the bladder, or because the spasticity caused by MS makes it difficult to control urination.
Bladder problems can also lead to other issues such as incontinence, which is the inability to hold urine in long enough for a normal trip to the toilet. In severe cases, people with MS may need to use a catheter to drain their bladder.
Urinary Urgency
Urinary urgency is a sudden, strong urge to urinate. This can be accompanied by a feeling of discomfort or pain in the bladder area. Urinary urgency can be caused by a variety of factors, including infection, inflammation, or obstruction. It can also be a symptom of other conditions such as MS or diabetes.
Urinary Hesitancy
Urinary hesitancy is a common issue that many people with MS face. It is characterized by difficulty initiating urination, which can lead to incomplete emptying of the bladder.
You are not alone in this fight against MS.
This can cause a number of problems, including urinary tract infections and incontinence. Urinary hesitancy can be caused by a variety of factors, including nerve damage, muscle weakness, and medication side effects.
How Bowel Incontinence Happens In Ms
Normal bowel function depends on a network of signaling throughout your central nervous system, says Tamara Bockow Kaplan, MD, a neurologist at Brigham and Womens Hospital in Boston.
The brain and bowel are in constant communication. Normally, the bowel sends information through the spinal cord, which has to get to the brain and then back to the bowel, Dr. Kaplan says. Your brain considers not just the information from your bowel, but also convenience and social signals, to determine whether its time to have a bowel movement.
Even though it may seem counterintuitive, one of the most common causes of bowel incontinence is actually constipation.
Bowel problems often go hand-in-hand with bladder problems, and not just because theyre both caused by a disruption in nerve signaling affecting the same region of your body.
Oftentimes when someone has an overactive bladder, they try to self-treat by limiting their fluid intake, says Kaplan. That can, in turn, worsen constipation and, in some cases, lead to incontinence.
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Combined Storage And Emptying Issues
Its possible to have both emptying and storage dysfunctions if you have MS. This occurs when nerve damage causes the muscles in your bladder and urinary sphincter to fail to coordinate properly with each other. Symptoms can include all of those associated with both emptying and storage problems, and can also lead to kidney damage.
Incontinence Pads And Underwear
Absorbent pads sold specifically for urinary incontinence can help a person stay dry and odor-free during the day or night. Incontinence pads are made for men as well as for women.
A lot of people use menstrual pads or adult diapers for urinary incontinence, and these can be embarrassing and uncomfortable, notes Kaplan. Next to the menstrual supplies in drugstores and supermarkets, there is usually a whole section dedicated to urinary incontinence, she says.
A variety of companies now make absorbent washable underwear for incontinence, primarily in womens styles and sizes, although mens absorbent underwear is also available.
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How To Get Bowel Movements Back To Normal
- Drink more fluids. Make sure you get enough water every day. You might be tempted to cut back on it if your MS gives you bladder problems. But that makes constipation worse. Make your first beverage of the day something hot, such as hot water or apple cider, or drink 1/2 to 1 cup of prune juice in the morning to get things moving.
- Get more fiber. The best way is to eat plenty of fresh fruits and vegetables and whole-grain breads and cereals. Add 2 to 4 tablespoons of unprocessed wheat bran to hot or cold cereal or casseroles, or mix it with applesauce, pancake batter, pudding, muffin batter, milkshakes, or cookie dough. Be sure to drink plenty of liquids, which help the bran work inside you. Your doctor may also recommend that you take a fiber supplement.
- Stick to a schedule. Set a regular time when youâll go to the bathroom. Try going right after meals since eating is a natural way to prompt a bowel movement. Try to wait no more than 2 to 3 days between bowel movements.
- Exercise. Itâs a great way to get your digestive tract going.
- Use stool softeners. But only if your doctor says its OK.
Evaluation Of Luts In Ms
MS is characterized by heterogeneous clinical presentation and evolution. Patient profiles vary greatly. Although most patients urinate by themselves, they may suffer from over-active bladder symptoms or recurrent urinary tract infections . Other common complaints are voiding and emptying difficulties with a smaller group of patients who cannot void at all.
Evaluation has to be uniquely tailored for every patient after taking into account his/her symptoms, disease course and length, comorbidities, physical status, and medications. However, complete history, including QOL assessment, physical examination, and urine culture and analysis with post-void residual measurements, should be obtained systematically for all patients. More advanced evaluation, including UDS, may be reserved for cases where the results may change the treatment regimen chosen.
At present, international management guidelines, developed by the International Consultation on Incontinence 12 and the European Association of Urology ,13 exist for neurogenic LUTD in general, but not specifically for MS patients. Unlike spinal cord injury , MS patients, even with detrusor external sphincter dyssynergia and neurogenic detrusor overactivity , rarely suffer from upper urinary tract deterioration.1,11 Therefore, active and invasive evaluation of NLUTD patients, as proposed by these guidelines, does not seem fully applicable to the MS population.
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Ms Bowel & Bladder Issues Explained
Life with Bowel and Bladder Problems Caused by MS
Hear from two people living with MS as they discuss challenges and tips.
Speakers: Megan Weigel, DNP , Sharleen , and Jeff
The Toll on Your Mind, Emotions, and Relationships
Understand the psychological effects of bowel and bladder symptoms.
Speakers: Rosalind Kalb, PhD , Julie Stamm , and Adam Romsdahl
The Effects of MS on Your Bladder
Understand why you may be experiencing bladder issues.
Speaker: David Ginsberg, MD
The Effects of MS on Your Bowel
Understand why you may be experiencing bowel issues.
Speaker: David Ginsberg, MD
Understand what treatments can help your unique bladder and bowel concerns.
Speaker: David Ginsberg, MD
Physical Therapy for Your Bladder and Bowel
Understand how pelvic floor exercises and other PT can improve bladder and bowel functions.
Speaker: Lindie Schreiner, PTA
Tips and Tricks for Daily Life
Understand how catheters and other tools can be discreet, simple options to improve your life.
Speaker: Megan Weigel, DNP, ARNP-C, MSCN
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Treating Stones And Infections
If you end up with a UTI because of your bladder dysfunction, youll need to be treated with antibiotics. Untreated and frequent infections can cause serious complications in your kidneys. Both stones and infections can be very painful and can lead to permanent kidney damage if left untreated.
Treatment for stones varies depending on their size. You may be able to simply pass them as they are, or your doctor may be able to break them up with sound waves to make them smaller and easier to pass. A scope may also be inserted to remove stones.
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Can Ms Bladder Issues Come And Go
Many people with MS have relapsing-remitting MS, which means the symptoms come and go. This can include bladder symptoms.
At times, the myelin repairs itself, which makes symptoms disappear after a relapse. Other times, a person may have an exacerbation, meaning symptoms come back.
Additionally, doctors may ask a person to make a 3-day urination diary.
What Is Multiple Sclerosis
Multiple sclerosis is an inflammatory disease that interferes with nerve cells in the brain and in the spinal cord. The term sclerosis actually means scarring, and multiple relates to the fact that the scarring can occur in many different places in the brain and spinal cord. In people with multiple sclerosis, the messages from the brain carried by the nerves are interrupted and can interfere with a wide range of bodily functions.
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What Can I Do If I Have Bladder Problems
Get in touch with a health professional if bladder problems are affecting your daily life your MS specialist nurse, GP or continence advisor will be able to help.
Get to know your bladder by keeping a diary. This gives you an overview of how your bladder problems affect you over time. You could keep notes in a notebook or there are smart phone apps available to help you monitor your bladder function. It’s useful to note what you have to eat and drink, any medication you take, when you go to the loo, any problems with stopping or starting, and if you have any bladder accidents. You can share this with your health professionals. It can also help you to see what difference changing something in your diet has made, for example drinking less caffeinated drinks.
Adjusting What And When You Drink
Your body needs six to eight cups of fluids daily, but you can modify what you drink and when. Limiting your consumption of coffee, tea, and soda may help, says Epstein.
There is no need to decrease your water intake overall this can lead to dehydration, which can lead to constipation, says Kaplan. She tells her patients to limit fluid intake after dinner to avoid nighttime urination.
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What Treatments Are Available For Ms
There’s no cure for the disease, however, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms. The best thing to do when living with MS is to find a trusted interdisciplinary medical team that can help you monitor and manage the conditions. There are many options to help you live a full life. Further down in this text we will guide you to the available solutions that could help you manage and take control of your bladder and bowel.
Why Does Ms Cause Incontinence
When your bowel or bladder starts to become full, your body sends signals to your brain that you will need to go to the bathroom. When you get to the bathroom, your brain transmits signals to your bowel or bladder that its OK to void your bladder or have a bowel movement.
When MS destroys myelin, it creates scarred areas called lesions. These lesions can destroy any part of the pathway of transmission from the brain to the bladder and bowels.
The results can be a bladder that wont empty fully, is overactive, or wont hold urine well. Examples of symptoms someone with MS may have related to their bladder include:
- difficulty holding urine
- difficulty starting a urine stream
- feeling like the bladder wont empty completely
- having to go to the bathroom at night frequently
- having to urinate frequently
Many people with MS experience an overactive bladder. MS can also affect the nerves that transmit to the muscles responsible for emptying your bowels. The results can be constipation, incontinence, or a combination.
Both medical and lifestyle treatments are available to treat MS-related bladder incontinence. Examples of medical interventions include:
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Pelvic Floor Muscle Exercises
The pelvic floor is layers of muscles that stretch from the pubic bone to the coccyx and then from side to side. These muscles help to support the bladder and bowel plus the womb in women. These muscles can become weak through trauma such as childbirth or surgery, changing hormones, persistent coughing, chronic constipation or nerve damage from MS. When these muscles become slack it can weaken the sphincter muscle to the rectum or bladder allowing the involuntary passing of stool or urine.
Common Ms Bladder Problems To Be Aware Of
There are a few different bladder control problems with can occur with MS. They include:
Urinary Urgency
Those who experience urinary urgency feel the need to urinate frequently. While frequent urination can be annoying, its not the real issue here.
The issue with this particular bladder control issue is the urgency. You may feel fine one moment, and then when urinary urgency takes place, you will experience an uncontrollable urge to urinate, leading to incontinence.
If you experience urinary urgency, you can control this by paying attention to your bodys signals. Prior to urinating, you will experience what is described as a small tickle, along with pressure. This is your bodys way of telling you it is time to go to the restroom. By heading to the restroom as soon as this sensation is experienced, youre more likely to make it on time.
Incontinence
Incontinence is a complete loss of bladder control. This occurs when the nerve signals in your body that control urine movement are disrupted. Those with MS sometimes experience a disruption, which causes urine to move out without notice and beyond your control.
Bladder training, frequent trips to the restroom and fluid management techniques along with medication can help prevent loss of bladder control due to incontinence.
Nocturia
MS is one of the most common causes of nocturia. If left untreated, this problem can contribute to the fatigue associated with MS.
Urinary Hesitancy
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Why Does Multiple Sclerosis Cause Bladder Issues
The bladder, which stores urine, is controlled by the nervous system. Because multiple sclerosis damages nerves, bladder function may be affected. Some people find that they need to urinate more frequently or urgently, whereas others experience difficulty emptying the bladder. Some people with multiple sclerosis may experience occasional urinary incontinence.
Treating And Managing Bladder Problems
The management of bladder problems in MS includes two key approaches: the use of clean intermittent self-catheterisation to manage incomplete emptying, and medications to treat an over-active bladder that results in inadequate storage of urine and urgency or frequency problems. A comprehensive evaluation of bladder problems by an experienced healthcare professional and motivation on the part of the person with MS can result in successful management of these problems.
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Talk With Others Who Understand
MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 187,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.
Have you found solutions to bladder issues? Share your experience in the comments below, or start a conversation by posting on your Activities page.
How Multiple Sclerosis Impacts Bladder Health
Your urinary tract system is a delicate system that works in conjunction with many parts of the central nervous system. Multiple Sclerosis is a defined as an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.2 With that definition, its understandable how Multiple Sclerosis would impact bladder health. The isolating layer that surrounds the nerves is lost and in its place, scar tissues called sclerosis, also known as plaques or lesions are left.3 These lesions are what cause the disruption in communication.
Since the communication between body and brain are disrupted, so are many healthy functions of other internal systems. Some of these functions are more serious than others, but many can be managed with a few lifestyle changes and awareness. In this article, well explore how multiple sclerosis impacts bladder health and what you can do to reduce any associated bladder problems.
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Are There Any Complications For Ms Incontinence
Treatments for MS-related incontinence may not completely reverse your symptoms. But theyre important for ensuring you dont experience side effects. For example, people who are unable to fully empty their bladders are at greater risk for UTIs.
If your incontinence results in repeat bladder infections or UTIs, this can compromise your overall health. Sometimes UTIs can trigger other immune responses in a person with MS. This is known as a pseudo relapse.
A person having a pseudo relapse may have other MS symptoms, such as muscle weakness. Once a doctor treats the UTI, the pseudo relapse symptoms usually go away.
Also, bladder and bowel incontinence can lead to skin infections. The most serious infection is called urosepsis, which can be fatal.
Seeking treatments as early as possible may help to delay or slow the progression of MS-related incontinence symptoms. This can reduce the likelihood that your bladder could become weaker or more spastic.
In addition to the physical side effects of incontinence, there could be mental health effects. Those with MS may avoid going out in public for fear they will have an incontinence episode. This can lead to a withdrawal from friends and family who are often great sources of support.