How You Can Cope With Ms Bladder Problems
MS bladder problems can be embarrassing, but help is available. The first step in coping with MS bladder problems is to see your doctor. Your doctor will determine the cause of the problem and recommend a course of treatment, which may include medications or intermittent catheterization, which involves draining the bladder using a thin tube inserted through your urinary opening.
Here are a few other things you can do to cope:
Follow your treatment plan:
- Follow the treatment plan that you and your doctor have discussed. Take any medications exactly as prescribed.
- If you have a urinary tract infection , continue to take the full course of treatment, even if you feel better after a few days. This can help prevent the bacteria from becoming resistant to antibiotics.
- Ask your doctor or pharmacist when you should expect the medication to start working, which side effects to watch for, and when to return for a follow-up appointment. Contact your doctor or pharmacist if you notice any symptoms that worry you.
Keep drinking fluids:
- Do not restrict your fluid intake this can affect the kidneys and cause bladder irritation.
- Drink 6 to 8 glasses of fluid daily. Don’t drink large amounts of fluid at once, especially before going out or going to bed. Instead, try to spread your fluid intake out over the day by drinking smaller amounts more often.
- Avoid caffeine and alcohol, which can irritate the bladder and worsen your bladder symptoms.
Wear absorbent pads if needed:
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.
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.
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How Does Ms Affect The Bowel
People with MS rank bowel problems as the third most bothersome symptom after fatigue and mobility issues. This is not surprising due to the embarrassing nature of the symptoms and that bowel symptoms affects their daily activities and social interactions. Actually, bowel symptoms are one of the primary causes of inability to work for people with MS, after spasticity and incoordination.
Bowel symptoms are correlated to disability and disease duration, but people with low disability and short illness can also have bowel symptoms. In fact, severe constipation can be one of the first presenting symptoms of MS.
Its common in MS patients with bowel problems, both constipation or bowel leakage affects about 50% of MS patients at some point and is an continuous symptom in one out of four. It may sound strange but constipation and bowel leakage coexistent and alternates in many people affected by MS.
The time spent on bowel care is an important contributing factor to reduced quality of life since many affected by MS plan their lives around their bowel and have to spend a lot of time in the bathroom. In fact, some might hardly ever leave the house because of repeated attempts to empty their bowel and fear of accidental bowel leakage.
How Can Bowel Function Be Affected With Multiple Sclerosis
Bowel dysfunction is also a common symptom for patients with MS. One study of 77 patients with clinically definite MS showed that bowel problems are not associated with bladder dysfunction, patient’s age, degree of disability, or duration of disease.
The most common bowel complaint from a person with MS is constipation, but the most distressing bowel complaint is probably that of involuntary bowel/fecal incontinence. Because MS interrupts or slows the transmission of signals to and from the brain, the electrical impulses to the muscles that are involved in emptying your bowel can become disrupted.
Depending on your particular bowel problem, helpful suggestions can be made. General interventions for bowel dysfunction include:
- Education about the causes of bowel dysfunction
- Encouraging dietary changes to include more fiber and fluid
- Consulting with your healthcare provider to adjust medication regimens that may be contributing to bowel dysfunction
- Establishing a regular bowel routine, individualized to the patient
- Encouraging regular physical activity
Bladder and bowel symptoms are common in MS and can be effectively managed. Speak with your healthcare provider about what you can do to help keep these symptoms under control.
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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.
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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How Diet And Medication Can Contribute To Bowel Problems
I dont think people realize that the food we eat and what we drink can really make a difference in bowel symptoms, says Rachael Stacom, an adult nurse practitioner and senior vice president of population health at Independence Care System in New York City.
Not consuming enough fiber or fluids can contribute to constipation, while consuming spicy foods, dairy products, caffeine, and artificial sweeteners can all lead to problems with bowel urgency.
In more difficult cases, it may help to follow a very restricted diet to see what foods might be problematic, Stacom says. Then, well have people slowly introduce foods to see if that aggravates your stomach.
Another potential contributor to both constipation and urgency is what kinds of medication you take. Some may have a stimulant effect or bother your stomach, leading to bowel contractions. Others may slow down your digestion, leading to constipation and possibly a higher risk of incontinence.
Adjusting medication doses may be difficult, especially if theyre working for their intended purpose. But sometimes there are some easy things we can do, such as adjusting diet and a bathroom schedule to respond to the effects of the medication, says Kaplan.
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Multiple Sclerosis And Incontinence Treatments
There is plenty that can be done to help improve incontinence in MS patients. There are many conservative methods, which can help improve or it may be a case of adjusting your medication to help alleviate your symptoms. If conservative methods alone are not effective then there are many medications available. As a last resort, if incontinence symptoms are severe then you may be recommended surgery in order to improve your quality of life.
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Bowel Problems Are Less Common But Just As Important
- Constipation, which is the most common bowel problem in people with MS, is caused by:
- Slowed nerve conduction in the central nervous system that slows the action of the bowel
- Reduced physical activity
- Reduced fluid intake
- Inadequate fiber intake
The best solution to bowel problems in MS is a consistent bowel regimen that includes a regular and relaxed schedule for bowel movements, a diet full of fiber and fluids, and enough physical activity to help your system do its work. An MS nurse or gastroenterologist can help you identify the precise problem you are having and help you create a regimen that will give you optimal control over your bowel function.
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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How To Control Diarrhea
- Drink more liquids to make up for what your body is losing. Try water, lemonade or fruit-flavored drinks, fruit or vegetable juice, broth, milk, or soup.
- Talk with your doctor or dietitian about how much fiber you should eat.
- Eat soft foods that have a lot of liquid, such as sherbet, yogurt, and pudding.
- Ask your doctor whether changing your medications might help relieve the diarrhea. But donât try to take less or stop taking them before you talk to them.
- Dont take over-the-counter drugs for diarrhea without talking to your doctor.
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If So Youre Not Alone
These are common bladder and bowel problems for folks with MS.
MS can take away your sense of personal control — over your vision, walking ability, thinking and memory. But losing control of your bladder and bowel function — which you worked hard to master as a very young child — is tough to take. So learning how MS affects bladder and bowel function — and what you can do about it — is the first step toward taking back control.
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Bladder And/or Bowel Retraining
Bowel retraining and bladder retraining involves establishing your bladder or bowel into a regular routine and retraining your brain to hold on. You start by going to the bathroom when you get the urge to go and hold for 1 minute before sitting down. Gradually increase the length of time until the you feel more confident with your control. It is also helpful to regulate the times that you visit the toilet. This may alo help to avoid accidents. Make sure that this is at a time that is comfortable and allows enough time so that you dont feel anxious. Some people also like to record a bladder/bowel diary to see if any foods or drinks affect function.
Something To Think About
Changes in bladder and bowel function also happen naturally with pregnancy and childbirth, normal aging, menopause, and other factors. Your MS provider or your primary care physician can help you figure out the cause of any changes youre experiencing, and the best strategies for dealing with them.
Feeling comfortable and in control are essential to your quality of life — so speak up and advocate for yourself!
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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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Symptoms Of Multiple Sclerosis
- Symptoms of MS can be vague and vary greatly but below are the most commonly reported symptoms. Only a healthcare specialist can diagnose MS, which is usually confirmed by an MRI scan which can show detailed images of the damaged nerve fibres.
- Bladder and/ or bowel issues
- Problems with speech and swallowing
- Affect balance and coordination
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What Are Some Bladder Management Points To Remember If I Have Multiple Sclerosis
- Adequate fluid intake is 1½-2 quarts of fluid a day. The urge to urinate comes about 1½ -2 hours after drinking something.
- Caffeine, aspartame, and alcohol are all bladder irritants.
- Smoking also is irritating to the bladder.
- Limiting fluid is harmful.
- It is not normal to leak urine, wake up more than once at night to urinate, or to have frequent urinary tract infections.
- Bladder infections in people with MS may result in an increase in MS symptoms, spasticity, and fatigue.
Plan of action
- Drink fluids all at once . If you sip, sip, sip you will feel the urge to urinate frequently. Try to go about 1½ to 2 hours after you drink.
- Stop drinking fluids about 2 hours before bedtime urinate right before bedtime.
- If you tend to get frequent bladder infections you are probably not emptying your bladder completely.
- Taking cranberry pills may keep your urine more acidic and decrease the bacteria in your urine.
What Else Can I Do To Manage These Symptoms
There are many things you can do to manage bladder and bowel continence. As mentioned above, Continence Nurse Advisors have specialised training in bladder and bowel issues. They are an important part of the management plan for people living with MS. Most MS Nurses will also have specialised training in continence as well and can perform initial assessments to determine the best pathway forward. This may mean a referral to a specialist urologist or gastroenterologist , in some cases for more advanced care.
Management strategies include:
- Continence care products such as pads worn inside underwear, or bottles for night-time use.
- Ensuring you have an easy-to-access toilet or bathroom at home and work.
- Drinking plenty of water to avoid complications such as urinary tract infections or constipation. Aim to drink 1.5 to 2 litres of water daily, in regular intervals rather than sipping all day. This way, you maintain your fluid intake but dont increase frequency. Avoid too much fluid for up to two hours before bed or going out.
- Avoid too much caffeine in tea, coffee and cola drinks.
- Maintaining a healthy diet to support a healthy bowel regime by including high-fibre foods such as oats, fruits , vegetables and wholegrain or wholemeal foods including oatmeal, rice, wheat and barley, cereals and breads, nuts and lentils.
- Quitting smoking as smoking has been linked with the development and progression of MS. Smoking can also increase coughing and, in turn, the risk of incontinence.
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