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Ms Bowel And Bladder Issues

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Bladder Control Treatments In Ms

Managing Bladder and Bowel Issues in MS

A bladder problem is more than an inconvenience. Without treatment, it can turn into other health issues, including bladder infections, kidney damage, and hygiene problems. It also can keep you from doing the things youâd normally do and make you feel isolated.

Talk to your doctor if you notice any changes in when and how often youâre going to the bathroom. They might recommend that you see a doctor who specializes in bladder problems, called a urologist. They might also talk to you about some things you can do on your own:

Diet changes. One way to start is to change the liquid you put into your body every day. Your doctor may recommend that you:

  • Drink no more than 2 quarts of liquids a day.
  • Drink a small glass of water all at once every few hours. That’s better than sipping drinks constantly, which might make you want to pee more often.
  • Stop drinking at least 2 hours before you go to bed.
  • Steer clear of drinks with caffeine, such as coffee, tea, and sodas.
  • Have no more than one alcoholic drink per day.

Change your behavior. Some things you can try:

Absorbent products such as mini-shields that attach to underwear or plastic-backed diapers. These items help you guard against accidents. Most of them are disposable, but you can also buy absorbent cloths that you can wash and reuse.

Medications. If behavior changes donât work, your doctor may prescribe medicines to help with bladder control. You might also take them while you keep up your behavior training.

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 it’s OK.

Multiple Sclerosis And Incontinence

Originally published on: April 6th, 2017. Last modified on June 17th, 2021

Multiple Sclerosis is a neurological condition, so affects the nerves. A coating around the nerve fibres called myelin becomes damaged and can produce a wide range of symptoms, which vary greatly from person to person. MS is a complex condition and it can take a long time to get a definitive diagnosis due to the symptoms being attributed to other conditions. MS is usually diagnosed when a person is in their early 20s or 30s and affects around 100,000 people in the UK.

There are several types of MS

  • Relapsing Remitting relapses of symptoms with periods of partial or complete remission in between
  • Primary Progressive Symptoms gradually get worse over time
  • Secondary Progressive Sustained build up of disability with separate relapse
  • Benign MS Small number of relapses followed by complete remission, this can only be confirmed retrospectively approx 10 15 years after remission

Around 85% of MS sufferers have RRMS and many of these people will go to have Secondary Progressive. It is extremely rare but there is also a type of MS that affects children too.

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Articles On Complications Of Ms

If you have multiple sclerosis , your bathroom habits may not be what they used to be. You might have bowel movements a lot more, not as much, or it may be harder to go. Talk to your doctor about these troubles. They can suggest ways to make things regular. But there are also simple ways to adjust your habits to make bathroom visits more predictable.

How Can Bowel Function Be Affected With Multiple Sclerosis

Bowel and bladder problems and MS

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 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.
  • Don’t take over-the-counter drugs for diarrhea without talking to your doctor.

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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.

Read Also: Heavy Feeling In Bladder And Frequent Urination

Why Does Ms Affect The Bladder And Bowel

The spinal cord plays a central role in bladder and bowel function. When MS damages the myelin, messages between the brain and the section of the spinal cord that controls the bladder and bowel can be interrupted, resulting in bladder and bowel dysfunction.

The areas of the central nervous system that control the urinary system are situated in the lower part of the brain and the lower part of the spinal cord. Messages are transmitted between the brain and the urinary system along the nerves that make up the spinal cord.

  • Lesions may lead to changed or interrupted nerve transmission
  • Pathways destroyed nerve signals do not reach their destination
  • Less control of nerve signals and muscular coordination leads to either underactivity or over-activity of the muscles in the bladder walls.

The bowel function is controlled by the brain and spinal cord, as well as the bowels own nervous system: the enteric nervous system, which coordinates movements, secretion and absorption of the content in the bowel. Bowel dysfunction in MS is similar to bowel dysfunction in spinal cord injuries and is called neurogenic bowel dysfunction . The precise mechanism underlying NBD in MS is not known, but lesions in the brain and the spinal cord has been shown to:

  • Delay nerve signals to the anal sphincter
  • Muscle coordination issues resulting in problems with emptying the bowel
  • Loss of voluntary control over bowel emptying

Why Might A Person With Multiple Sclerosis Become Incontinent

How does MS cause bowel and bladder issues?

Nerve damage caused by MS can affect how the body interprets the signals between the brain and the bladder and bowel. In the bladder, the muscles that store the urine and and the muscles that empty the bladder can be affected. The two sets of muscles need to coordinate in order to expel urine. Often, in MS patients, the coordination of these muscles can be affected, which leads to incontinence problems.

Most bowel incontinence issues are caused by constipation, which in turn can lead to overflow incontinence. If a person is less mobile due to MS, this can lead to sluggish bowels and constipation. Many medications for MS can affect bowel motility too. Faecal incontinence can also happen if there are disruptions in the signals from the brain to the bowel resulting in weak sphincter muscles.

Someone with MS may experience

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How Does Bowel Irrigation Work

Transanal irrigation or bowel/rectal irrigation is a therapy that effectively empties the bowel by instilling water. This is performed using the Navina bowel irrigation system with a rectal catheter or cone to get water into the bowel. The water may then start the bowel movements and empties the lower part of the bowel. This therapy can save a lot of time and reduce frustration when conservative methods do not give the desired results.

What are the benefits of Navina bowel irrigation?

  • A way to regularly empty the bowel so that the lower part of the bowel remains empty up to 2 days effectively preventing leakage.
  • A safe way of emptying the bowel that you can perform yourself at home
  • A way to take control of your bowel – using TAI allows for choosing the time and place to empty the bowel that suits you and your life.
  • Other important benefits are that you do not have to spend so much time and energy caring for your bowel, freeing up time for what you like to do in life.

Give it time. It is worth it!

Why Do Bladder And Bowel Incontinence Happen

When the bladder and bowel function normally, nerves tell certain muscles when to tense up and when to relax. Nerves in the spinal cord send messages from the brain to the bladder. Sphincter muscles control the flow of urine. Muscles in the rectum and anus control or release stool. These nerve and muscle processes allow urine and feces to be removed when you want them to.

Read Also: Unable To Hold Urine When Bladder Is Full

How Can Bladder Function Be Affected By Multiple Sclerosis

As with other MS symptoms, the kinds of bladder problems vary from person to person and can change over time. People may:

  • Have trouble controlling the release of urine
  • Experience a sense of having to go right away
  • Experience frequent urges to urinate
  • Have difficulty in starting to urinate or in sustaining a steady stream

In fact, some people may experience urinary retention and will require some form of intermittent catheterization. All these symptoms usually indicate problems in the functioning of the muscles that control urination, although urinary tract infection must be eliminated as a cause.

An appointment with an advanced practice nurse or physician assistant to initially assess the bladder symptoms is helpful. Initial bladder assessment includes obtaining a thorough history from the patient and focusing on the primary concern.

You may be asked to urinate during the time of the appointment. The amount of urine may be measured. Please come to the appointment well hydrated with the need to urinate.

The specimen will be checked for a urinary tract infection through laboratory urinalysis and culture and sensitivity . Other tests may be done if needed.

Do not try to self-treat your bladder problems by drinking less fluid! This can lead to constipation or urinary tract infections.

What Should I Do If I Experience Bladder And Bowel Issues

Bowel, Bladder Problems Tied to Higher Levels of Fatigue, Disability in ...

If you have bladder or bowel concerns, its important to talk to your neurologist, MS Nurse or GP about your symptoms. Often MS Nurses have had extra training in continence management and can help provide practical help.

Its also important to remember that pregnancy and childbirth for women, prostate issues for men, and urinary tract infections for both women and men, can also cause bladder and bowel issues, therefore a proper assessment is vital. Sometimes a very simple diet and lifestyle adjustments can make a big difference.

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Lets Talk About Your Bladder First

  • At least 80 percent of people with MS experience bladder problems.
  • While some have difficulty storing urine , others may be unable to empty their bladder completely. Some even experience both.
  • Because each of these problems can cause similar symptoms, including feelings of urgency, frequent daytime and nighttime trips to the bathroom, and bladder accidents, it takes a thorough assessment by a urologist to determine exactly what is causing your symptoms.
  • If your MS provider hasnt asked you about your bladder function, speak up so you can get an accurate diagnosis and prompt treatment.

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
  • Loss of bowel control can also occur, most often the result of muscle weakness and loss of sensation in the rectum.
  • Diarrhea in people with MS is much less common, and generally caused by something other than MS. Sometimes, when hardened stool caused by constipation gets lodged in the rectum, loose stool from above may leak around it, appearing like diarrhea.
  • 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.

    Read Also: Medicine To Stop Bladder Leakage

    Bowel Incontinence In Ms: Why It Happens What To Do About It

    Many people with MS have reduced control over bowel movements, but there are ways to take control back.

    Multiple sclerosis can disrupt many different areas of function in your body not just movement in your arms and legs, but also your vision and speech. Another common area of dysfunction in MS is your pelvic region, where it can disrupt sexual, bladder, and bowel function.

    Bowel dysfunction is a source of frustration and embarrassment for many people with MS and sometimes for their caregivers as well. Its very common, affecting around 50 percent of people with the disease, according to an article published in July 2017 in the Journal of Neurology.

    One form this dysfunction can take is bowel incontinence, or inability to control bowel movements. People who experience this symptom often fear they could have an accident at an inopportune time, without much warning.

    But bowel incontinence isnt disconnected from other bowel symptoms, such as constipation and urgency, according to an article published in December 2018 in the journal Degenerative Neurological and Neuromuscular Disease. In fact, many people with MS experience all three of these issues on a regular basis.

    Heres an overview of how MS can change your bowel function, leading to incontinence and steps you can take to regain some control over your bowel habits.

    What Causes Bladder And Bowel Issues

    What health professionals can help me deal with MS bowel and bladder issues?

    MS can disrupt the nerve signalling between the central nervous system and the bladder or bowel, disrupting the flow of the nerve messages and causing problems. MS lesions in some areas of the brain can affect what is known as a micturition centre which controls the messages between the brain and bladder or bowel to tell someone that its time the visit the toilet. Other MS lesions may occur in the spinal cord, which has a more direct effect on the nerves arising from the spinal cord which control the bladder and bowel.

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    Getting Help For Bowel Incontinence With Ms

    One huge barrier to people with MS getting effective help for bowel problems is that most doctors dont ask about these issues, says Kaplan. Shes seen this in a research project that involves going through the records of MS patients.

    Doctors arent bringing this up, and a lot of times patients arent sure how to bring it up, she says. Patients are also potentially not aware that this could be related to their MS, or what their neurologist would do about it if it were related.

    So the first step in getting help for bowel problems is telling your neurologist or primary care doctor whats been happening. Getting an accurate picture of symptoms is really important, says Kaplan. We often base a lot of our management on what patients self-report.

    Your doctor may ask you to keep a journal of your bowel symptoms, along with what youre eating and drinking, and other potentially relevant behaviors. Patterns related to what you eat or drink may emerge, and your doctor will also get a picture of your overall diet.

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