MANAGING BLADDER AND BOWEL FUNCTION IN MS
Bladder and bowel symptoms occur in the majority of people with MS, usually as a consequence of the disease. Symptoms can vary in degree, be very bothersome, and can impact on medical, physical, psychological and social well–being, profoundly affecting quality of life.
MS can affect bowel and bladder function directly-by MS lesions damaging the areas of the central nervous system that control reflexes, disrupting function – or indirectly, for example decreased mobility due to MS can increase the risk of constipation. Surveys show that Bladder symptoms are reported by 80% or more of people with MS, and bowel symptoms by mores more than 50%. Problems with bladder or bowel control can occur at any stage of the disease. It is important to remember that other factors such as pregnancy and the normal ageing process can also influence bladder functioning.
Bladder and Bowel issues are two MS symptoms for which there is a variety of effective interventions and treatments. Lifestyle changes such as altering fluid intake, diet or routine can be very effective. Medications and treatments can also help alleviate symptoms. Individuals may have to try a few options to find the most effective treatment plan for them.
Many people, whether they have MS or not, may try to reduce their fluid intake or diet in order to avoid bladder or bowel problems. Unfortunately this only makes the symptoms worse. It is often believed that if fluid intake is reduced, the bladder will empty less frequently. But in reality, urine becomes more concentrated and the bladder becomes irritated. Over time this bladder this causes the bladder to reduce its capacity, causing increased urgency and frequency.
Correct fluid intake varies depending on a person’s weight, build and activity, but generally an intake of around eight to ten cups of fluid a day is recommended. It is best to avoid highly caffeinated, coloured, carbonated or acidic drinks.
In general, urinating every two to three hours – or an average of six to seven times during the daytime is normal. Most people are able to sleep six to eight hours a night without needing to get up to urinate, although waking up to use the toilet once during the night is normal for many people, especially if they drink liquids right before going to bed.
People with MS can help take control of their bladder if they: Keep well hydrated, limit the amount of caffeinated beverages and alcohol as these can cause more frequent and urgent voiding. Void according to a schedule. Drink 180180–240mls of fluid at regular intervals and then urinate on a regular schedule rather than wait for the urge. It takes about one and a half hours for fluid to get to the bladder. Stop drinking fluids before bedtime and try to empty the bladder before going to bed.