Multiple sclerosis

Learn more about multiple sclerosis Introduction to multiple sclerosis Multiple sclerosis is a degenerative condition that affects the central nervous system (the brain and spinal cord communication). This can interfere with cognitive and bodily functions including control of the bladder and bowel. Learn more about multiple sclerosis
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Introduction to multiple sclerosis

Multiple sclerosis is an inflammatory disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. 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.

The central nervous system 

Consisting of many nerve fibres, the central nervous system carries messages to and from the brain and spinal cord to different parts of the body. Nerve fibres are surrounded by a protective sheath of myelin, which helps to insulate them and ensure that the messages they carry – the nerve impulses – travel quickly and correctly. In people with multiple sclerosis, the myelin sheath around nerve fibres becomes damaged or scarred. This interrupts the messages carried by the nerves and can interfere with a wide range of bodily functions. 

Multiple sclerosis can lead to

  • Bladder and bowel symptoms 
  • Physical limitations 
  • Fatigue 
  • Cognitive impairment 

There are four types of multiple sclerosis characterised by the pattern in which the symptoms occur. These are: 

  • Relapsing remitting
  • Primary progressive 
  • Secondary progressive
  • Benign 

In Europe and North America, multiple sclerosis affects one in 800 people, making this illness the most common cause of neurological disability in young adults. Symptoms are typically first seen between the ages of 20 and 40. Multiple sclerosis is approximately twice as common in women as in men. It is not known what causes multiple sclerosis, although it is thought to be a combination of genetic and environmental factors.

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Learn more about multiple sclerosis and bladder problems and how to take care of your bladder.

Learn more about multiple sclerosis and bowel problems and how to take care of your bowel.

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Multiple sclerosis and bladder issues Multiple sclerosis and bladder issues More than 50% of people with multiple sclerosis will experience bladder issues. The symptoms vary from person to person. Learn more about multiple sclerosis and bladder issues
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Multiple sclerosis and bladder problems

Many people with multiple sclerosis have neurogenic bladder dysfunction, which means a decreased ability to control the bladder. Some people may find that they need to urinate more frequently or urgently, whereas others may experience difficulty emptying the bladder or a feeling of incomplete emptying.  

Bladder problems, if left untreated, can be severely detrimental to the course of the disease and subsequently have a high impact on quality of life. 
The symptoms below may be one of the first indications of having multiple sclerosis but they may also develop during the course of the illness.

Urinary incontinence

  • Urinary leakage
  • Small or large amounts of urine leaking without warning or without feeling the urge to go to the toilet
  • Involuntarily leakage when sneezing, coughing, laughing or exercising
  • A sudden urge to rush to the toilet to urinate
  • The need to get up to pass urine two or more times a night (nocturia)

Urinary retention

  • Urinary hesitancy which is difficulty initiating urination
  • Urgent sense to urinate but inability to start the urinary flow
  • Frequent visits to toilet
  • Dribble due to overflow incontinence
  • Weak flow
  • Bloated lower abdomen 

Urinary tract infections

Urinary tract infections have a harmful effect on multiple sclerosis and may even contribute to relapse. When the body tries to fight the infection, it triggers excess immune activity and demylelination (destruction to the coating that protects the nerves). Therefore it is extremely important to regularly empty your bladder in order to avoid  urinary tract infections in the first place.

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Products that can help to manage bladder problems associated with multiple sclerosis:

Learn more about neurogenic bladder and how to take care of your bladder

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Multiple sclerosis and taking care of the bladder Taking care of your bladder Multiple sclerosis affects people differently and many will experience bladder problems. Various treatments are available to help manage your bladder and improve general health. If left untreated, bladder control problems can cause other health concerns. How to take care of your bladder
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Taking care of your bladder

Managing bladder issues

There are a number of treatments and products available to help manage your bladder. Luckily bladder issues are one of the most treatable symptoms of multiple sclerosis.

Treating urinary retention

If you have difficulty emptying your bladder or experience incomplete bladder emptying, your healthcare professional will determine if you need to use an intermittent catheter. Your first step will be to find a catheter that fits you and your lifestyle. It is important that you follow the guidance in terms of technique and how often you need to catheterise.

Dealing with urinary incontinence

Though less common than urinary retention, sudden and complete emptying of the bladder, also called leakage, can also be associated with multiple sclerosis. Incontinence pads are often used, however, collecting devices such as an urisheath and urine bag provide a far more comfortable and effective solution for many men with urinary incontinence. Urisheaths are worn over the penis like a condom and connect to a discreet urine bag. It is important you use the right size urisheath while finding the right collecting bag depends on how much you leak. 

Urinary tract infections

The presence of bacteria in the urinary tract is quite common and does not always cause a urinary tract infection. If, however, the bacteria grow and multiply to a certain level, they may cause an infection of the urinary tract that needs treatment.

Symptoms of urinary tract infections

Symptoms of a urinary tract infection vary and may be subtle. They include:

  • Dark-coloured and strong-smelling urine
  • Cloudy urine
  • Blood in the urine
  • Fever/sweating
  • Bladder spasms
  • Increased muscle contractions in your leg

If you experience any of the symptoms listed, you should consult your healthcare professional.

Avoiding urinary tract infections

While there is no definite solution to avoiding urinary tract infections, there are a number of precautions that can help you prevent and sidestep recurrent infections:  

  • Generous intake of fluids – at least 1.5 litres a day
  • Good personal hygiene when you catheterise
  • Catheterisation routines – completely emptying the bladder regularly
  • Healthy digestion – a good bowel routine may reduce the risk of urinary tract infections

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Following the right technique and using a hydrophilic coated catheter can also help reduce the number of urinary tract infections you experience. Products that can help to manage bladder problems:

Learn more about neurogenic bladder and how to take care of your bladder

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How to take care of your bowel Taking care of your bowel Constipation and bowel leakage affect people with multiple sclerosis but it isn’t always easy to determine the best way of managing this important problem because the response to treatment varies from person to person. How to take care of your bowel
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Taking care of your bowel

Bowel problems can often be improved by making specific changes to a person’s diet. There are also several types of medication that can help. Bowel irrigation is another solution that may help to prevent constipation and bowel leakage, simply because it ensures regular emptying of the bowel.

Managing bowel leakage

A key aim of a bowel management routine is to ensure a convenient time to empty your bowel, thereby minimising the risk of bowel leakage. Establishing a routine may help prevent constipation which often is a factor in causing leakage.

Managing constipation

Regular emptying of the bowel helps to prevent excessive build up of stools and chronic constipation, which is not only uncomfortable but also has health implications if left unmanaged.

Bowel irrigation for the prevention of constipation and bowel leakage

Bowel irrigation is a well-documented technique, where water is introduced into the bowel via the rectum. The water and waste is then emptied from the bowels. By preventing the build-up of stool, it is an effective method for reducing the risk of constipation. Irrigating on a regular basis helps prevent bowel leakage and eliminates the risk of bowel accidents.

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Products that can help to manage bowel problems include: 

Read more about how to take care of your bowel. For answers to the most common questions about multiple sclerosis and bladder and bowel issues read more in the FAQ

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FAQs about multiple sclerosis and issues related to bladder and bowel function Frequently asked questions about multiple sclerosis bladder and bowel issues Find the answers to the most commonly asked questions about multiple sclerosis and issues related to bladder and bowel function. FAQs about multiple sclerosis
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Frequently asked questions

This FAQ is intended as a guide to commonly asked questions. Please always consult your healthcare professional regarding bladder and bowel issues. 

What are the symptoms? 

Some of the most common symptoms of multiple sclerosis are: 

  • Urinary incontinence
  • Urinary retention
  • Faecal incontinence
  • Physical limitations 
  • Fatigue 
  • Cognitive impairment 

However, it is unlikely that a person with multiple sclerosis will experience all of these symptoms and each person is affected differently depending on how much and where the nerves have been damaged.

Can multiple sclerosis be treated?

There are many treatments available to help manage the symptoms of multiple sclerosis – some medicines may potentially slow the progression of the disease (disease-modifying drugs). The treatment chosen will depend entirely on the individual. There are also methods that can be used to help manage specific complications of multiple sclerosis, such as bladder and bowel problems. 

Why does multiple sclerosis cause bladder problems?

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. 

How can bladder issues be managed? 

A number of methods can be used to help manage bladder problems, including catheters, sheaths (for men) and absorbent products such as incontinence pads and pants.

Why does multiple sclerosis cause bowel problems?

Nerve endings in the rectum help to alert people of the need to pass a stool when it enters the rectum. In people with multiple sclerosis, this message may become lost or incomplete increasing the risk of bowel problems such as constipation, faecal incontinence or a combination of both. Certain drugs commonly prescribed for multiple sclerosis can also increase the likelihood of constipation. 

How can bowel problems be managed?

Bowel problems include  constipation and bowel leakage. Bowel problems can often be improved by changing diet; there are also several types of medication that can help. Bowel irrigation can be used to help prevent constipation and bowel leakage.

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Following the right technique and using a hydrophilic coated catheter can also help reduce the number of urinary tract infections you experience. Products that can help to manage bladder problems:

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