What is multiple sclerosis (MS)?

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

Find out more

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:

• Female catheters
• Male catheters
• Collecting devices for men

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.

Find out more

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:

• Female catheters
• Male catheters
• Collecting devices for men

As no two people with multiple sclerosis experience the exact same course of the disease, the extent and type of bowel problems people experience vary greatly. About 34% of people with multiple sclerosis are believed to have bowel problems to such a degree that it affects the quality of their daily life. 

Normal bowel function

Normal bowel function depends on all of the following working properly:

• Muscular action and reflexes
• The feedback messages carried by nerves between the brain and the bowel which control continence.

Both these functions can be affected by multiple sclerosis.

How multiple sclerosis affects bowel function

Bowel problems occur when muscular action, reflexes or the feedback system are disrupted; this is also known as neurogenic bowel dysfunction and symptoms include, diarrhoea, constipation and bowel leakage. In multiple sclerosis, bowel leakage and constipation frequently co-exist.

Constipation 

Constipation is usually defined as less than two bowel movements per week and it is thought to affect almost half of people with multiple sclerosis. It may also be a factor in causing bowel leakage episodes. Certain drugs commonly prescribed for multiple sclerosis can also increase the likelihood of constipation. Managing constipation is very important and as a first step it should be addressed via diet and exercise. If these steps do not help then seek a healthcare professional’s advice because unmanaged constipation not only has a detrimental influence on quality of life but it can have more serious health consequences.

Bowel leakage and faecal incontinence

Constipation may also be a factor in causing bowel leakage / faecal incontinence episodes. Bowel leakage, or the loss of voluntary bowel control is a symptom of neurogenic bowel dysfunction and a person suffering from this may not be able to reach the bathroom fast enough. Overuse of laxatives can contribute to bowel leakage.

Find out more

Products that can help to manage bowel problems include: 

• Bowel irrigation

Read more about how to take 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.

Find out more

Products that can help to manage bowel problems include: 

• Bowel irrigation

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.