Bladder and bowel issues

Bladder and bowel problems occur commonly in MS, and can range from mild incontinence or constipation to more severe problems. Bladder problems include the need to pass water frequently and/or urgently, incomplete emptying or emptying bladder at inappropriate times. Bowel problems include constipation and, infrequently, loss of bowel control.

Why does MS affect the bladder?

When MS damages myelin in the central nervous system, messages between the brain and the section of the spinal cord that controls the bladder can be interrupted, resulting in bladder problems. The most common bladder problems are:

• urgency (the feeling of having to empty the bladder immediately)
• frequency (an increase in the number of times urination occurs)
• nocturia (frequent urination during the night)
• incontinence (the inability to hold urine in the bladder)
• hesitancy (difficulty in beginning to urinate)

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.

Bowel problems in MS

Constipation is the most common bowel symptom in MS. A bowel management programme includes dietary manipulation (such as increasing fibre content), increasing fluid intake (which may create difficulty for those who also have bladder problems), and ensuring a regular and sufficient time for bowel movements. Varying combinations of fibre, stool softeners and peristaltic stimulants are usually needed.

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On the toilet, Little Gao likes to play with his smart phone, refreshing his chat app and looking at the news. Reproduced with the kind permission of Li YouHao,© 2014 Li Yu Hao