Many people with multiple sclerosis (MS) experience some form of bladder or bowel issues at some stage. Continence refers to the ability to control bladder or bowel function, and incontinence is the loss of this control. Incontinence is a common symptom for people with MS – although the severity and longevity vary from person to person. For some people this may be short-term with a relapse, and for others the problems can be more long-term.
With the right information and support, incontinence can be managed effectively to maintain a healthy and active lifestyle.
Bladder and bowel issues are common in MS. However, incontinence is a widespread condition affecting many Australians without MS as well, so you shouldn’t feel alone.
Bladder issues (affecting urine or wee) can include problems with storing urine (leaking, flooding), releasing urine (dribbling, hesitancy, frequency), or a combination of both in some cases. Other symptoms include greater or less frequent passing of urine, urinary tract infections and nocturia (the need to urinate frequently overnight).
Bowel issues (affecting stools, faeces or poo) can include constipation, faecal incontinence, passing of wind and diarrhoea.
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 it’s 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.
If you have bladder or bowel concerns, it’s 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.
It’s 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.
There are many things you can do to manage bladder and bowel continence. As mentioned above, Continence Nurse Advisors have specialised training in bladder and bowel issues. They are an important part of the management plan for people living with MS. Most MS Nurses will also have specialised training in continence as well and can perform initial assessments to determine the best pathway forward. This may mean a referral to a specialist urologist (for bladder issues) or gastroenterologist (for bowel issues), in some cases for more advanced care.
Management strategies include:
There are several medications to control bladder frequency and urgency, prescribed by a doctor or continence advisor. There are also treatments to help manage constipation that you can buy over the counter, but always seek professional advice from the pharmacist before purchase, to ensure you use the best option for your specific needs and with consideration to your other medications.
Some options to treat bladder issues include:
There is support available to help you manage your MS.
Your neurologist, MS Nurse or GP should be the first contact for any new and/or persistent bladder or bowel concerns, so they can perform a detailed assessment and tailor a management plan or referrals if needed.
Contact your state or territory MS organisation to access services such as MS nurses, peer support and other resources.
The following support services may be able to provide lifestyle, wellbeing, or other advice: