MS Symptom:

Bladder and Bowel Issues

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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:

  • Continence care products such as pads worn inside underwear, or bottles for night-time use.
  • Ensuring you have an easy-to-access toilet or bathroom at home and work.
  • Calling ahead to your destination to ensure there are adequate, accessible facilities can provide peace of mind and lessen stress levels.
  • Drinking plenty of water to avoid complications such as urinary tract infections or constipation. Aim to drink 1.5 to 2 litres of water daily, in regular intervals rather than sipping all day. This way, you maintain your fluid intake but don’t increase frequency. Avoid too much fluid for up to two hours before bed or going out.
  • Avoid too much caffeine in tea, coffee and cola drinks.
  • Maintaining a healthy diet to support a healthy bowel regime by including high-fibre foods such as oats, fruits (fresh, stewed or dried), vegetables and wholegrain or wholemeal foods including oatmeal, rice, wheat and barley, cereals and breads, nuts and lentils.
  • Quitting smoking as smoking has been linked with the development and progression of MS. Smoking can also increase coughing and, in turn, the risk of incontinence.

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:

  • Specific medications, including specialised Botox injections to calm an overactive bladder and reduce bladder spasms.
  • Antibiotics to treat urinary tract infections.
  • Other procedures that are less common, such as catheterisation, using a special tube to access the bladder and empty the urine.

General Information and Assistance

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: 

  • The Continence Foundation of Australia has trained advisers and whilst you don’t need a referral, it’s helpful if your doctor is aware of the visit.
  • NDIS Continence Provider List is a list of providers to help people with MS, family and carers find trusted information on continence products and providers.
  • National Continence Helpline, call 1800 33 00 66
  • The National Public Toilet map (developed through the National Continence Management Strategy) details over 16,000 toilet facility locations and has a trip planner with the facility to plan toilet breaks for short and long journeys. You can access the map via compatible mobile phones and the National Public Toilet Map iPhone App.
  • Independent Living Centres 1300 885 886 provides information about products and services to help people remain independent and improve their quality of life
  • Carers Australia 1800 242 636 provides information and advice to carers, their friends and families about carer support and services
  • The national Continence Aids Payment Scheme (CAPS) provides financial assistance for eligible people living with MS, to meet some of the cost of continence products. Visit www.bladderbowel.gov.au for guidelines and applications forms (to be completed by your doctor or continence adviser).
  • The Department of Veteran’s Affairs (DVA) 133 254 has various continence products for eligible veterans via the Rehabilitation Appliances Program (RAP). Speak with your doctor or the DVA. 
  • Other government-funded schemes provide financial assistance depending on your location, condition and products used. Speak with your local community nurse or continence adviser.
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Bladder and Bowel Issues