MS Seminar part 3 - bowel and bladder issues

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Date Joined Jan 2007
Total Posts : 3571
   Posted 7/10/2008 4:44 PM (GMT -6)   
OK everyone, here is your next installment. 
Let's start with the bladder.  10% of people with MS will experience constant bladder problems.  80% of people with MS will experience bladder problems at some time during their lifetime. 
Bladder problems should be addressed by an urologist and preferrably by a neuro-urologist.  Bladder dysfunction is caused by lesions to certain parts of the brain or spinal cord. 
There are three kinds of bladder dysfunction types:
Overactive bladder: hyperreflexive, spastic, failure to hold urine. Treated with exercises to increase holding power. Meds =  Ditropan, Levsinex, and botox.
Underactive bladder: hyporeflexive, flaccid, sensation of fullness, failure to empty.  Treated with pelvic floor exercises, scheduled voiding and intermittant self-cathertization.
Mixed bladder: combined symptoms as described above.
These issues can compound MS in various ways.  With the overactive bladder, sleep is disrupted and that increase in fatigue exacerbates all symptoms.  Underactive bladder can cause frequent urinary tract infections that also cause MS symptoms to increase. 
Cranberry juice is not an old wive's tale.  It causes the urine to be more acidic which makes it much more difficult for bacteria to grow.  It can be taken as a supplement and can actually stave off the need for antibiotics. 
Some manage night time frequency by limiting fluids 3 hours prior to bed.  A bedside commode or a portable urinal (for men) can help with sleep issues.  It allows for quicker return to bed and less interruption of critical sleep patterns.
Bowel problems:  This can take form of either diarhea or constipation.  Constipation is much more common.  This stems from a spinal lesion.  It is usually caused by slower motility through the large intestine which allows for too much water absorption (this is in fact is the job of the lower intestine).  Too little water results in dry, hard to pass stool.  Increasing fiber can help maintain water in the lower instestine.  You must increase water and fluids or the fiber will increase constipation. 
Exercise helps with bowel motility.  Even short walks can help with this. 
Supplements like metamucil can be taken long term with no side effects.  Miralax can also be taken (upon doctor's recommendation) long term. 
Chronic constipation left untreated can create serious health problems.  This can result in permanent damage to the lower intestines (rectocele or enterocele).  It can also result in blockages which can be life threatening if left untreated. 
Dietary changes can help.  Avoid or decrease meats and cheeses.  Increase vegetables and fruits.  Dark green, leafy vegetables are the most beneficial. 
Avoid caffiene and aclohol as they can dehydrate you increasing the chance for constipation.
Normal bowel movement frequency can vary from person to person but it is considered optimal to have at least 3 bowel movements per week.
Gretchen       co-moderator MS board       diagnosed with MS July 2006

New Member

Date Joined Jul 2008
Total Posts : 7
   Posted 7/11/2008 1:17 PM (GMT -6)   
I'm not definately dx w/ anything yet but I've had constipation issues for years and I can attest to the fact that frequent walks and drinking tons of water work better than you would believe possible.

Regular Member

Date Joined May 2008
Total Posts : 88
   Posted 7/11/2008 10:02 PM (GMT -6)   
Thanks Gretchen- these are helpful. I have found the little Metamucil wafers to be easy to carry and use especially for travel, but there's a lot of great fiber options. This year I bought a half share in a local Community Supported Agriculture or CSA farm. They deliver to my work and I have had more leafy greens and fresh veggies each week than I can figure out what to do with sometimes. I highly recommend that as a way to increase veggie consumption, you get really creative.
oh, and on the bladder thing, well...every time I read these I am reminded to do my kegels. Somehow I think that might help.
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