Multiple sclerosis can cause bladder control problems like incontinence and nocturia. Bladder control problems are actually quite common in multiple sclerosis patients, affecting at least 80% of patients. In some cases, bladder problems are the first warning sign of multiple sclerosis.
Multiple sclerosis affects the myelin, the protective layer around nerves, which can block or delay signals from the bladder to the brain. Multiple sclerosis patients may experience an overactive bladder, and under-active bladder, or even both.
Types of bladder problems in MS
Multiple sclerosis patients can experience a variety of bladder problems, including nocturia, urinary urgency, incontinence, and urinary hesitancy. Nocturia is a condition where a person frequently must awaken during the night in order to urinate. Urinary urgency is when a person feels a strong urge to urinate and yet only a small amount comes out. Incontinence is the loss of bladder control that causes leaks, while urinary hesitancy is when it is difficult to begin urinating.
Bowel problems, too, can be an issue for multiple sclerosis patients, as they can experience constipation and fecal incontinence. Fecal incontinence is the loss of control over one’s bowel movements.
Multiple sclerosis and incontinence
Multiple sclerosis contributes to bladder incontinence because it affects the central nervous system. For the bladder to work properly, it sends signals to the brain indicating when it is full or empty. Multiple sclerosis damages these nerves, which send and receive signals messages from the bladder that may be blocked or interrupted. Thus, they do not reach the brain properly. This, in turn, leads to bladder problems.
Incontinence isn’t just a nuisance or embarrassing. It can have serious complications, including urinary tract infection symptoms, like:
- Urgency in urination
- Burning sensation during urination
- Abdominal or lower back pain
- Increased spasticity
- Dark urine with foul smell
- Fever
A fever in particular can be harmful for multiple sclerosis patients. As body temperature goes up, this affects nerve conduction. This can lead to muscle weakness, vision loss, and spasms.
Multiple sclerosis and nocturia
As mentioned earlier, nocturia is frequently waking up throughout the night in order to urinate. This can be quite troublesome for those with multiple sclerosis, as it causes greater fatigue, which can increase flare-ups and can be dangerous if mobility is compromised.
Nocturia is caused by urinary frequency, which is commonly seen in MS patients along with urinary tract infections. Additionally, consuming caffeinated beverages or alcohol prior to bedtime can increase the risk of nocturia.
Speaking to your doctor can help offer insight into better managing nocturia. You may have underlying reasons as to why you are staying awake at night; including anxiety or stress. Or maybe your symptoms related to MS are worse at night. Whatever the reason, talking to your doctor is a good step in getting your nocturia under control.
Manage and treat bladder symptoms in MS
Gaining control of your bladder is important, especially if you have multiple sclerosis. Here are some tips you can try in order to better manage and treat your bladder symptoms related to multiple sclerosis:
- Modify your diet and consume less fluids prior to bed but ensure you are not causing yourself to become dehydrated
- Speak to your doctor about specific medications that can help control bladder symptoms
- Try pelvic floor physical therapy, which uses pelvic floor training, biofeedback, neuromuscular stimulation, and daily home exercises to reduce urinary urgency and frequency and treat loss of bladder control
- Consider percutaneous tibial nerve stimulation (PTNS), where a needle is inserted into the ankle and stimulates the tibial nerve; weekly PTNS treatments are thought to inhibit an overactive bladder
- Ask your doctor about intermittent self-catheterization (ISC), where a catheter is inserted for those who have difficulty emptying their bladder
In order to pick the right treatment for you, it’s important you speak to your doctor and relay your symptoms so they are aware of your issues and can offer a proper suggestion for optimal relief.
Even if you have multiple sclerosis, you don’t need to fall victim to your bladder. The first step is to open the conversation to treat your specific needs.
By: Emily Lunardo | Bladder, General Health
