Not everyone who has MS will experience continence problems. Most bladder problems are due to over-activity of the bladder’s muscular wall which is important for expelling urine effectively. In MS, bladder muscle can become overactive or "sensitive" causing feelings of urgency and possibly some leakage of urine. This can be upsetting but is usually treated with medication and advice from an experienced continence nurse with a good knowledge of MS.
Some people are tempted to avoid drinking water during the day to overcome urgency. This is not advisable as it may cause dehydration which can, itself, heighten symptoms. If the urine stored in the bladder becomes too concentrated it is more likely to trigger episodes of urgency. General advice is to drink little and often and to plan your route when out and about!
Urinary infections can occur as a feature of MS bladder function so keeping a regular flow of urine is also helpful to avoid infections. If the urine looks cloudy or has a strong smell it is advisable to contact your doctor or local MS team. They can dip a urine sample to determine whether there is an infection and treat as necessary. Some MS symptoms may worsen as a result of bladder infections but generally improve on treatment with the right antibiotics to treat infection.
If you have trouble in urinating, if the urine stream is slow or is intermittent it’s best to speak to your MS team or continence adviser. Failure to empty the bladder completely can cause long term problems including kidney infections.
Bowel problems in MS are most often caused by constipation. Maintaining a good, well-balanced diet with fibre from cereals, fruit and vegetables will help to avoid constipation. Ensuring good hydration and avoiding too many caffeinated drinks is also helpful. Some medicines can add to the problems of constipation. It’s always best to take note of any continence problems and discuss them with a Neurologist or MS team through appointment or by a local helpline.