Urination and Bowel Problems:
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Bladder function varies from person to person and can change over time. People may:
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Some people may experience urinary retention and may require some form of catheterization, although alternatives are increasingly becoming available to help with emptying of the bladder without frequent catheterization. All these symptoms usually indicate problems in the functioning of the muscles that control urination, although urinary tract infection (UTI) must be eliminated as a cause.
Initial bladder assessment typically includes obtaining a thorough history from the patient and focusing on the primary concern. You will be asked to void during the time of the appointment and urine volume will be measured. The specimen will be analyzed for a urinary tract infection through laboratory urinalysis (UA) and culture and sensitivity (C&S). The Post-void residual amount of urine will be measure with a bladder scanner that uses ultrasound to detect the volume without a need for catheterization.
Initial bladder assessment typically includes obtaining a thorough history from the patient and focusing on the primary concern. You will be asked to void during the time of the appointment and urine volume will be measured. The specimen will be analyzed for a urinary tract infection through laboratory urinalysis (UA) and culture and sensitivity (C&S). The Post-void residual amount of urine will be measure with a bladder scanner that uses ultrasound to detect the volume without a need for catheterization.
Management Plan of Action
- Eat regularly for regular bowel habits. Plan for a bowel movement each day about ½ hour after eating or drinking something warm (bowel activity is naturally increased at this time). Sit on the toilet about 10 minutes, and try to have a BM. You may want to gently rock back and forth on the toilet. If nothing happens, leave the bathroom and try again later.
- Use a suppository to help stimulate bowel activity. (It takes about 20 minutes for a suppository to work.) Occasionally, it might be helpful to take milk of magnesia or citrate of magnesia to stimulate bowel activity.
- It may take two to three months to establish a regular bowel regimen.
Some recommendations for treating bladder symptoms can be made after the initial assessment. However, if these recommendations are not successful or if you continue to experience frequent bladder infections you may require a referral to a specialist in urology. The urologist can help evaluate the cause of the problem through evaluation of the upper and lower urinary tracts. Other treatment options may include Botox® injections into the bladder neck or surgical interventions.
Do not try to self-treat your bladder problems by drinking less fluid! This can lead to constipation or urinary tract infections.
Basic Bladder management
- Adequate fluid intake is 1 ½-2 quarts of fluid a day. The urge to void occurs about 1 ½ -2 hours after drinking something.
- Caffeine, aspartame, and alcohol are all bladder irritants.
- Smoking also is irritating to the bladder.
- Limiting fluid is harmful.
- It is not normal to leak urine, wake up more that once at night to void, or to have frequent urinary tract infections (UTIs).
- Bladder infections in people with MS may result in an increase in MS symptoms, spasticity, and fatigue.
Plan of action
- Drink fluids all at once (drink 6 to 8 ounces at a time.) If you sip, sip, sip you will feel the urge to void frequently. Try to void about 1½ to 2 hours after you drink.
- Stop drinking fluids about 2 hours before bedtime; void right before bedtime.
- If you tend to get frequent bladder infections, you are probably not emptying your bladder completely.
- Taking cranberry pills may keep your urine more acidic and decrease the bacteria in your urine.
Here is a great resource on Bladder Function from the National MS Society. Read More about Bladder Problems HERE
What products/services should I consider to help me manage this symptom?
Catheter Recommendation:
"I use catheters daily and have found that the SpeediCath is the easiest to use. It is a coated catheter in a sterile solution." (recommended by MS patient). Click below for information about this catheter.
http://www.coloplast.com/products/bladder-bowel/#section=Catheters_7088
For free catheter samples, click on this site:
http://www.us.coloplast.com/products/samples
"I use catheters daily and have found that the SpeediCath is the easiest to use. It is a coated catheter in a sterile solution." (recommended by MS patient). Click below for information about this catheter.
http://www.coloplast.com/products/bladder-bowel/#section=Catheters_7088
For free catheter samples, click on this site:
http://www.us.coloplast.com/products/samples
Bowel Dysfunction
Bowel dysfunction is also a common symptom for patients with MS at any stage of the disease. Bowel dysfunction is caused by a number of factors including the disease process, inactivity, diet, inadequate fluid intake, medications and associated conditions such as irritably bowel syndrome or inflammatory bowel disease.
The most common bowel complaint from a person with MS is constipation, but the most distressing bowel complaint is probably that of involuntary bowel/fecal incontinence. Because MS interrupts or slows the transmission of signals to and from the brain, the electrical impulses to the muscles that are involved in emptying your bowel can become disrupted.
Depending on your particular bowel problem helpful suggestions can be made. General interventions for bowel dysfunction include:
Bladder and bowel symptoms are common in MS and can be effectively managed. Speak with your healthcare provider about what you can do to help keep these symptoms under control.
Basic Bowel management
The most common bowel complaint from a person with MS is constipation, but the most distressing bowel complaint is probably that of involuntary bowel/fecal incontinence. Because MS interrupts or slows the transmission of signals to and from the brain, the electrical impulses to the muscles that are involved in emptying your bowel can become disrupted.
Depending on your particular bowel problem helpful suggestions can be made. General interventions for bowel dysfunction include:
- Education about the causes of bowel dysfunction.
- Encouraging dietary changes to include more fiber and fluid.
- Consulting with your health care provider to adjust medication regimens that may be contributing to bowel dysfunction.
- Establishing a regular bowel routine, individualized to the patient. A regular bowel routine should take advantage of the normal reflex urge to defecate approximately 45 minutes after first eating or drinking in the morning.
- Encouraging regular physical activity.
Bladder and bowel symptoms are common in MS and can be effectively managed. Speak with your healthcare provider about what you can do to help keep these symptoms under control.
Basic Bowel management
- The goal is a comfortable bowel movement (BM) either every day, every other day or every two to three days. For regular bowel movements you need fluid (1 ½ to 2 quarts a day), fiber (20 to 30 grams a day) and activity.
- One-third of a cup of Fiber One®, All Bran® or 100% Bran Buds® gives you half the fiber you need for the day.
- Greasy foods, spicy foods, or food intolerances (for example, lactose intolerance) may cause loose stool and may result in involuntary bowel.
Click on the File for a good overview of bowel problems from the National MS Society |
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PLEASE NOTE: The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
