Gotta go! gotta go!
Bladder and bowel accidents are embarrassing. About 85% of people with MS are likely to experience these problems. It can happen early in the disease or late. Whenever it does, the fear of accidents can make people with MS stay at home and give up their outside activities.
The good news is You CAN manage MS related bladder and bowel issues.
Consult with your healthcare provider for a comprehensive evaluation at the first sign of a problem. These can include:
- Bladder urgency
- Frequency of urination
- Leaking urine
- Loss of bowel control
As with other symptoms of MS, these can vary greatly from person to person. Depending on the cause, a management plan can include a combination of self-help strategies and medications. It may take some time working with your healthcare provider to identify the most effective techniques.
You might think that cutting back on fluids is a good strategy. Don’t do it. It can lead to serious bladder and kidney problems. You need 6-8 cups of water a day.
- Plan your fluid intake. To drink 6-8 cups of water, divide this amount into portions. Drink fluids in larger amounts at 3 or 4 designated times a day. You can then plan a bathroom stop about 1 to 2 hours later. Sipping fluids throughout the day is a bad idea. It encourages more frequent bathroom visits.
- Establish a schedule of urinating every 2 to 4 hours, whether you feel the need or not. This behavioral technique is called bladder training or timed voiding. You can coordinate this with your drinking schedule.
- Reduce or eliminate caffeinated drinks (coffee, soda, tea, and alcohol) in your diet. These are bladder irritants. Avoid them altogether if you are traveling or going out.
- Discuss prescription medications for frequency and urgency with your health-care provider.
If the above approaches aren’t enough, Intermittent self-catheterization (ISC) may be recommended.
- Establish a regular schedule of elimination, usually in the morning after eating breakfast, although any time that works for you is fine as long as it is consistent. When the bowel becomes used to emptying at specific times, accidents are less likely.
- Keep up your fluid intake (6-8 cups a day) and eat plenty of fiber-rich food—fruits, vegetables, and bran cereals to prevent constipation.
- Get some physical activity. It helps keep things moving.
- Discuss remedies such as stool softeners, bulk forming supplements, suppositories, or manual stimulation with your healthcare provider. It may take several weeks to know if these remedies are working.
Out and About
- When going out or traveling, plan frequent stops.
- Use and carry extra protection such as pads. They are discreet and afford you confidence.
- Wear clothes that you can easily remove such as trousers with elastic waistbands or Velcro closures.
- If you're on an airplane, wear a pad “just in case.”
- Stash a change of clothes and underwear, pads, medication, wipes, catheters, paper towels—whatever you need—in a tote bag or back pack.
Don’t wait to address the issue. Neglected symptoms can lead to more serious health conditions and can be harder to fix.
You CAN manage your MS bowel and bladder issues so that you can do the things you want to do.
Author: Patricia Kennedy, RN, CNP, MSCN
Nurse Educator, Can Do Multiple Sclerosis