Multiple sclerosis (MS) is a disease that affects the central nervous system. The disease causes the immune system to attack the protective material surrounding nerve cells (myelin), damaging them. Symptoms include:
- pain, numbness, and tingling
- blurry vision
- bladder dysfunction
For most people with MS, symptoms flare up and then recede. In rarer instances, symptoms get progressively worse. However, most people with MS have normal life spans and can maintain a healthy lifestyle with treatment.
MS and the bladder
Up to 90 percent of people with MS experience issues with bladder function, according to Cleveland Clinic. Bladder issues aren’t necessarily constant and can flare up on occasion. But in some cases, these bladder problems can lead to kidney damage.
Bladder issues can develop with MS due to damage to the nerves signaling bladder contraction. Disruptions in these signals can lead to a number of symptoms.
Bladder storage issues
Bladder storage dysfunction is a symptom of an overactive bladder, meaning that nerve damage within your body can cause your bladder muscle to contract more often than it should.
Spastic contractions make you feel as if you need to urinate more frequently. Symptoms of bladder storage dysfunction include:
- a strong urge to urinate
- frequent need to use the bathroom
- the need to get up several times at night to urinate
- an inability to control urination, also referred to as incontinence
Bladder emptying issues
A problem with emptying means that your bladder doesn’t empty completely when you urinate. Nerve damage has caused an interruption in the signal that tells your bladder to void. This causes your bladder to never completely empty and may even cause it to overfill.
Symptoms of an emptying dysfunction include:
- a feeling of urgency to urinate
- hesitancy when you try to urinate
- weak urinary stream
- urinary tract infections
Combined storage and emptying issues
It’s possible to have both emptying and storage dysfunctions if you have MS. This occurs when nerve damage causes the muscles in your bladder and urinary sphincter to fail to coordinate properly with each other. Symptoms can include all of those associated with both emptying and storage problems and can also lead to kidney damage.
A bladder emptying dysfunction can lead to a urinary tract infection (UTI). When your bladder doesn’t fully empty, you run the risk of developing a UTI because the urine left over in your bladder allows bacteria to grow.
UTIs associated with MS are likely to recur, especially if you don’t get treatment for the emptying dysfunction.
Symptoms of a UTI include:
- an urgent need to urinate
- frequent urination
- burning sensation when you urinate
- pain in your lower back or lower abdomen
- dark urine with an unusual smell
Kidney stones and infections
In rare cases, especially when left untreated for a long time, an emptying dysfunction can lead to more serious problems in the kidneys. This can cause an infection to spread to the kidneys from the bladder.
Retained urine can also lead to the formation of mineral deposits, causing kidney stones. Both stones and infection in the kidneys are serious health problems that require medical treatment. If you get UTIs from your emptying dysfunction, seek treatment and be aware of any pain in your lower back, which could be caused from kidney issues.
Simple lifestyle changes can help you manage symptoms of bladder emptying and storage issues caused by MS.
Restrict fluid intake to less than two liters per day. And schedule bathroom breaks throughout the day.
Also avoid bladder irritants, including:
- artificial sweeteners
Stop drinking two hours before you go to bed. If you have trouble emptying your bladder completely, wait several minutes after each time you urinate and then try again. Use pads for incontinence or times when you know you won’t be able to get to a bathroom immediately.
If lifestyle changes don’t relieve your bladder dysfunction symptoms, your doctor may prescribe medication to control bladder contractions and reduce the urge to urinate.
For an emptying dysfunction, intermittent catheterization (IC) may be recommended. This involves inserting a thin tube into your bladder to drain excess urine. The process is easy to do with practice and is painless. It can prevent infections and serious kidney problems.
Treating stones and infections
If you end up with a UTI because of your bladder dysfunction, you’ll need to be treated with antibiotics. Untreated and frequent infections can cause serious complications in your kidneys. Both stones and infections can be very painful and can lead to permanent kidney damage if left untreated.
Treatment for stones varies depending on their size. You may be able to simply pass them as they are, or your doctor may be able to break them up with sound waves to make them smaller and easier to pass. A scope may also be inserted to remove stones.
It may sometimes be difficult to talk to your doctor about bladder problems, but it’s important that you do. If you constantly need to urinate or experience incontinence, you may be concerned about being too far from a bathroom or being around others. Discomfort and complications from bladder issues can become serious and symptoms can cause you to become socially isolated.
Bladder issues related to MS are common and treatable. Although they may sometimes be difficult to bring up with you doctor they can lead to serious issues with your kidneys.
There are plenty of interventions and treatments that can help you, so talk to your doctor as soon as you experience any symptoms of bladder issues.