Multiple sclerosis (MS) is a disease that affects the central nervous system. In a patient with MS, the immune system attacks the protective material that surrounds the nerve cells. This causes damage and results in symptoms that may include:
- pain, numbness, and tingling
- blurry vision
- bladder dysfunction
For most people with MS, symptoms flare up and then recede. In rarer instances, the symptoms get progressively worse. Most MS patients have normal lifespans and are able to maintain a healthy lifestyle with simple treatments.
MS and the Bladder
Up to 90 percent of MS patients experience some issues with bladder function, according to Cleveland Clinic. In fewer cases, such bladder problems may lead to kidney damage. Bladder issues aren’t necessarily constant, but may occur with flare-ups.
MS can cause bladder problems due to the damage caused to the nerves that signal how the bladder contracts. Disruptions in these signals can lead to a number of symptoms.
Bladder storage dysfunction is a symptom of overactive bladder. This means that the nerve damage within your body has caused your bladder muscle to contract more often than it should. The spastic contractions make you feel as if you need to urinate more frequently than you actually need to.
Symptoms of bladder storage dysfunction include the following:
- strong urge to urinate
- frequent need to use the bathroom
- the need to get up several times at night to urinate
- the inability to control your urination (also referred to as incontinence)
Bladder Emptying Problems
An emptying dysfunction 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. The result is that your bladder never completely empties, and may even overfill.
Symptoms of an emptying dysfunction include:
- a feeling of urgency to urinate
- hesitancy when you try to urinate
- incomplete urinary stream
- urinary tract infections
Combined Emptying and Storage Problems
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. The 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 retained urine left over in the 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:
In rare cases, especially when left untreated for a long time, an emptying dysfunction may lead to more serious problems in the kidneys. Emptying dysfunction may cause an infection to spread to the kidneys from the bladder.
The retained urine can also lead to the formation of mineral deposits, which can cause kidney stones to form. 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 you feel in your lower back, which could be coming from your kidneys.
Simple lifestyle changes can often help you manage the symptoms of bladder emptying and storage problems caused by MS. Avoid bladder irritants, which include cigarettes, caffeine, artificial sweeteners, and alcohol.
Drink plenty of fluids, but avoid sipping a drink slowly. Drink each glass all at once to avoid frequent urges.
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 that you’ll be unable to access a bathroom immediately.
If lifestyle changes aren’t adequate to relieve your bladder dysfunction symptoms, your doctor may prescribe you medication to control bladder contractions and reduce the urge to urinate.
For emptying dysfunction, the most common treatment is called intermittent catheterization (IC). It involves inserting a thin tube into the bladder to drain excess urine. The process is easy to do with practice, and it’s painless. The simple procedure can prevent infections and serious kidney problems.
If you end up with UTIs 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 infections and stones can be very painful and can lead to permanent kidney damage if left untreated.
Treatment for stones varies depending on their size. You may simply pass them as they are, or a doctor can break them up with sound waves to make them smaller and easier to pass. A scope may also be inserted to remove stones.
You may feel embarrassed to talk to your doctor about bladder problems, but it’s important that you do. The discomfort and complications from bladder issues can become serious, and the symptoms can cause you to become socially isolated.
If you constantly need to go, or experience incontinence, you may be afraid to travel far from home. Or, you might feel embarrassed about being around others. There are plenty of interventions and treatments that can help you, so talk to your doctor as soon as you experience any bladder symptoms.