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A chronic, typically progressive disease involving damage to the sheaths of nerve cells in the brain and spinal cord, whose symptoms may include numbness, impairment of speech and muscular coordination, blurred vision, and severe fatigue.
A term for several conditions affecting bladder control, often characterised by urinary incontinence, frequent urination, and discomfort, which can be a common symptom in people with MS.
A urinary problem in which the bladder does not function properly due to a brain, spinal cord or nerve condition like MS, leading to symptoms like incontinence or an inability to fully empty the bladder.
The unpredictability is the essence of living with Multiple Sclerosis (MS), and one of the most common - and often distressing - changes is bladder dysfunction. Managing this, alongside other symptoms of MS can be challenging, but there are treatments and strategies that can help.
MS is a condition that affects the central nervous system. The myelin sheath, a protective layer around nerves, becomes damaged, creating disruptions in the communication between your brain and your body.
Well, your bladder is essentially a muscular bag controlled by nerves. When MS disrupts these nerves, the bladder's ability to store and empty urine efficiently can be compromised. This can lead to symptoms such as urinary urgency, frequency, incontinence, and urinary tract infections.
Conversely, others might find it hard to fully empty their bladder, leading to urinary retention. Night-time issues can also be present, disturbing sleep patterns and affecting quality of life.
Understanding and recognising the signs of bladder dysfunction can help you maintain control. Symptoms might include:
The need to urinate frequently
Waking up frequently at night to urinate
A sudden, intense urge to urinate, sometimes leading to involuntary leakage
Difficulty emptying the bladder fully
Painful urination or urinary tract infections
If you notice any of these changes, talk to your healthcare provider. They can help diagnose if bladder dysfunction is indeed the issue and can provide appropriate management options.
Alright, now let's get to the crux of the matter: How do you manage this?
Several medications and therapies have proven effective. Anticholinergic drugs can relax the bladder muscles, reducing urgency and frequency. For some people, Botox injections in the bladder muscle can help manage symptoms.
Don't shy away from physiotherapy either. Studies have shown pelvic floor muscle training to be effective in managing bladder symptoms in MS.
One of the most common misconceptions is that reducing fluid intake will reduce urinary symptoms. But in reality, concentrated urine can irritate the bladder and actually increase symptoms, as well as heightening the risk of urinary tract infections.
Drink enough to keep your urine light in colour and reduce caffeine and alcohol intake as these can irritate the bladder.
This involves developing a urination schedule, gradually increasing the interval between trips to the bathroom. A diary can help you track your progress. It might seem tedious, but it's a simple strategy that can lead to significant improvement.
If other strategies aren't successful, your doctor might suggest intermittent self-catheterisation. Although it might seem daunting at first, many find it a useful tool to regain control. Don't worry, training and support are available to help you get the hang of it9.
More unconventional yet proven therapies also exist. For instance, neuromodulation, where electrical signals are used to alter nerve activity, has shown promise in managing bladder dysfunction. Acupuncture, too, has shown potential benefits.
Living with MS and bladder dysfunction is a journey, and it's okay to lean on others. Support groups, both online and in-person, can provide a space to share experiences, tips, and encouragement.
As we've seen, there's no one-size-fits-all solution, and you might need to experiment with different strategies to find what works for you.
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