People living with MS frequently report various bladder and bowel issues. Some individuals with MS don’t know that a bladder dysfunction can be a neurological problem and they don’t seek help because they do not know they can be helped. For some people, this problem is so embarrassing that they do not want to discuss it–even with their doctor. Bladder problems and incontinence often result in urinary tract infections (UTI’s). Decreased sensation, which is common in MS, can mask the symptoms of a UTI. Untreated, these can cause medical complications that pose a risk to a person’s general health.MS bladder problems can be caused by a spastic bladder, a spastic sphincter muscle, or a combination of both (called a dyssynergic bladder).
A spastic bladder has trouble storing urine. Symptoms of a spastic bladder include:
- Urgency (the feeling of having to empty the bladder right now)
- Frequency (voiding more often and in smaller amounts)
- Incontinence (the inability to hold urine in the bladder)
A tight or spastic sphincter muscle prevents the bladder from emptying. The bladder therefore stores too much urine. Symptoms of a spastic sphincter include:
- Hesitancy (the inability to empty the bladder on command)
- Occasional incontinence – due to overfilling of the bladder
- Frequent urinary tract infections
A combination bladder can cause urgency and hesitancy, or can mask the need to urinate followed by incontinence.
The source of the bladder problems should be determined before initiating treatment. An evaluation to identify the exact cause of the bladder trouble can be performed by a urologist.
Individuals with MS often have problems with constipation and/or urgency and incontinence, but because these manifestations frequently appear in the general population, they are not always recognized as MS symptoms. These problems can be directly related to MS, and once the cause is identified and diagnosed, the symptoms can be treated. People may be reluctant to discuss bowel function, even with their health care providers. Some people find their bowel problems have become so severe that they cope by simply staying at home, which can increase social isolation.