Multiple sclerosis (MS) is a condition of the central nervous system (CNS), interfering with nerve impulses within the brain, spinal cord and optic nerves. It is characterised by sclerosis.
MS blocks or delays the transmission of nerve signals in single areas of the CNS that control bladder and urinary sphincter.
These scars occur within the central nervous system and depending on where they develop, manifest into various symptoms.
Bladder and bowel dysfunction (including incontinence) can occur. If demyelination of the nerves (which control the bladder and bowel) affects the speed at which nerve impulses travel from the brain to the bladder.
- Bladder dysfunction occurs in at least 80% of people living with MS and is usually treated quite successfully.
Blader dysfunction symptoms include:
- Greater or less frequency of micturition (passing of urine)
- Urinary tract infections
- Nocturia (the need to urinate frequently overnight).
Bowel issues can include:
- Severe constipation
- Faecal incontinence
- Diarrhoea often due to pasticity of the bowel or the anal sphincter, loss of gastro-colic reflex, and loss of sensation in the anus and rectum.
Treatment strategies include dietary and fluid management, medications and intermittent or continual catheterisation (inserting a thin tube into the bladder to remove urine).
Bladder dysfunction Development of a neurogenic bladder associated with MS occurs in these patients as lesions in the brain and spinal cord interfere with signal transmission to the urinary system, producing ladder and bowel, and back again.
a range of lower urinary tract symptoms (LUTS) involving urine storage, emptying, or both. The primary symptoms are urgency and incontinence, with frequency and nocturia signalling a storage dysfunction, while dribbling and hesitancy are problems associated with improper emptying.
Often symptoms become most noticeable to patients when they begin to develop gait difficulties that slow or hinder their ability to readily reach a bathroom.
Bowel dysfunction/constipation is a particular concern among people with multiple sclerosis, although diarrhoea, incontinence (or loss of control) and other problems of the stomach and bowels can also occur.
Causes of constipation include insufficient fluid intake, reduced physical activity and mobility and decreased or slowed "motility" (movement of food through the intestinal tract). Certain medications, such as antidepressants or drugs used to control bladder symptoms, may also cause constipation. Loss of bowel control in multiple sclerosis may be neurologic in origin or related to constipation and should be evaluated by a health care provider generally a physician or nurse).