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BOWEL & BLADDER SYMPTOMS Bladder Concerns Normal voiding of the bladder depends on proper functioning of the pathways between the brain and the voiding reflex center, which is located at the base of the spine. Urinary tract infections (UTI's) are common in MS . When short-circuiting occurs in this area, bladder and bowel problems develop. The definitions of the problems that are encountered are as follows: Spastic Small Bladder Symptoms include urinary frequency, urgency, dribbling and/or incontinence. In this case, the bladder remains small because as soon as it starts to fill, it empties. Flaccid Big Bladder Symptoms include urinary frequency, urgency, dribbling, hesitancy, and incontinence. Flaccid big bladder is similar to that of a spastic small bladder except that with a flaccid big bladder it becomes overfilled and stretched. Because urine stays in the bladder for longer than it should, the bladder is prone to infection. Incoordinated Bladder An incoordinated bladder can have one of the following problems. Either the sphincter remains closed when the bladder wall contracts creating a sense of urgency followed by hesitancy in voiding, or the bladder wall relaxes while the sphincter stays open causing dribbling, incontinence or overfilling of the bladder to occur. Treatments Before an individual management program can be designed, your physician will need to determine the cause of your symptoms and perhaps refer you to a Urologist for consultation and assessment. There are a variety of methods that physicians use to help treat bladder problems, such as: Medication Eliminating diuretics Relaxation techniques to relax the sphincter muscle Intermittent catheterization Bowel Concerns Bowel concerns are also found amongst patients living with MS. As with bladder symptoms, bowel problems occur because of demyelination in the brain or spinal cord which interferes with messages to the bowels thereby creating the following problems: Constipation is the difficult or infrequent elimination of stool. It is the most common bowel problem in MS. Constipation can occur for several reasons such as interference of nerve messages to the bowel, the patients limit in his/her fluid intake, weakness, spasticity, and fatigue. Strategies The following are tips in managing constipation: Drink adequate amounts of liquid Add fiber to your diet, including fruits and vegetables Establish a routine for daily bowel movements Medications such as fiber based products, suppositories, and enemas Incontinence or loss of bowel control is less frequent but can occur as well. The use of stool bulkers and a regular bowel program are useful. Medication can also be prescribed to help alleviate this problem. Medication Eliminating diuretics Relaxation techniques to relax the sphincter muscle Intermittent catheterization Bowel Concerns MS Central Support � 2002, 2003