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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
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