Multiple sclerosis (MS) is a degenerative disease of the central nervous system that can affect many aspects of a person’s body — and that includes their bladder and bowels.
It’s always annoyed me that the ever-encroaching, ever-worsening symptoms of my MS are referred to as “progression.”
It also strikes me as odd that the overfunction, underfunction, and nonfunction of the bowels and bladder in MS are all called “dysfunction.” It sounds like the type of diagnosis that results in hours on a therapist’s couch talking about family difficulties, rather than one that describes the myriad of difficult symptoms at the end of the excretory and digestive tracts.
How MS Affects the Bladder and Bowels
Symptoms of dysfunction in the bladder and bowel due to MS typically fall into two categories:
- Overactivity of these systems leads to urgency (I have to go … NOW), frequency (I have to go … AGAIN), and incontinence (I guess I had to go) are one side of the equation.
- Underactivity can lead to hesitation, retention or constipation, and failure to fully empty.
In both cases, it is usually the nerve pathways that connect the brain to the sphincter muscles (which open and close on command when healthy) and the sensory nerves of the systems that are affected by MS.
As many as 90 percent of people living with this disease report some sort of issue with their bladder, and more than 68 percent have trouble with their bowels.
With Overactivity, the Problem Is Obvious
The overactivity of our systems can be and usually is recognized. If you’re going more often, feel like everything is normal and then must go now, or are waking several times in the night to go, then you’re likely to seek help (or at least you are aware that it is an issue).
Odd as it may seem, the more severe symptom of overactivity — incontinence — is so embarrassing that some people are inclined to seek medical advice more quickly for minor symptoms of overactive or spastic bladder than for incontinence.
Underactivity Can Be Harder to Notice
When our symptoms are from underactivity, that’s when many people with MS think everything is fine — or don’t think of it at all.
We can’t know if we’re not emptying fully without having that checked (though frequent urges with small return can be a symptom of underactivity).
Not fully emptying the bladder can cause recurrent urinary tract infections (UTIs), and repeated UTIs can lead to more and permanent damage.
Not moving our bowels regularly has its own set of painful and dangerous results.
A Few More MS-Related Complications
As if these were not enough to cope with, reduced or total lack of physical sensation in the area due to MS can cause us not to notice when something is going wrong, even if it gets serious.
Infections can cause dehydration; they can cause fevers, which can raise all kinds of havoc for people with multiple sclerosis; and they can travel up the system to our kidneys and cause an even more dangerous kidney infection.
Restricted mobility can keep us from moving our bodies around, which would help with the digestive process. If a person spends much of the day sitting in a chair or scooter, detrimental consequences to bowel health and function can follow.
Don’t Let Embarrassment Keep You From Speaking Up
It is so important that we not risk our overall health out of a feeling of shame or embarrassment. Many bowel and bladder symptoms of MS can be easily attended to well before they become severe.
Not talking to our doctors about concerns early, and hiding behind the bathroom door, seems rather childish, especially when (let’s face it) MS has made us wise beyond our years.
Wishing you and your family the best of health.