One of these is ‘loo taboo’ as it is a potentially uncomfortable issue to raise. Changes to bladder function effect both men and women and you should always be asked about your bladder function this when you see your MS team.
It is statistically likely in many centres in NZ, with the gender mix of our doctors, that you will end up seeing a male neurologist and if you’re a woman with MS this may play a role in under reporting. In addition many women who have gone through childbirth tend to attribute bladder changes and light bladder leakage to the rigours of pregnancy; something that needs to be accepted while avoiding jumping on the trampoline with their children.
Bladder over or underactivity in MS is related to the pontine micturition centre in the brain and its communication to the bladder nerves in the spine causing either overactive symptoms: urgency and frequency or an underactive bladder: incomplete emptying, straining and urine retention.
Overactive bladders want to be emptied frequently and trigger the need to get to the toilet urgently, which can lead to not making it in time, which in turn causes anxiety and embarrassment. If you have an overactive bladder, it is likely you will know where all the best public toilets are situated. You may carry a spare pair of underwear for ‘just in case’ moments and you’ll potentially reduce your fluid intake before going out. As a guideline you should need to empty your bladder about every four hours, so if you empty your bladder more frequently or if you wake to empty your bladder more than once overnight please do consider sharing these details with your MS team or GP.
An underactive bladder often means having problems coordinating its sphincters to empty fully which in turn leads to a greater risk of urinary tract infections. As you may already know, infections are the enemy of MS as the increase in body temperature can bring about the return of previous MS symptoms (a pseudo relapse). Someone with an underactive bladder will notice UTI’s and the feeling that they need to apply pressure on their abdomen to clear the urine.
Completing a bladder (or bowel diary depending on your issue) can be helpful to track exactly what is happening.
To help raise this issue an MS bladder check has been developed by Coloplast. There is a new Australasian bladder bowel and sexual function publication now available from www.hollister.co.nz who also have a bladder function webinar, Multiple Sclerosis and the Urinary System | Hollister NZ which you may find a quick and interesting watch. Bladder and Bowel Health at Continence NZ is a great resource.
You should always be asked about your bladder function when you see your MS team and if for some reason you are not and you have concerns please feel confident to raise this.
Let face it when you’re having issues with your bowels it’s not fun and breaking the ‘Loo Taboo’ around this very normal and vital bodily function is required, especially if you are needing help and advice.
According to Continence NZ, normal bowel function varies individually, typically ranging from three times a day to three times a week. A healthy, normal bowel motion is soft, well-formed, easy to pass without straining, and leaves you feeling completely emptied.
What we know about MS and bowel function is that in some people delayed peristaltic movements in the gut can impact bowel function causing constipation and at the other end of the spectrum there are those who can experience unpleasant bowel urgency and in some cases not make it to the toilet in time. These events can be mortifying and socially awkward as most people have gained bowel control before starting school.
If you’re having bowel issues I encourage you to complete a bowel diary so you can track what’s going on and this is an invaluable tool for your healthcare team so they can better advise you. Make yourself aware of the Bristol stool chart so you can identity what sort of bowel motion you’re having Bristol Stool Chart and in turn this can help your team advise on changes you should make: eat more fibre, drink more water etc.
It’s important to know that constipation can lead to loose stools – don’t be fooled that you’re not constipated as there is a phenomenon called ‘overflow’ which sometimes occurs in people who constipated where new faeces squeezes around the constipation
Causes for constipation in MS
Reasons for loss of bowel control in MS
Factors that cause constipation
Top Tips
Hollister bladder and bowel booklet Australasia (can we have a photo of the bowel page 23 of attachment) Quick Educational Tools | Hollister AU,
Podcast- But you look so good episode: 20/1025 Wee Confessions with KJ
Continence.org.nz
Whatever your issue is I encourage you to be brave and speak to your GP who can make suggestions and if needed refer you to a continence nurse/ gastro or colorectal expert
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