Some of the most common and
even dangerous symptoms of multiple sclerosis make us feel ‘dysfunctional.’
July 18, 2022 – By Trevis
Gleason
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.
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