Bladder & Bowel Teleconference Update

Shared Solutions (copaxone) sponsored a phone-in teleconference this  week on bladder and bowel problems in people with MS, and here are the highlights as requested by Sailorsong (Dennis) :

The doctor was Dr. Chris LaGanke,  from Cullman, AL.  

He was emphatic that we have to “get over the prideful nature” of avoiding these discussions with our doctors.  If our doctors are not questioning us about bladder, bowel and sexual  dysfunction, we need to bring up the topic for ourselves.

Don’t be embarrassed – all of these problems come with MS.  His take is 80% of MS patients have bladder dysfunction.  Any neurologic problem can affect the bladder and bowels.

Key points about bladder:

*there are tests to determine the nature of bladder problems.  The spastic bladder is the most commn.  Do this early with a urologist before the problem gets out of hand or too overwhelming.

*self-management is important.  Drink at least 8 glasses of water a day, which is necessary to help flush your kidneys and bladder of bacteria and minerals.

*caffeine and alcohol are irritants to the bladder. You don’t have to avoid these, but he warned that you should be cautious about the amount you have and when you have these.

* if infections are a regular problem, he suggested adding cranberry tables and/or vitamin C (not in mega doses)

*void the bladder after intercourse to help curb  infections

* suggested cutting off fluids 2 hours prior to any activity if there are no facilities handy.

*recommends intermittent self-catherization if you have retention or a neurogenic bladder.

*spasticity (stop & go), urgency (got to go now), and retention (creates sensation of got to go all the time)

*set a schedule to urinate – very 2-3 hours  - to try to regulate your body

*try bladder exercises, including holding your urine longer before voiding . He said Kegel exercises can help some people but not all people.  Neurogenic bladder isn’t just about strengthening the pelvic floor muscles.

*botox is proving effective for spastic bladders because it relaxes the bladder wall.  However, FDA has still not approved this use and the urologists have to use if off-label.  Make sure your insurance will cover this procedure before you have it done – pre-authorization is essential.

Key points  about bowel :

*he says 60% of MS patients have bowel dysfunction, because the lesions effect the signaling

*constipation is the major complaint, but problem can also be loose stools.  

*many causes of bowel dysfunction, including our diet, immobility (lack of exercise), medications, withholding  fluid because of bladder problems, and infections.  

*depression can affect the bowels, making them sluggish

*caffeine dehydrates stool so if you have a lot of caffeine you need to increase your intake of other decaffeinated drinks

* it is rare to have total loss of bowel control.

* constipation can affect bladder function, because of the pressure on the bladder.

*bowel impaction is a serious problem and needs to be treated by a doctor.  You can have runny stools and still have bowel impaction – it can go around the edges of the impaction.  

*Stool softeners can be used as part of the regular routine but NOT laxatives, which can become addictive and make your bowels dependent on them

*it takes 30-60 days to change the bowels into a different regimen so you have to be patient when trying a new treatment.

Unfortunately he did not get into the differences between male and female bladder problems – I had hoped that topic would be covered.  I hope something in this is of use to you.

Knowledge is power.
Lulu

[moose28]

Thanks for posting the info - I wanted to do that conference - forgot all about it though. :)