Bladder Infections Can Be Symptoms of MS | Living Like You
Why MS Can Be a Real Pain in the… Bladder

Spending more time than usual in the toilet? It’s just your Multiple Sclerosis (MS), right? Well, yes and no. Either way, you shouldn’t just cross your legs and hope for the best.

Urinary tract infections (UTIs) are pretty common – especially in women1 (thanks for that one, Mother Nature). But if you have MS, you may be more familiar with that feeling of peeing broken glass than most.

Bladder issues are common among people with MS, affecting up to 90% of those with the condition2. Some of the most common problems include urinary incontinence (urinary incontinence is the unintentional passing of urine3) and increased frequency4 of urination, both of which can put you at higher risk of developing a UTI4. In fact, one study in Europe found that three in ten people with MS reported having had urinary tract infections5. This may be due to nerve damage caused by MS, which can affect the signals telling the bladder to release6. This again may mean that you don’t always empty your bladder completely when you go to the loo, and the residual urine allows the build-up of bacteria. If you use a catheter this can be another cause of infection as it can make toilet hygiene tricky which can make infection more likely.

What causes UTIs?

The most common explanation for bladder infections is bacteria entering the urinary tract – that’s your kidneys, ureters, bladder, and urethra – and causing inflammation7. This gives you the feeling of wanting to go to the toilet more frequently, and often a burning pain when you do.

Signs of a UTI

As well as the constant urge to pee, and that all-too-familiar burning pain, UTI symptoms include feeling generally tired or washed out, painful bladder or abdomen even when not urinating, and passing only small amounts of urine each time8, you go. Your pee may also appear cloudy and smell more strongly than usual.

Why UTIs are more serious if you have MS

If left untreated, the bacteria can pass from the bladder up the ureters and into the kidneys, leading to a far more serious infection. In fact, UTIs are the most common reason for people with MS to be admitted to the hospital9. Unfortunately, even a mild bladder infection can trigger a cascade of inflammation within the body10, aggravating spasticity, and causing a relapse11. In addition to this, the relapse may be more severe than usual and last longer9. For this reason, recurrent infections may even be associated with the progression of neurological symptoms2. Because of all of this, it’s important not to dismiss bladder changes or even blame feeling tired as “just another annoying MS symptom.”

Treating UTIs

Treatment for UTIs is usually fairly straightforward. Your doctor will test your urine for the presence of bacteria and prescribe antibiotics when necessary12. Most bladder infections clear up in a matter of days, but you can make the situation less painful in the meantime by drinking plenty of water.

Preventing UTIs

Having MS might make UTIs more likely, but there are ways to reduce your risk. Drinking plenty of water is one – around 6-8 glasses a day is recommended to dilute your urine and help flush out bacteria5,12. You’ll need to drink even more in hot weather, or if you have been exercising. Paying more attention to your urination habits is also a good idea. Both men and women should urinate shortly after sex to flush away bacteria that might have entered the urethra. Also, after using the toilet women should always wipe from front to back to keep bacteria from entering the urethra12.

If you do suffer regular bladder infections, it’s definitely worth speaking to your doctor about the underlying causes. There are plenty of options for treating bladder problems for those living with MS13, from medication to prevent an overactive bladder, to catheterization to prevent incomplete emptying. Understandably, bladder issues can seriously affect quality of life14, so it’s important to take action – so you don’t spend all your time en route to the toilet! Speak to your doctor about ways to improve matters today.

References:

  1. Recurrent Urinary Tract Infections Management in Women. A review. Ahmed Al-Badr and Ghadeer Al-Shaikh. Sultan Qaboos Univ Med J. 2013 Aug; 13(3): 359–367. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749018/
  2. Urinary tract infections may trigger relapse in multiple sclerosis. Metz LM1, McGuinness SD, Harris C. Axone. 1998 Jun;19(4):67-70. http://www.ncbi.nlm.nih.gov/pubmed/9849133
  3. Website “NHS Choices” – Urinary Incontinence. Last accessed: 15.10.19 https://www.nhs.uk/conditions/urinary-incontinence/
  4. Association Between Urinary Symptoms and Urinary Tract Infection in Patients With Multiple Sclerosis. Nikseresht A1, Salehi H, Foroughi AA, Nazeri M. Glob J Health Sci. 2015 Sep 28;8(4):48574. doi: 10.5539/gjhs.v8n4p253.http://www.ncbi.nlm.nih.gov/pubmed/26573031
  5. Website “MS Trust” – Urinary tract infection (UTI). Last accessed: 31.05.16 https://www.mstrust.org.uk/a-z/urinary-tract-infection-uti
  6. Website “National Multiple Sclerosis Society” – Bladder Problems. Last accessed: 31.05.16 http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Bladder-Dysfunction#section-1
  7. Jasmine B.L. Lee, Guy H. Neild, Urinary tract infection, Medicine, Volume 35, Issue 8, August 2007, Pages 423-428, ISSN 1357-3039, http://dx.doi.org/10.1016/j.mpmed.2007.05.009 http://www.sciencedirect.com/science/article/pii/S1357303907001466
  8. Website “NHS Choices” – Urinary Tract Infections In Adults. Symptoms. Last accessed: 31.05.16 http://www.nhs.uk/Conditions/Urinary-tract-infection-adults/Pages/Symptoms.aspx
  9. Managing urinary tract infections in multiple sclerosis – can we do better? Bart MS Blog. Friday, 4 July 2014. http://multiple-sclerosis-research.blogspot.com/2014/07/managing-urinary-tract-infections-in.html
  10. Role of inflammation in bladder function and interstitial cystitis. Grover S, Srivastava A, Lee R, Tewari AK, Te AE. Ther Adv Urol. 2011 Feb;3(1):19-33. http://www.ncbi.nlm.nih.gov/pubmed/?term=21789096
  11. Urinary tract infections in multiple sclerosis: under-diagnosed and under-treated? A clinical audit at a large University Hospital. Mahadeva A, Tanasescu R, Gran B. Am J Clin Exp Immunol. 2014; 3(1): 57–67. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3960762/
  12. Website “National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)” – Urinary Tract Infection In Adults. Last accessed: 31.05.16 http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-tract-infections-in-adults/Pages/facts.aspx
  13. Contemporary management of the neurogenic bladder for multiple sclerosis patients. Stoffel JT1. Urol Clin North Am. 2010 Nov;37(4):547-57 http://www.ncbi.nlm.nih.gov/pubmed/?term=Contemporary+management+of+the+neurogenic+bladder+for+multiple+sclerosis
  14. Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction. Vitkova M, Rosenberger J, Krokavcova M, Szilasiova J, Gdovinova Z, Groothoff JW, van Dijk JP. Disabil Rehabil. 2014;36(12):987-92. doi: 10.3109/09638288.2013.825332. Epub 2013 Aug 20. http://www.ncbi.nlm.nih.gov/pubmed/23962192

 

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