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Get control of bladder and bowel issues


Gotta go! gotta go!

Bladder and bowel accidents are embarrassing. About 85% of people with MS are likely to experience these problems. It can happen early in the disease or late. Whenever it does, the fear of accidents can make people with MS stay at home and give up their outside activities.

The good news is You CAN manage MS related bladder and bowel issues.

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Personal Care: Bladder and Bowel Problems

First step

Consult with your health-care provider for a comprehensive evaluation at the first sign of a problem. These can include:

  • Bladder urgency

  • Frequency of urination

  • Leaking urine

  • Constipation

  • Loss of bowel control

As with other symptoms of MS, these can vary greatly from person to person. Depending on the cause, a management plan can include a combination of self-help strategies and medications. It may take some time working with your health-care provider to identify the most effective techniques.

Below are some of the strategies.



You might think that cutting back on fluids is a good strategy. Don’t do it. It can lead to serious bladder and kidney problems. You need 6-8 cups of water a day.

photoPlan your fluid intake. To drink 6-8 cups of water, divide this amount into portions. Drink fluids in larger amounts at 3 or 4 designated times a day. You can then plan a bathroom stop about 1 to 2 hours later. Sipping fluids throughout the day is a bad idea. It encourages more frequent bathroom visits.


photoEstablish a schedule of urinating every 2 to 4 hours, whether you feel the need or not. This behavioral technique is called bladder training or timed voiding. You can coordinate this with your drinking schedule.



Reduce or eliminate caffeinated drinks (coffee, soda, tea) —and alcohol in your diet. These are bladder irritants. Avoid them altogether if you are traveling or going out.


photoDiscuss prescription medications for frequency and urgency with your health-care provider.


If the above approaches aren’t enough, Intermittent self-catheterization (ISC) may be recommended. To learn more about ISC, click here.



Establish a regular schedule of elimination, usually in the morning after eating breakfast, although any time that works for you is fine as long as it is consistent. When the bowel becomes used to emptying at specific times, accidents are less likely.


photoKeep up your fluid intake (6-8 cups a day) and eat plenty of fiber-rich food—fruits, vegetables, and bran cereals to prevent constipation.


photoGet some physical activity. It helps keep things moving!


Discuss remedies such as stool softeners, bulk forming supplements, laxatives, suppositories, or manual stimulation with your health-care provider. It may take several weeks to know if these remedies are working.


Discuss medications that address bowel issues.


Out and About

photoWhen going out or traveling, plan frequent stops.


If you’re traveling to major cities, a free resource called “Where to Stop and Where to Go” can be helpful in planning those bathroom stops. It can be ordered from http://www.wheretostopwheretogo.com/.


photoUse and carry extra protection such as pads. They are discreet and afford you confidence.


Wear clothes that you can easily remove such as trousers with elastic waistbands or Velcro closures.


If you're on an airplane, wear a pad “just in case.”


photoStash a change of clothes and underwear, pads, medication, wipes, catheters, paper towels—whatever you need—in a tote bag or back pack.


Don’t wait to address the issue. Neglected symptoms can lead to more serious health conditions and can be harder to fix.


You CAN manage your MS bowel and bladder issues so that you can do the things you want to do.



These tips brought to you by The Heuga Center, promoting health and creating hope for people with MS since 1984, and by the National Multiple Sclerosis Society.
Author: Patricia Kennedy, RN, CNP
Heuga Center for MS program staff and Board of Director member
Contributing editors: Brian Hutchinson, PT, President, The Heuga Center; InsideMS Magazine.

You CAN! is brought to you with the help of The Heuga Center as a reminder that despite the challenges MS may bring, you have a whole life to live.

We encourage you to visit You CAN! regularly. Topics change every other month.


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