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Introduction

How Multiple Sclerosis can affect the bladder and bowels Many people with multiple sclerosis (MS) find that the disease also affects their bladder and bowels. While obviously not ideal, there are effective ways of dealing with the issues so you stay on top of the condition. Consequences of Multiple Sclerosis

The bladder

The symptoms of Multiple Sclerosis (MS) vary from person to person but approximately 20-25% of people with Multiple Sclerosis will experience bladder issues. Typical symptoms include: 

  • Need to urinate more frequently or urgently
  • Difficulty in emptying the bladder
  • Occasional urinary incontinence

The above symptoms may be one of the first signs of Multiple Sclerosis but they may also develop during the course of the illness.

The bowels

Multiple Sclerosis may also affect the bowels, with about 34% of people believed to have issues to a degree that interferes with their daily life. Typical symptoms include: 

  • Constipation
  • Bowel leakage

Certain drugs commonly prescribed for multiple sclerosis can also increase the likelihood of constipation.

Taking care of your bladder and bowel

To avoid troublesome complications and improve your quality of life, it’s important to take care of your bladder and bowel. The following section describes some practical solutions you may find useful:

Unable to empty the bladder

Clean intermittent catheterization is considered the gold standard for people who can’t empty their bladders themselves.

Bladder leakage

Male External Catheters are an effective way for boys and men to deal with bladder leakage.

Chronic constipation/bowel leakage

Peristeen® anal irrigation system is an effective way to get into a good bowel care routine. 

Multiple Sclerosis - facts
MS is a so-called autoimmune disease, meaning that the immune system attacks the person’s own cells. In the case of MS, the central nervous system (CNS) is attacked. MS ratio of female to male is about 2:1.  MS can gradually lead to:

  • Bladder and bowel symptoms

  • Physical limitations

  • Fatigue

  • Cognitive impairment

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Good to Know

How can I deal with my bladder problems? Depending on your condition, you might need to use an intermittent catheter or a male external catheter. Either way, finding a product that meets your needs and fits your lifestyle is important for your overall quality of life. How to deal with bladder issues
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Dealing with bladder problems

Dealing with bladder retention

If you have difficulty emptying your bladder, you will typically use an intermittent catheter. Your first step will be to find one that fits you and your lifestyle. Once you’ve decided on catheter, it’s important that you follow the guidance in terms of how often you catheterise.
If you experience frequent urinary tract infections (UTIs), it could be a good idea to do the following:

  • Drink more fluid during the day
  • Increase how often you catheterize daily. Typically you will be advised to catheterize 4-6 times a day if you are not able to void by yourself.
  • Ensure you have clean hands and materials when catheterizing
  • Reassess your intermittent catheterization technique with our Tips, Tools and guides section below

If you keep getting UTIs despite following these guidelines, be sure to contact a healthcare professional.

Dealing with urinary incontinence

Male External Catheters are used effectively by many men dealing with urinary incontinence. These are discreet, condom-like sheaths worn over the penis and connected to a collecting bag worn on the leg.
It’s important you use the right size Male External Catheter while finding the right collecting bag depends on how much you leak.

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Caring for your bladder and bowels Finding effective ways to manage your bladder and bowel issues can make a difference in your quality of life. Here’s an overview of some things to consider to stay your healthiest. Learn more about managing your bladder and bowel
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Taking care of your bladder and bowel

Why is taking care of your bladder important?

 
Emptying your bladder properly will allow you to:

  • Avoid urinary tract infections and damage to the kidneys
  • Take control over your bladder
  • Preserve, or in some cases, regain continence
  • Improve your quality of life

 

Dealing with retention

According to international guidelines on healthy bladder management, intermittent catheterization is considered best practice for people with urinary retention. Healthy bladder management with intermittent catheterization is all about routine and regularity. You’re still producing the same amount of urine as before, so it makes sense that you still need to empty your bladder the same amount of times as you did before, normally about four to six times a day. The obvious difference is that now you will need to use a catheter.

 

Learn more about SpeediCath catheters and request your free catheter samples

 

Dealing with leakage

Managing urine leakage with a male external catheter and a urine collecting bag may improve quality of life in men compared to using diapers and pads.

 

Learn more about Male External Catheters and request your free samples


Things to think about when choosing a catheter

It’s important that you feel comfortable catheterizing yourself so you can stay independent and feel in charge of your own body. Take some time to consider the following issues:

 


Is the catheter easy to use?

 

  • Does the coating allow for smooth insertion of the product?
  • Is the catheter ready to use straight out of the packet?
  • Is the catheter intuitive to use?

 

Does it suit your lifestyle? 

  • Is its size and shape discreet so only you know about it when you are out and about?
  • Does it contain materials that you are allergic to or don’t want to be exposed to?
  • Do you need to use several accessories (extension tubes, urine bags, application guides, etc.) and how easy is it to put it them all together?
  • Do you need help using your incontinence system or could you be independent if you used a different catheter?

 

Learn more and about Coloplast catheters and range of bladder care solutions

 

 

Why is good bowel care so important?

As with bladder care, having a good bowel care routine will improve your physical and emotional well-being and help you to:

 

  • Have regular and pain-free bowel movements
  • Prevent bowel leakage and constipation
  • Improve your quality of life

 

 

There are several ways to take care of your bowels, including:

 

  • Making specific changes to your diet and fluid intake
  • Using suppositories and/or laxatives
  • Using other methods such as digital or manual stimulation
  • Bowel irrigation

 

Everyone is different, so creating a good bowel care routine will differ from individual to individual. If some of the options above are not effective enough, then bowel irrigation may be a good alternative to avoid bowel leakage and constipation. This is a well-documented technique, whereby water is introduced into the bowel via the rectum. The water and waste is then emptied from the bowels.


Read more about Coloplast’s bowel irrigation system

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How can I deal with my bowel issues?

How can I deal with my bowel issues?

Issues such as bowel leakage and constipation are a common symptoms of conditions that cause damage to the central nervous system.

How to deal with bowel issues
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How can I deal with my bowel issues?

Nerves in the spinal cord control bowel movement and if they are damaged, the feeling of needing to empty the bowel and the movement of stools through the body are affected. As a result, it can be difficult to tell when your bowel is full, and you can also have trouble controlling the release of stools. This can lead to different types of bowel problems: 

  • Bowel leakage
  • Constipation
  • A combination of the two

 

Bowel leakage

Bowel leakage occurs when you are unable to control your bowel muscles. This can result in accidental leakage of stools or having to rush to the toilet. Bowel accidents can be a distressing experience and can also lead to skin irritations and bladder infections, all of which can greatly affect a person’s confidence and general well-being.


Constipation

Constipation occurs when stools in the bowel stay there for too long and become hard and dry. This makes it difficult to pass stools and results in the inability to have a bowel movement. Symptoms vary from person to person but the most common are straining, bloating and severe discomfort.

You may experience a combination of both bowel leakage and constipation – when softer stool or fluid leaks past hard stools stuck in the colon – often culminating in a bowel accident.

Whatever issues you are dealing with, it’s important to find a bowel routine that enables you to continue with your daily life in confidence.

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Frequently asked questions about MS Multiple sclerosis can affect many bodily functions, including your bladder and bowel. Here we detail some of the most commonly asked questions and provide some answers. FAQs on Multiple Sclerosis

The bladder

Why does multiple sclerosis cause bladder problems?

The bladder, which stores urine, is controlled by the nervous system. Because multiple sclerosis damages nerves, bladder function may be affected. Some people find they need to urinate more frequently or urgently, whereas others experience difficulty emptying the bladder. Some people with multiple sclerosis may experience occasional urinary incontinence.


How can bladder problems affect my health?
If your bladder is not emptied regularly, it can cause infections. These start in the bladder but can move back to the kidneys and cause serious damage, which can cause renal damage. Even small amounts of urine left in the bladder can cause infections.
Alternatively, if you cannot control the urge to urinate, you may leak involuntarily. Finding a way to take control of your bladder issues can help you stay healthy and confident.


What can I do to manage my bladder issues?
There are a number of methods and products available, including catheters, Male External Catheters, and absorbent products. Get help finding the right product for your needs.


What is a catheter?
The catheter is a slim, flexible tube that is inserted into the bladder through the urethra to allow the urine to drain.


Does it hurt to catheterize?
No. You might feel some pressure when the catheter goes in. If you experience discomfort or if it is difficult to slide in the catheter, take a short break. Try to relax by taking a deep breath or by coughing. Talk to your doctor or nurse if you find it painful.


Can I just empty my bladder in the morning and in the evening?
No. You should follow the schedule your doctor has given you. As a rule, the bladder should be emptied at least 4–6 times a day.


Can I drink less so that I don’t have to empty my bladder so often?
No. It is very important that you drink enough. This keeps the urinary system clean and healthy.


What if the urine looks cloudy or dark and smells funny?
You may have an infection. Talk to your doctor or nurse.


What if I get frequent urinary tract infections?
Using an intermittent catheter increases the risk of urinary tract infections. However, compared to other catheter types such as permanent (indwelling) catheters, intermittent catheters are less likely to cause urinary tract infections. There are ways to reduce the risk of urinary tract infections:

  • Drink more fluid during the day – the principle is simply to wash out the urinary tract, providing you continue to catheterize
  • Make sure that the bladder is fully emptied every time you catheterize
  • Increase number of daily catheterizations
  • Ensure you have clean hands and equipment when catheterizing
  • Reassess your intermittent catheterization technique 

What should I do if I am still leaking?
Urine leakage may occur for different reasons:

  • A urinary tract infection may cause urine leakage and you should contact your doctor if you suspect you have one. Typical symptoms to be aware of include:
    • Dark-colored and strong-smelling urine
    • Cloudy urine
    • Blood in the urine
    • Fever/sweating
    • Bladder spasms
    • Increased muscle contractions in your leg
  • If you catheterize less than four times per day, the leakage may occur because you do not catheterize often enough.
    • Consider catheterizing more frequently to prevent the bladder pressure from building
    • Make sure your bladder is fully emptied every time you catheterize. Reassess your intermittent catheterization technique 
    • If you are catheterizing more than seven times per day and still have problems with urine leakage you may wish to consult your doctor 
  • You may leak because you have involuntary bladder spasms/contractions (not caused by a UTI).
    Talk to your doctor about the possibilities of being prescribed some medication that will relax your bladder
  • If the leakage mainly occurs doing physical exercise, you should consider catheterizing before you start to exercise.

The bowel

Why does multiple sclerosis cause bowel issues?
Nerve endings in the rectum help to alert people of the need to pass a stool when it enters the rectum. In people with multiple sclerosis, this message may become lost or incomplete, increasing the risk of bowel problems such as constipation, bowel leakage or a combination of both. Certain drugs commonly prescribed for multiple sclerosis can also increase the likelihood of constipation.


How can bowel problems affect my lifestyle?
Bowel leakage and constipation can be very uncomfortable, and they also have a significant impact on our quality of life. Apart from the frequent physical discomfort and bloating, you may worry about having an accident in public.

Therefore it is important to find a way to manage your bowel issues.


What can I do to manage my bowel issues?
Bowel issues can often be improved by changing diet. There are also several types of medication that can help. Transanal irrigation can be used to help prevent constipation and bowel leakage. 

 

What is transanal irrigation?
Transanal irrigation is where water is introduced into the bowel using a rectal catheter. The water stimulates the bowel and flushes out the stool, leaving the lower half of the bowel empty. It’s important to do it regularly to prevent constipation and the risk of bowel accidents.

 

How often should I irrigate?
For most people, every 1–2 days works well. It is important to do it regularly to prevent constipation and the risk of bowel accidents. It is best to get into a regular routine, rather than changing too much. With time and practice you’ll find out what works best for you. If you are not sure, ask your doctor or nurse for advice.

 

What time of the day is best for transanal irrigation?
Try to get into a routine where you irrigate around the same time of the day. Eating and drinking helps the bowel’s natural movement, so about 30 minutes after a meal is a good time. But don’t be afraid to change the routine slightly to suit your day-to-day habits.

 

Can I travel with the transanal irrigation equipment?
Yes – remember to bring your irrigation system along with lots of disposable catheters as they may not sell them everywhere. If you are going to use the system abroad, use bottled or cooled boiled water in places where the tap water is not safe to drink. Remember in different time zones your body may take a while to get used to a new routine. You may also be eating different types of food, which can affect the bowel.

 

Does it hurt?
No, transanal irrigation does not normally hurt and is perfectly safe. However it may feel a little strange at first. If it is uncomfortable when the water is pumped in, stop for a while and then continue. If you are in pain, stop irrigating immediately, deflate the balloon and remove the catheter. If the pain persists contact your nurse or doctor for help.

 

Are there any risks or complications?

 Some people experience minor problems, such as discomfort or a little bleeding. If the catheter is not inserted correctly, it can cause a hole or tear in the bowel, however this risk is very small provided you follow the instructions you get from your doctor or nurse.

 

What should I do if I leak between irrigations?
If you experience bowel leakage between irrigations, the cause may be insufficient emptying of your bowel due to constipation or hard stool. Alternatively, you may be using too much water during irrigation. Contact your doctor or nurse to help you adapt to your bowel plan. 

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Finding the right product Coloplast offers a wide range of products to help you with bladder and bowel issues. Here are a few suggestions for what to look for when choosing a product. Read more
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Finding the right product

Taking care of your bladder

Products that can help you with your bladder issues include:

  • Catheters – for urinary retention (when you can’t empty your bladder naturally)
  • Male External Catheters and urine bags – for men who can’t control when they pass urine  

What to look for when choosing a catheter

Finding the right catheter is very important in order to make sure that the bladder is emptied safely and with as little hassle as possible. Use the links below to read more about the key factors to consider when choosing a catheter

  • Ease of use 
  • How it fits you and your lifestyle 

Lastly, when discussing product choice with your healthcare professional, make sure you also talk about your lifestyle, concerns and special needs.

Coloplast’s catheters

Coloplast offers a range of catheters. Here are brief descriptions of the most popular ones: 

SpeediCath®

  • Instantly ready to use – straight from the packaging
  • Intuitive handling – with no preparation required
  • Minimized risk of urethral damage due to the smooth coating of the catheter and eyelets

 


SpeediCath® Compact – all the benefits of the regular SpeediCath and more

  • Discreet – the most compact catheter for women and men
  • Compact- small enough to fit in your pocket or a handbag
  • More hygienic catheterization – with the easy-grip handle*



*Only for SpeediCath Compact female



Taking care of your bowels 

 

There are ways to take care of your bowel issues. One method is bowel irrigation to prevent bowel leakage and constipation.

 

Bowel irrigation is a well-documented technique for emptying the bowel. Water is introduced in the bowel via the rectum. The water is then emptied from the bowel along with the stools. It enables you to empty your bowels on a regular basis, helping to prevent bowel leakage and constipation.

Products from Coloplast

Peristeen®, Coloplast’s bowel irrigation system, offers predictable bowel management. As it only requires water, Peristeen is an effective alternative to other bowel management methods that also require medication. Peristeen:

  • Prevents bowel leakage and constipation for up to 2 days
  • Enables you to decide when to empty your bowels
  • Improves quality of life
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What are my rights as a user of Coloplast products? Receiving a different product can lead to challenges with managing your bladder or bowel. Read about your rights with regard to the products you receive from your healthcare provider. Get the products you want and need!
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What are my rights?

If your healthcare provider begin sending you a different product to the one you normally receive, they are required to provide an explanation for the change. Your provider may only send you products that are functionally identical to what you are used to, and you are not obliged to accept the new product unless you are satisfied that it meets your needs. If you do not find the product satisfactory, you are entitled to file a complaint.

 

Grounds for filing a complaint include: failure on the part of your healthcare provider to provide an explanation for the change of product and accompanying instructions for filing a complaint; failure on the part of your provider to assess which product is best and most affordable for you; an incomplete quality and affordability assessment; or dissatisfaction with the provider’s reasons for making the change.

 

If you have any questions about receiving the product you want and need,  please contact Coloplast Customer Care.

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Tips, tools and guides

Self-catherization guides

Underneath you can find video guides for wheelchair users also and for different product brands

Bowel emptying guides

Underneath you can find video guides for children and adults on how to use Peristeen® for anal irrigation.

Getting started using Peristeen®

Getting started using Peristeen®

Using Peristeen to manage your bowels can be challenging at first, but with the right training and routine, you’ll soon start to see the benefits.

Watch step-by-step Peristeen guide for adults
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Getting started using Peristeen®

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Using Peristeen® daily or every other day, as recommended by your doctor or nurse, helps prevent bowel leakage and constipation. This means that you don’t have to worry about leakage and can feel confident to do things you want to do.

 

Take your time

Using Peristeen will mean having to get used to a new routine, but the effort will pay off. Regular emptying of your bowels can make a big difference to your quality of life.

The three most important things to remember when getting started: 

  • Use Peristeen regularly. Keep to the plan that your doctor or nurse has recommended. Regular bowel emptying with Peristeen helps prevent leakage and constipation. It can also reduce the time you need to spend taking care of your bowels. 
  • Find a time when you can empty your bowels without being disturbed or rushed. The exact time that you empty your bowel is not critical, but try to keep to the same each day, so that you get in a regular routine. 
  • Keep in regular contact with your doctor or nurse during the first few months of using Peristeen. They can help you with any queries you might have and help you adjust your routine if needed. 
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Helping children manage their bowels with Peristeen

Helping children manage their bowels with Peristeen

Learning how to empty their bowels is an important step in every child’s development. Using Peristeen can help them feel more confident and give them the freedom to take part in social activities.

Watch the step-by-step guide for children using Peristeen
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Helping children manage their bowels with Peristeen

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Most children with spina bifida, especially when they are younger, rely on their parents to help them empty their bowels. Traditional methods to prevent bowel leakage and constipation include change of diet, suppositories, enemas, constipates, stool softeners and laxatives.


More predictable

Some children, however, find these methods of treating the bowels ineffective, as you cannot schedule when you will have a bowel movement, which often results in bowel accidents.

Bowel irrigation is one type of bowel care routine that ensures bowel movements are both regular and predictable. If performed regularly, it will make your child feel more comfortable and prevent problems such as bowel leakage and constipation.


What exactly is bowel irrigation?

Bowel irrigation is when water is introduced into the bowel via the rectum, using a rectal catheter. The water stimulates the bowel and flushes out the stool. The process takes about 30–45 minutes. After irrigating, the lower part of the bowel is empty. Bowel irrigation is performed every 1 to 2 days.

 

It is important to do it regularly as:

  • Regular irrigation prevents bowel accidents, simply because the lower bowel is empty of stool
  • Regular irrigation prevents chronic constipation as it encourages bowel movements, meaning they become regular 

 

Until your child learns how to irrigate themselves, you need to make sure that it is done correctly and safely. Find a good, regular routine that works and encourage your child to take an interest. They will have to do it themselves when they are older.

It can be a good idea to keep track of your child’s progress. For inspiration, why not download and print a the Bowel Emptying Diary (pdf, 1MB).

Coloplast offers a bowel irrigation system called Peristeen®.

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