ALL ABOUT MS Symptoms of MS (Part 4)

Urinary disorders

About one-third of patients have sphincter disorders: an overwhelming need for urinary incontinence, which can sometimes be accompanied by frequent urination (so-called polacizuria), difficulty in urinating, retention (complete inability to urinate) and incontinence (loss of control over the process urinating, so that the urinary bladder empties reluctantly and unexpectedly). Urinary disorders can be accompanied by constipation and incontinence of the stool and impotence.

Urinary disorders are very disturbing disorders, which significantly affect the quality of life, personal, professional and social functioning of the patients.

Urinary disorders in MS are very common and occur in approximately 96% of patients with MS after 10 years of illness.

Urinary disorders can occur at any time during the course of the disease, even at its inception (in about 2% of patients). Some researchers believe that patients in whom the disease begins with problems in the form of urinary disorders later have a more severe form of illness, but this is by no means a rule. It has also been shown that the duration of the disease is not directly related to the occurrence of urinary disorders in MS. Urinating disorders can be manifested in two basic modes: in the form of urinary tract disorders (most commonly occurring) and bladder discharge disorders. In some patients, urinary complaints can be manifested in several ways.

Patients with MS who have urinary disorders may also have complications. The main complication is urinary tract infections, which later, if not detected and not treated, can lead to kidney damage. In addition, urinary tract infections may exacerbate some symptoms of the disease, such as spasticity.

Urinating problems can be treated. They can be relaxed sometimes and spontaneously, as many of the symptoms in MS can sometimes be spontaneously improved. Drugs used in the treatment of general worsening of the disease can also lead to withdrawal of urinary disturbances. If there is an infection of the urinary tract, it should also be treated with adequate antibiotic therapy.

However, in addition, urinary complaints can be mitigated by the application of appropriate drugs and procedures. In patients with night urination and drowsiness, positive action can sometimes have desmopressin acetate, which is produced in the form of sprays or nasal drops. Some of the drugs that can relieve disturbances in the presence of urinary tract disorders are Probantine and Detrusitol (produced as tablets). Also, some of the drugs that are primarily used as antidepressants (eg Amyzol), might show a similar positive effect to this type of disorder.

Unfortunately, these drugs do not have a positive effect in patients with disorders of the discharge of the bladder, but they can worsen it even worse. In some patients with this type of disorder, medication from the spasmolithic group (eg, Lioresal) could have beneficial effects. Some other attempts of medication, even surgical treatment of disturbed discharge of the urinary bladder, unfortunately did not give positive effects. In any case, a bladder discharge may be attempted by stimulating the abdominal wall above the bladder bladder, as this procedure can facilitate urinary incontinence. In the end, those patients who have impaired or unexplained discharge of the bladder should be instructed to apply the method of occasional sterile self-laboratory testing, which, if applied in an adequate manner, significantly improves the quality of life of patients with MS.

Defect disorders

Since, among other things, the function of the bowel is regulated by the nervous system, and defect disorders (discharge of the bowel) can occur in MS.

Defect disorders in MS are very often associated with urinary disorders and are estimated to occur in about 50% of patients.

The most common disorders of this type in MS are constipation or inability to postpone the discharge of the bowel, and sometimes unwanted and uncontrolled discharge of the bowel can occur.

Unlike the therapeutic possibilities of the urinary tract disorders, these attempts are less effective here. In the case of imprisonment, it is recommended to eat a lot of vegetable fiber, which should be advised with the doctor. If this is not sufficient, laxatives (preparations that facilitate the discharge of the intestine, eg Bilaks, Dulkolaks, etc.) can be used, which are produced in the form of tablets and capsules and are used every 2 to 3 days. Positive effects in disabling disorders, as well as unwanted and uncontrolled discharge of the bowel can demonstrate the use of Loperamide as a tablet.