b'Symptom ManaGementBBoowweellaannddBBllaaddddeerrIIssssuueesswwiitthhMMSSCues, diet, and retrainingkey to addressing issuesBy Cherie BinnsBowel and bladder problems are, for many with 80 ccor about a third of that amountwith MS, some of the more embarrassing and in the bladder. The other end of the spectrumdicult to talk about. As a result, some do not is a neurogenic bladder where an individualreceive the help that is available to manage does not feel the urge to go until the bladder hasthem until they have signicantly aected stretched to three or four times the capacitytheir quality of life. For some, incontinence is ofanormalbladderandmay voidonlyathe issue but for others, it is an inability to couple of times a day instead of the norm ofempty. Lets look at some of the causes of these every four to six hours while awake.conditions and then methods to manage them. Food and beveragesN Food and beveragesNeerrvveessaannddccuueess Many foods and beverages have theThe nerves that help to cue individuals potential to be bladder stimulants. These maytheir bladders or bowels need to empty are in aect dierent people in dierent ways so itthe middle section of the spinal cord. Nerves is recommended if you have OAB to eliminatethat feed the responses to the pelvis and them and see if it makes a dierence, thenlower extremities are in close proximity to reinstitute if no dierence is noted. The bigeach other a little above the waist. Because of ones are caeine and alcohol, which do aectthat, individuals with MS who have altered almost everyone. Carbonated beverages cansensation in their legs may also not be getting also be a problem.normal messages coming from those nerves Foods that are acidic also are a problemto their bladders or bowel. This can result in for most people whose bladder is too active.leakage or incontinence of either urine or Foods high in acid content include chocolate,stool because the individual does not feel the citrus fruits, pineapple, tomatoes, and rawsensation to empty. For others, the nerve is onions. Hot spicessuch as chili powder,hypersensitive and makes it feel like there is cayenne pepper, curry and more have thea need to be on the toilet every hour or more. potentialtointerferewithnormalbladderAn overactive bladder often sends a cue that function in some people. it is full when, in fact, it contains only a smallportionoftheurinetheaveragebladder BBoowweellpprroobblleemmssholds before the urge to void is felt.Bowel problems often go hand in handA healthy normal bladder generally cues with bladder issues because the nerves areus to empty it when it contains about a cup (8 so closely located within the spinal cord.ounces or 240 cc) of urine. With an overactive MS lesions in that region may set the stagebladder, a person may feel the need to void for people to need to learn to manage both.msfocusmagazine.org 12'