Bladder problems are very common in people with MS, but what steps can you take to look after your bladder and give yourself the best chance of maintaining good bladder function? Here are some top tips from an MS specialist nurse, a dietitian and a physiotherapist.
Drink enough fluids and check your wee
It’s important to drink around two litres of fluid a day to stay hydrated and reduce your risk of urinary tract infections. You may need to drink more than this when the weather’s hot and after exercise. The best guide to tell if you’re drinking enough is to look at your wee. The aim is for it to be a pale yellow colour. If it’s darker than this, you’re not drinking enough.
All fluid counts!
Don't worry about the type of fluid you're drinking – it all counts! It doesn’t just have to be water. Drinking squash, juice and smoothies will all help to keep you hydrated. You'll be pleased to hear that drinks containing caffeine, like tea and coffee, are fine too. The only thing that’s not included in this is alcohol, which can have a dehydrating effect.
If you’re not very good at drinking regularly, you can also get fluid from your food. Foods like yoghurt, soup, sauces, jelly, watermelon, and other juicy fruit, can all increase your fluid intake.
Don’t rely on your sense of thirst
As we get older, we lose some of our sense of thirst. It’s therefore best to try and build drinking regularly into our daily routine, rather than relying on feeling thirsty. Although it’s important to drink when you feel thirsty too!
Limit just-in-case wees
It’s normal to use the loo between four and seven times a day. If you’re emptying your bladder more frequently than this, your bladder muscle isn’t being given the chance to fully expand and stretch. This can reduce the overall volume your bladder can hold in the long term. So, try not to use the toilet just in case and only go when you really need to.
Try holding on exercises
If you’re going to the toilet very frequently, try holding on exercises. This gives your bladder muscle a chance to stretch. When you’ve got an urge to wee, see how long you can hold on for. It might be 30 seconds or 10 minutes! It can help to stay sat down as getting up and using your abdominal muscles can increase the urgent need to go. Over time you can increase the amount of time you’re holding on for. This will give you that extra bit of time to get to the loo and reduce the number of times you’re going in a day.
Practise pelvic floor exercises
Both men and women should exercise their pelvic floor muscles to help maintain bladder function. Your pelvic floor is a sheet of muscles that extends from your tailbone at the bottom of your spine, to your pubic bone at the front. They form the floor to your pelvis and support your bladder and bowel.
To find your pelvic floor muscles while sitting down, try and draw up the pelvic muscles from underneath you. In a standing position, turn your feet in slightly and then pull everything up inside of you. Another way to find the muscles is to try and stop your urine mid flow. This last one shouldn’t be done regularly, but it can be useful to give an indication of how well your pelvic floor muscles are working.
When you do pelvic floor exercises, try to do a strong contraction of the muscles followed by a period of relaxation. Hold the contraction for as long as possible. This helps to build strength and stamina of the muscles. The relaxation part is important too, as this is what allows you to initiate and maintain your urine stream.
If you are experiencing bladder symptoms, speak to your MS nurse or your local bladder and bowel service for advice.
Read more about bladder problems
Thank you to the following health professionals for your contributions to this blog:
- Claire Fenlon, Dietitian, Chilterns Neuro Centre
- Lou Grace, Physiotherapist, Chilterns Neuro Centre
- Grace Hazlett, MS specialist nurse, Central London Community Healthcare NHS Trust.
