Bladder or bowel problems? You're not alone

Recent guidance from NHS England suggests that people have “suffered in silence” because they are too embarrassed to talk about bladder or bowel problems with health professionals and don’t know what help is available.

What does the guidance say?

Excellence in continence care; practical guidance for commissioners, providers, health and social care staff and information for the public recognises that continence problems can be managed better and people have the right:

• to be heard
• to receive the right treatment at the right time
• to live the best achievable quality of life possible.

NHS England acknowledges that continence services vary throughout the country but by bringing together the most up-to-date evidence–based information the guidance aims to provide a framework to support improvement of continence care. The objective is to support Commissioners and other health service providers to ensure that people have access to the best and most appropriate services. One aspect of this is ensuring that health professionals receive the training they need. 

What does this mean for me?

Bladder and bowel problems are common for people with MS. They can be a distressing symptom and have a real impact on your life but there are many successful treatments available and straightforward lifestyle changes can also make a real difference. 

As these continence problems can also affect other aspects of your MS, for example constipation or a urinary tract infection can cause an increase spasticity, knowing who to talk to, what you can do yourself and what treatments are available is vital.

What can I do?

Some people feel a sense of shame or embarrassment and feel awkward raising bladder or bowel problems with health professionals. Your MS specialist nurse, GP or continence advisor are all experienced in dealing with bladder and bowel problems and should be able to put you at your ease so don't be shy in raising this.

“If only I had discussed this with someone sooner it would have saved years of uncertainty, worry, loss of dignity and freedom”

• Talk to your health professional

Recent work by the bladder and bowel foundation found that of the people who called their helpline only half had spoken to a health professional.  Use the language you feel most comfortable with, people find different approaches work for them

“I’ve got problems with water works”

“I just tend to say 'I can’t poo'”.

• Make changes

There are also straightforward changes that can make a real difference, these include:

• looking at what you eat and drink 
• maintaining a healthy weight and staying as active as you can
• stopping smoking
• trying pelvic floor exercises
• reviewing your medicines.

Keeping a diary can help you monitor your bladder and bowel activity and note the impact of any changes you might make. 

• Learn about treatment options

There are many approaches to treating and managing bladder or bowel problems and you can find out more in our resources which cover treatments available and management strategies that you can try for yourself and discuss with your MS team. You can also find answers to some of the questions you might have in the short bladder and bowel video discussion.