Multiple sclerosis (MS) is an autoimmune disease that affects upper motor neurons in the brain and lower motor neurons in the spinal cord. Damage occurs to the myelin sheath, fat wrappings around axons, which causes nerve signals (action potentials) to slow down or stop. This poor electrical conductance leads to a lack of neuron to neuron communication. Symptoms can vary including muscle weakness, slurred speech, bowel and bladder issues, impaired vision and possibly paralysis. Bowel and bladder symptoms include constipation, stool leakage, frequent urination and urinary incontinence.
A recent clinical trial in Australia was led by Louise Kurczycki, a nurse from Melbourne-based Monash University, to determine better ways of managing MS symptoms. The trial facilitated a team of scientists to develop a new screening tool that aids in identification of bladder and bowel symptoms in MS patients.
Kurczycki notes, bladder and bowel symptoms are common in multiple sclerosis and can have profound effects on an MS patients quality of life and self esteem. If these symptoms are left untreated, urinary problems can have long-term effects. Research has elucidated the benefit of treating bladder/bowel problems, however symptoms are often disregarded or tolerated by MS patients and overlooked or poorly managed by healthcare professionals.
Eastern Health MS service at Monash University previously trialled a screening tool to determine the extent of urinary and bowel issues in 100 MS patients. Researchers reported they found many had urinary and bowel problems, including incontinence, and had not informed their neurologist or MS nurse.
The next stage of the trial will try to identify whether therapy initiated by a continence nurse improves and reduces the burden and impact of bladder symptoms. Kurczycki adds, “Identifying continence issues is vital in MS to reduce the possibility of longer term bladder and bowel dysfunction, and contribute to improved quality of life for people with MS.”
MS patients participating in the trial who are identified as having bladder issues will be offered either immediate therapy or individualized information to help deal with their specific problem.