Multiple Sclerosis and UTIs
Urinary tract infections (UTIs) are far more frequent in people with multiple sclerosis (MS) than the general public. When someone with MS gets a UTI, it is harder to treat, and it can be life-threatening. So, what's the link between multiple sclerosis and UTIs, treatment, and prevention?
What is multiple sclerosis (MS)?
Multiple sclerosis, or MS, is a long-lasting disease that affects the central nervous system, brain, and spinal cord. MS causes the immune system to attack and damage the protective sheath (myelin) that surrounds nerve cells. This nerve damage causes problems with vision, balance, muscle control, and other basic body functions, such as the bladder.
What types of urinary problems are linked to MS?
90 percent of people with MS experience problems with bladder function. Oftentimes, bladder issues develop because MS damages the nerves that signal bladder contraction. Interruptions with these signals can lead to:
- Bladder emptying dysfunction: You have an urgent feeling to urinate, however, your bladder does not empty entirely when you urinate. You may experience hesitancy when you try to urinate, and/or have a weak urinary stream. Nerve damage may also cause your bladder to overfill.
- Badder storage dysfunction: Nerve damage can cause your bladder muscle to contract more frequently than it should. These spastic contractions make you feel like you need to urinate more often. You may have to get up several times during the night to urinate.
- Incontinence: Loss of bladder control. The connection between urinary incontinence and multiple sclerosis stems from disrupted nerve signals that direct the movement of urine from your bladder to your urethra so that it flows out when you’re not ready.
Why are UTIs common for people with MS?
Bladder emptying dysfunctions (as stated above) are the link between multiple sclerosis and UTIs. When you have issues emptying your bladder completely, this means urine sits in your bladder for longer than it should. Leftover urine allows harmful bacteria to multiply in your bladder, which leads to a urinary tract infection. While this article primarily focuses on the bladder, this overpopulation of harmful bacteria can occur anywhere in the urinary tract: urethra, ureters, bladder, or kidneys.
How do you know you have a UTI? Why are they difficult to diagnose for people with MS?
UTIs are likely to happen if you do not seek treatment for bladder emptying dysfunction. UTI symptoms include:
- A strong, frequent urge to urinate or frequent urination
- A burning sensation when urinating
- Dark or bloody urine
- Lower back pain, pain in the pelvis or behind the pubic bone
- Fever, chills, or body aches
- If you get UTIs from your bladder dysfunction, be aware of pain in your lower back as it may stem from kidney issues.
UTIs are diagnosed by your healthcare provider with a urinalysis or urine culture. Frustratingly, if you have MS, a UTI might fly under the radar because the common symptoms (urinary frequency, discomfort, and urinating in small amounts) are mistaken for bladder dysfunction, a common side effect of MS. If a UTI is taking place, a person with MS may experience a pseudoexacerbation, which is a worsening of MS symptoms. This includes severe fatigue, fever, a general feeling of illness, or mental changes. Because UTIs present themselves atypically in people with MS, they can be hard to detect. MS patients with recurring UTIs should take note of their symptoms that turned out to be a UTI.
How to treat a UTI
The only way to cure a UTI is through a 4-10 day course of antibiotics from your healthcare provider.
- Take every last antibiotic pill, even if you are no longer experiencing symptoms.
- Untreated and frequent UTIs can lead to serious complications in your kidneys, such as kidney stones.
- The relationship between kidney stones and MS comes from bladder emptying dysfunction as retained urine can lead to the formation of mineral deposits (kidney stones).
- Treatment for stones depends on their size. Contact your healthcare provider for proper treatment.
- If left untreated, stones and infections can lead to permanent kidney damage.
How can I avoid UTIs if I have MS?
- Go to your regular prenatal check-ups, routine urine tests will detect a UTI.
- Drink plenty of water.
- Avoid sitting in a bath, shower instead.
- Ditch the douches, feminine sprays, and harsh soaps in the genital area.
- Wear cotton underwear, go commando at night.
- Urinate after sex. Do not have sex while being treated for a UTI.
- Wipe front to back.
- Don’t let the fear of incontinence keep you from hydrating. Stay prepared with wipes, pads, and a change of underwear.
Living with multiple sclerosis is a challenge because the side effects impact your work, ability to exercise, social life, and intimacy. If you need extra support, explore this compilation of MS support groups— they'll point you in the direction of health providers and people to connect with. If you haven’t done so already, support groups on Facebook also help you get in touch with people who also have MS, you’re not alone. Even if you are doing everything in your power to keep on top your urinary health, you might need extra help or peace of mind, that’s where Uqora comes in.