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Yeremey Savin
Yeremey Savin

Managing Your Multiple Sclerosis Practical Advice To Help You Manage Your Multiple Sclerosis 'LINK'


Impairments in bladder function with multiple sclerosis (MS) are common and may affect up to 78 to 90 percent of patients during the course of MS. The prevalence of bowel dysfunction in MS is estimated to be about 68 percent of patients. Bladder and bowel symptoms are relatively common in MS and can be treated. Goals for bladder and bowel management include maximizing independence and preventing incontinence and complications.




Managing your Multiple Sclerosis Practical advice to help you manage your multiple sclerosis


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Multiple sclerosis is a chronic, usually progressive, disease that primarily affects young adults. Approximately 400,000 people in the United States and 2.5 million people worldwide have been diagnosed with MS. Its effects vary widely. Although there is no known cure for the disease, it can be successfully controlled with medical management and rehabilitation. Physical therapists help people with MS regain and maintain strength, flexibility, and general fitness, and to live active, productive lives.


The following articles provide some of the best scientific evidence related to physical therapy treatment of multiple sclerosis. The articles report recent research and give an overview of the standards of practice both in the United States and internationally. The article titles are linked either to a PubMed* abstract of the article or to free full text, so that you can read it or print out a copy to bring with you to your health care provider.


Bsteh G, Ehling R, Lutterotti A, et al. Long term clinical prognostic factors in relapsing-remitting multiple sclerosis: insights from a 10-year observational study. PLoS One. 2016;11(7):e0158978. Free Article.


Jongen PJ, Heerings M, Lemmens WA, et al. A prospective web-based patient-centered interactive study of long-term disabilities, disabilities perception and health-related quality of life in patients with multiple sclerosis in the Netherlands: the Dutch Multiple Sclerosis Study protocol. BMC Neurol. 2015;15:128. Free Article.


Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) characterized by chronic inflammation, demyelination, gliosis, and neuronal loss. The course may be relapsing-remitting or progressive in nature. Lesions in the CNS occur at different times and in different CNS locations. Because of this, multiple sclerosis lesions are sometimes said to be "disseminated in time and space." The clinical course of the disease is quite variable ranging from stable chronic disease to a rapidly evolving and debilitating illness. The most common form of the disease is relapsing-remitting multiple sclerosis; however, several other forms exist.[1]


The specific cause of multiple sclerosis is unknown. The most widely accepted theory is that multiple sclerosis is an autoimmune disease that preferentially destroys the CNS while the peripheral nervous system is spared. Demyelination causes symptoms of multiple sclerosis. Damage to myelin leads to symptomatic flares in multiple sclerosis. These damaged areas often do not fully recover leading to areas of scarring, damage, and ongoing symptoms. Over time, these cumulative areas of damage can lead to disability. Of note, patients can also develop subclinical areas of damage that are detectable early in the disease course only by radiographic studies[1].


The disease is the most common cause of neurological disability affecting people in their productive years, between 15 and 55 years of age. [12] It afflicts women more often than men (ratio of approximately 2:1).[13] Overall course and prognosis in multiple sclerosis are most likely to be related to age and the occurrence of the progressive phase of the disease, rather than to relapses or other clinical parameters. Individual prognosis remains hazardous.[14]


A study carrying out an online cross-sectional survey of physical therapists specialized in multiple sclerosis across Europe concluded that the content and delivery of physical therapy in Multiple Sclerosis differs across Europe and the guidance concerning access to treatment and adjustment according to disability do not appear to be widely implemented in clinical practice[46]. Also. a recent online cross-sectional survey taken by Physical therapists specialized in Multiple Sclerosis, to study the real-world use of goal setting and outcome measures in Europe showed discrepancies in goal setting and assessment across European regions[47].


Bowel problems are common symptoms in multiple sclerosis, and are probably under-reported. Although estimates vary about the number of people with multiple sclerosis who are affected by bowel symptoms, it is believed that around half of all people with MS will be affected at some stage.


There are a number of changes you can make or techniques you can try that may help with constipation. This includes eating regularly, increasing your fibre intake, drinking enough fluids, exercising regularly, getting your posture right when sitting on the toilet and abdominal massage. We have more information about these practical tips and suggestions on our constipation A-Z page.


Indication: Rebif is a prescription medicine used to treat relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.


Rebif (interferon beta-1a) is a prescription medicine used to treat relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. It is not known if Rebif is safe and effective in children.


Older adults with multiple sclerosis (MS) are living with an illness that comes with a lot of uncertainty and change. That can make life more challenging for them as well as those caring for them. Vive Health explains what MS is and what symptoms to expect. They also share tips that help you and your older adult cope with symptoms and major lifestyle changes.


These unknowns can leave you and your older adult feeling blindsided. Being prepared with a little knowledge and the right tips and tools can help. Advertisement What is multiple sclerosis (MS)?MS is an autoimmune disorder of the central nervous system. Scientifically speaking, in someone with MS, the body starts to attack the myelin sheath, the special protective membrane coating the spinal cord and nerve endings.


In Europe and North America, multiple sclerosis affects one in 800 people, making this illness the most common cause of neurological disability in young adults. Symptoms are typically first seen between the ages of 20 and 40. Multiple sclerosis is approximately twice as common in women as in men. It is not known what causes multiple sclerosis, although it is thought to be a combination of genetic and environmental factors.


Many people with multiple sclerosis have neurogenic bladder dysfunction, which means a decreased ability to control the bladder. Some people may find that they need to urinate more frequently or urgently, whereas others may experience difficulty emptying the bladder or a feeling of incomplete emptying.


Bladder problems, if left untreated, can be severely detrimental to the course of the disease and subsequently have a high impact on quality of life. The symptoms below may be one of the first indications of having multiple sclerosis but they may also develop during the course of the illness.


Urinary tract infections have a harmful effect on multiple sclerosis and may even contribute to relapse. When the body tries to fight the infection, it triggers excess immune activity and demylelination (destruction to the coating that protects the nerves). Therefore it is extremely important to regularly empty your bladder in order to avoid urinary tract infections in the first place.


Though less common than urinary retention, sudden and complete emptying of the bladder, also called leakage, can also be associated with multiple sclerosis. Incontinence pads are often used, however, collecting devices such as an urisheath and urine bag provide a far more comfortable and effective solution for many men with urinary incontinence. Urisheaths are worn over the penis like a condom and connect to a discreet urine bag. It is important you use the right size urisheath while finding the right collecting bag depends on how much you leak.


However, it is unlikely that a person with multiple sclerosis will experience all of these symptoms and each person is affected differently depending on how much and where the nerves have been damaged.


The bladder, which stores urine, is controlled by the nervous system. Because multiple sclerosis damages nerves, bladder function may be affected. Some people find that they need to urinate more frequently or urgently, whereas others experience difficulty emptying the bladder. Some people with multiple sclerosis may experience occasional urinary incontinence.


Nerve endings in the rectum help to alert people of the need to pass a stool when it enters the rectum. In people with multiple sclerosis, this message may become lost or incomplete increasing the risk of bowel problems such as constipation, faecal incontinence or a combination of both. Certain drugs commonly prescribed for multiple sclerosis can also increase the likelihood of constipation.


As no two people with multiple sclerosis experience the exact same course of the disease, the extent and type of bowel problems people experience vary greatly. About 34% of people with multiple sclerosis are believed to have bowel problems to such a degree that it affects the quality of their daily life.


Bowel problems occur when muscular action, reflexes or the feedback system are disrupted; this is also known as neurogenic bowel dysfunction and symptoms include, diarrhoea, constipation and bowel leakage. In multiple sclerosis, bowel leakage and constipation frequently co-exist. 350c69d7ab


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