What are some bladder management points to remember if I have multiple sclerosis (MS)?

  • Adequate fluid intake is 1½-2 quarts of fluid a day. The urge to urinate comes about 1½ -2 hours after drinking something.
  • Caffeine, aspartame, and alcohol are all bladder irritants.
  • Smoking also is irritating to the bladder.
  • Limiting fluid is harmful.
  • It is not normal to leak urine, wake up more than once at night to urinate, or to have frequent urinary tract infections.
  • Bladder infections in people with MS may result in an increase in MS symptoms, spasticity, and fatigue.

Plan of action

  • Drink fluids all at once (drink 6 to 8 ounces at a time). If you sip, sip, sip you will feel the urge to urinate frequently. Try to go about 1½ to 2 hours after you drink.
  • Stop drinking fluids about 2 hours before bedtime; urinate right before bedtime.
  • If you tend to get frequent bladder infections you are probably not emptying your bladder completely.
  • Taking cranberry pills may keep your urine more acidic and decrease the bacteria in your urine.

What are some bowel management points to remember if I have multiple sclerosis?

  • The goal is a comfortable bowel movement (BM) either every day, every other day, or every 2 to 3 days. For regular bowel movements you need fluid (1½ to 2 quarts a day), fiber (20 to 30 grams a day) and activity.
  • One-third of a cup of Fiber One®, All-Bran® or 100% Bran Buds® gives you half the fiber you need for the day.
  • Greasy foods, spicy foods, or food intolerances (for example, lactose intolerance) may cause loose stool and may result in involuntary bowel movements.

Plan of action

  • Eat regularly for regular bowel habits. Plan for a bowel movement each day about ½ hour after eating or drinking something warm (bowel activity is naturally increased at this time). Sit on the toilet about 10 minutes, and try to have a BM. You may want to gently rock back and forth on the toilet. If nothing happens, leave the bathroom and try again later.
  • Use a suppository to help stimulate bowel activity. (It takes about 20 minutes for a suppository to work.) Occasionally, it might help to take milk of magnesia or citrate of magnesia to stimulate bowel activity.
  • It may take two to three months to establish a regular bowel regimen.

Last reviewed by a Cleveland Clinic medical professional on 01/28/2019.


  • National Multiple Sclerosis Society. Bowel Problems. Accessed 3/21/2019.
  • Multiple Sclerosis Association of America. Bowel Problems. Accessed 3/21/2019.
  • National Multiple Sclerosis Society. Bladder Problems. Accessed 3/21/2019.
  • Zecca, C., Riccitelli, G. C., Disanto, G., et al. (2016), Urinary incontinence in multiple sclerosis: prevalence, severity and impact on patients’ quality of life. Eur J Neurol, 23: 1228–1234. doi:10.1111/ene.13010

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