Friday, 4 July 2014

Managing urinary tract infections in multiple sclerosis – can we do better?

Bladder infections in MS; what can we do about them? #MSBlog #MSResearch

Bladder dysfunction is common in MS. Around 50-90% of MSers will develop overactive bladder, which can lead to incomplete emptying of the bladder and in severe cases, retention of urine. Some MSers will need to use urinary catheters to empty their bladder, which together with stasis of urine leaves MSers susceptible to recurrent urinary tract infections (UTIs).

Infection, particularly recurrent infection can influence progression of disease in multiple sclerosis. We know that around the time of an infection, MSers are at greater risk of developing a relapse. Not only this, relapses can be more severe and of longer duration in the context of infection. Having more relapses, particularly in the early stages of multiple sclerosis may lead to worse long term outcomes.

Despite this, management of these infections particularly of UTIs remains an area for improvement. Recent data has shown that the most common cause of hospital admission in MSers is due to UTI. So what can we do to improve?

In other conditions such as chronic obstructive pulmonary disease (a condition affecting the lungs leading to progressive shortness of breath and often recurrent chest infections), community teams have worked together in order to ensure early treatment of chest infections. Patients are taught how to recognize early signs of infection. They are provided with rescue pack antibiotics and are encouraged to take these should they suspect infection. This has been shown to reduce rates of hospital admission and have a positive effect of quality of life.

Could this model be applied to UTI treatment in MS? 

Do you think that a self management tool could help MSers confidently recognize signs of early infection and initiate treatment independently at home in order to prevent subsequent relapses, hospital admission and ultimately disease progression?

Please take a few minutes to answer my short survey.


  1. I had urgency problems, but didn't do anything I thought it was an MS relapse. I carried on working until I was unable to function. it was a UTI. My neurologist suggested I do my own tests with the sticks.
    They are not available on the NHS and cost around £16. If I find I have an infection I can call my GP to get antibiotics. The urine sample goes to pathology. Having a supply of antibiotics would be wasteful as they would go out of date. I've been doing this for 14 years and it works for me

  2. I have been discussing triggers of relapses on an MS forum. I have MS and can see in my case there is definately the mind body connection in MS. Stress, servere anxiety, insufficient sleep and rest, heat, infection may bring on a relapse. I meditate twice a day, that reduces anxiety and is supposed to give deep rest. I think stress, insufficient sleep and servere anxiety must have an affect on the immune system as the body is under stress and strain. In a way I have become my own guardian and keep an eye out for all these. I would really like to get sticks to do my own urine tests.

  3. I think it's a great idea the self management tool as discussed. I was thinking of buying something so I am able to do my own urine tests. There is a delay at my GP surgery. I request a urine test at the start of a relapse, then this sample is sent off to the lab. I get a text saying my results are back 6 days later. I request a call back from my GP and am told yes signs of infection in urine. I get offered antibiotics. It's way too late then as my relapse is recovering. There needs to be a much quicker process.

  4. I've been reading about managing UTI's and including onions and garlic in the diet has a natural anticeptic and antibiotic quality (both are part of the Allium family). Cooked onions have some natural anticeptic and antibiotic quality but not as much as raw onions. Of course this is not the level of actual antibiotics and it would be dangerous to replace antibiotics for onions and garlic when antibiotics are needed for a UTI.

    I'm going to try drinking diluted cranberry concentrate too (100% juice) as there is no sugar or sweetner added.


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