Symptom Management

How to Avoid Urinary Tract Infections in MS

By Kimani Hendricks
While some conditions affect one gender or the other, urinary tract infections are not one of them. It can develop anywhere within the urinary system: the bladder, ureters, kidneys, and urethra. Women are more at risk, as 40 percent will have at least one in their lifetime, whereas only 12 percent of men will develop the infection. The female anatomy has a smaller urethra nearer to the anus, making it possible for anal bacteria to travel inside. In dealing with bladder and bowel dysfunction in multiple sclerosis, the numbers incline rapidly.

Between 70 and 90 percent of people living with MS will get UTIs. According to Dr. Ben Thrower, of the Andrew C. Carlos MS Institute at Shepherd Center, “An underactive bladder is parallel to an overflowing water glass. You can also have a sphincter dyssynergia, or a valve that's not opening well. Surprisingly, you can still have frequency, urgency, and spasm, but it does not do an adequate job of emptying the urine. Because it sits there and bacteria grows, a common side effect is a urinary tract infection.”

A UTI occurs when bacteria attach to the bladder wall, and once it binds, urinating that bacteria isn't possible. Furthermore, MS symptoms can also flare up when infections appear. "UTIs can cause pseudo-exacerbations or pseudo-relapses, so worsening of neurological function that's not due to a new lesion, but due to an infection. Bear in mind, any infection can do that," Dr. Thrower said.

Moreover, if the bladder doesn’t empty, the urine can cause backflow and enter the kidneys, damaging them. Common signs of UTIs can be fever; pain or pressure in the lower abdomen; bloody, cloudy, foul-smelling urine; discomfort or burning; and producing small quantities of urine.

The sooner UTIs get treated, the better. However, by forming a few habits, you can reduce the risk. For starters, what are you drinking? Though many of us go without it until our tongues turn to deserts, water consumption flushes bacteria from the urinary tract, preventing infection. Oddly enough, some with MS report their regularity and urgency slowed down after drinking plenty of water.

In using the restroom, wipe from front to back when done. This keeps anal bacteria from spreading to the urethra. Keep a change of undergarments, pads, and wipes handy in the event of accidents! Women should drain their bladders after intercourse, as men also transmit bacteria in the process. Storing wipes nearby will suffice if you don't have to go immediately; otherwise, water is your friend. Not all bacteria are harmful, but birth control methods with spermicide and feminine products often eliminate the good bacteria our bodies need to combat germs or aggravate the urethra.

As a treatment, patients get prescribed various antibiotics depending on the severity of their infection and overall health. But there is a supplement that may help in preventing UTIs. According to Dr. Thrower, “D-Mannose, an unabsorbed sugar, prevents e. coli from clinging to your bladder wall. E. coli is a bacteria that causes UTIs. A study of 308 women with recurring urinary tract infections received two grams of D-Mannose daily. It proved more effective than those put on a daily antibiotic.” Additionally, there are nearly no side-effects in using D-Mannose, and it is an over-the-counter treatment.

While few studies imply cranberry juice prevents UTIs, cranberries themselves contain chemical compounds called proanthocyanidins, which inhibits bacteria from adhering to the bladder wall. “E. coli can stick to your bladder from two surfaces: p-pili and type one pili. PACs attack the p- pili; the best dosage of PACs ranges between 36 and 72 milligrams per day,” says Dr. Thrower.

Several cranberry extracts are available. However, not all are produced the same. Those highly recommended among doctors are Utiva, Cranberex, Ellura, and Theracran. While these options are pricy, they can prove useful for individuals that frequently get UTIs and exacerbated symptoms that lead them to emergency rooms. Still, there is reason for some caution with cranberry usage. Dr. Thrower said, “Some of these products do contain salicylic acid, so if you're allergic to aspirin, you could negatively react to these cranberry products. They also include oxalates, which can increase the risk of kidney stones.” Talk to your doctor about these and other strategies to prevent and control recurrent UTIs.