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Old 04-19-2008, 04:59 PM #1
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Confused Cherie, Anyone, or Everyone: Lesion Location for Bowel/Bladder Issues

Anyone know what the correlation is with this? I know Cherie does a lot of research and I'm sure many more of you, as well. Anyone have any experience with this, and do you know the causes/treatments?

Attention: Cheri (Lady Express) I P.M.'d you about this. Not sure if I knew what I was doing?!
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Old 04-19-2008, 06:17 PM #2
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Hi friend,

My situation might be rather unique in that I know which lesion is causing the bowel troubles, at least at certain times with this disease.

I have one in my C-spine, that has caused me paralysis and/or complete numbness on several occasions, and that is the reason I seem to have the "type" of bowel troubles that I have. (This can be caused by lesions much lower down as well i.e. in the T-spine, but in my case it is the C-spine lesion that usually acts up and EVERYTHING below that level is affected). During those times, I can't feel anything what-so-ever down there, which definitely contributes to my issues, but when I am numb is not the only time I have difficulty either.

On a day-to-day basis, when I am not having obvious difficulties from my spinal lesion, I can still have intermittent bowel difficulties. Since this problem is intermittent (sometimes I am actually fine), then I think there must be some other MS-reason/lesion that can be causing problems for me.

Other then when it is directly caused by a spinal lesion attack, they don't seem to know a whole lot about why we can have bowel issues . . . but they recognize we do. Some theories include:

"Constipation can be caused by a number of factors. Lack of physical activity—brought on perhaps by fatigue or immobility—can disrupt the digestive system. Depression, poor dietary habits, spasticity, and medications can also be culprits. And, MS itself can be responsible. The loss of myelin in the brain or spinal cord can interfere with signals indicating that it’s time for a bowel movement. Finally, many people with MS who have bladder problems drink less fluids as a way to urinate less often—and this leads to constipation. This is such a common reason for MS-related constipation that your first step may be to seek medical help for your bladder problem."

http://www.copaxone.com/aboutMS/bowel.aspx

When I am in the midst of a spinal lesion attack, there is NOTHING that works to make me go. I can't feel anything, there seems to be no muscle or communication channels working, and no amount of roughage or anything else will help. When my bowel problems are not as a direct result of a spinal lesion attack though, there are several things that can help, like increased fruit, water, fibre (even "Benefibre"), etc.

Here's another good link:

http://www.mssociety.org.uk/about_ms..._ms/index.html

As far as bladder problems, again this can be complicated by spinal lesion attacks, but the most common reasons can be found in the attached brochure:

http://www.mswatch.ca/ContentRoot/Ed...adder%20EN.pdf

Cherie
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Last edited by lady_express_44; 04-19-2008 at 06:36 PM. Reason: added a link
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Old 04-19-2008, 07:06 PM #3
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Hi Friend4U:

Cheri has been a great source of help to me in this area too.

I don't have lesions, but I do have urinary retention and a neurogenic bowel. It can affect one's quality of life.

My MS neuro sent me to a gastroenterologist who commented that he could send me south for a manometry but it would be the same today as it would be in six months, in other words, there isn't much more that could be done other than symptom management.

Because of the constipation he put me on 75 ml/day of Milk of Magnesia. His goal was two bm's/day instead of one/week. Overflow incontinence could be stopped if the constipation stopped. The end result was daily incontinence and some embarrasing situations. I play with the dose and if I know I have to go out I won't take it the night before. He is willing to see me again if I feel the need, but I know there is little point - it's not going to go away.

I'm glad I went to the gastroenterologist. He was supportive, understanding and willing to do his best to help. I also appreciated that the MS clinic had exhausted their criteria and felt a referral was warranted.

If your problem is lesion-related hopefully it will settle down in time. Mine did the first few times. It boils down to quality of life - a gastro hopefully can help you with bowel issues if your MS clinic can't.

It's a frustrating problem. Hope you can find some relief.
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Old 04-20-2008, 10:32 AM #4
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For me it's a leison hanging out in my C spine.

Urologist had me do all the tests, reveiewed the results with me. Said everything look fine, but seemed to be some communication issues with it. He pointed at one of my MRI reports and said "ah ha! here's your culprit!"

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