Managing bladder and bowel changes in MS

Many people living with MS experience changes in bladder or bowel function at some stage. These symptoms may feel difficult to discuss, but they are more common than you might think, affecting approximately one in four Australians. Bladder or bowel changes can be short term, ongoing, mild, or more complex, but seeking support early can help you stay healthy, confident and in control.

Bladder and bowel function relies on nerve signals travelling between the brain and the digestive and urinary systems. When MS causes demyelination, those messages can become delayed, disrupted, or lost altogether. Understanding that these symptoms are neurological can be an important first step toward managing them.

A continence nurse is specially trained to support people experiencing these challenges. They can help identify symptoms, triggers, explain available treatment options, demonstrate techniques, and recommend continence aids or equipment that suit your lifestyle. Many people find that small adjustments, tailored to their needs, lead to significant improvement.

Symptoms vary from person to person and may include:

• Urinary urgency – a sudden, strong need to urinate
• Increased frequency – needing to go more often than usual
• Nocturia – waking multiple times overnight to urinate
• Difficulty “holding on” or accidental leakage
• Urinary tract infections due to incomplete emptying
• Constipation, diarrhoea, or alternating patterns
• Reduced sensation that makes it difficult to recognise fullness
• Abdominal pain or bloating related to slowed digestion
• Faecal incontinence linked to muscle changes or loss of sensation

Management strategies

With the right advice, these symptoms can often be reduced or resolved. Strategies may include:

• Lifestyle changes – adjusting fluid timing, caffeine, alcohol, or dietary irritants
• Bladder and bowel training programs guided by a continence nurse
• Pelvic floor exercises taught by a qualified physiotherapist
• Keeping a symptom diary to identify triggers or timing patterns
• Medications that support urgency, frequency, or constipation
• Hydration and a fibre-balanced diet to keep stools regular
• Movement and exercise to support digestion and muscle function
• Technology or phone apps to track routines and reminders

Equipment, products and aids

Continence products are practical tools that support confidence, mobility, and independence:

• Absorbent pads and protective underwear
• Urinal bottles or portable toileting options for travel
• Catheters (intermittent or long-term) to assist with bladder emptying
• Bowel care devices to support regular evacuation
• Bed protection, waterproof bedding, or discreet daytime wearables
• A continence nurse can help assess which products best support your lifestyle

Emotional impact and reassurance

Bladder and bowel changes can affect:

• Self-esteem and confidence in social situations
• Personal relationships, dating, and intimacy
• Emotional wellbeing, anxiety, frustration, or embarrassment
• Decision-making around work, travel, and hobbies

Available supports and funding (including CAPS)

People living with MS may be eligible for:

• The Continence Aids Payment Scheme (CAPS) – financial assistance for continence products
• Government-funded continence support through community health services
• Support and advice through the Continence Foundation of Australia
• Access to the National Public Toilet Map and planning tools for travel
• Assistance completing CAPS applications with your doctor or continence adviser

Support is available to help with treatment, planning, emotional wellbeing, and the cost of continence products through schemes such as CAPS for eligible people living with MS. 

Download our Bladder and Bowel Changes in MS factsheet or reach out to book a free consult with an MS Nurse Advisor or Continence Nurse today 1800 042 138 or connect@msplus.org.au