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Multiple Sclerosis and Urinary Tract Infections

Urinary tract infection (UTI), an infection in one or more of the structures in the urinary system, is a common problem in multiple sclerosis (MS). It is so common, in fact, that this is one of the first things your doctor will check any time your symptoms act up.

Anyone with a bladder emptying problem is at risk for a UTI because urine that sits around builds up bacteria. However, women are generally at greater risk for a UTI than men because their anal, urethral, and vaginal openings are so close together (which is why women are encouraged to wipe from front to back).

A mild UTI may cause nothing more than increased urgency and frequency of urination. Because some people with MS experience a loss of sensation in the bladder area, you may notice hardly any symptoms. With a more significant infection, though, you may experience burning or discomfort when urinating or foul-smelling urine. You may also see blood or mucous in the urine.

Because so many of the symptoms of a UTI can also be caused by other bladder problems, the doctor cultures a urine specimen to look for bacteria. After the bacteria have been identified, the doctor can prescribe the appropriate antibiotic.

If you get an antibiotic for your UTI, be sure to take it for the full number of days it has been prescribed because a UTI quickly recurs if it’s not fully treated. Even worse is the fact that an untreated UTI can pose a serious threat to your health.

If you’re prone to recurrent UTIs, your doctor may prescribe a long-term, low-dose antibiotic, such as Septra (sulfamethoxazole), to reduce the amount of bacteria is your system.

The best way to deal with UTIs, of course, is to prevent them in the first place. Here are some strategies you can try:

  • Empty your bladder completely — by urination if you can and by ISC if you can’t. Double-voiding may also help. For example, after you’ve finished peeing, wait a few seconds, stand up if you’ve been sitting down or move a bit if you’ve been standing up, and then try again. The movement can restimulate the urination process.

  • Drink plenty of fluids. Many people with MS try to manage a misbehaving bladder by cutting down on fluids. This is called the “If I don’t drink, I won’t have an accident” philosophy. However, cutting back on fluids causes the urine to become overly concentrated, which significantly increases your risk of infection.

    Because liquids help flush wastes, mineral deposits, and bacteria from your system, we recommend drinking six to eight glasses of water per day. Other fluids are okay too, but keep in mind that caffeine, the aspartame in diet sodas, and alcohol are big-time bladder irritants that will increase urgency and frequency.

  • Keep your urine as acidic as possible. Acidic urine is less friendly to bacteria. You can maximize acidity by increasing your daily intake of protein, cranberries (or their juice), plums, and prunes and by decreasing your intake of citrus fruits and juices, milk and milk products, beverages or antacids containing sodium carbonate or sodium bicarbonate, and potatoes.

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