The case for MS continence management and advice

The NICE Guidelines on MS refer to the need for investigation and treatment of problems such as frequency or urgency of micturition (discharge of urine), sleep disturbance from nocturia (awaking with need to empty bladder), difficulty in passing urine or incontinence of urine. NICE Management of multiple sclerosis in primary and secondary care November 2003 (1).

	Bladder symptoms in multiple sclerosis are common and distressing but also highly amenable to treatment (2).
	Any person with MS who, despite treatment, has incontinence more than once a week should: be referred to a specialist continence service for further assessment and advice. NICE Guidelines on MS (1).
	Bladder problems can be all too familiar for people with MS but they do not have to cope alone because 'bladder problems can almost always be managed effectively and help is available'. MS Essential 7, Managing Bladder Problems (3)
	Discussing bowel problems and getting the right support from health care professionals can help many people manage bowel problems more effectively. MS Essential 25, Managing the Bowel in MS (4)
	Health service professionals in regular contact with people with MS should consider in a systematic way whether the person with MS has a ‘hidden’ problem contributing to their clinical situation, such as fatigue, depression, cognitive impairment, impaired sexual function or reduced bladder control. NICE Guidelines on MS (1) .
	Professionals in contact with a person with MS should consider whether the person has any problems controlling bowel function. Potential problems include urgency, difficulty, pain, constipation or incontinence. NICE Guidelines on MS (1).