Bladder Dysfunction in Multiple Sclerosis Patients Seeking Disability Benefits
A common problem I see among my clients seeking disability benefits is bladder dysfunction. It is particularly common among people that suffer from Multiple Sclerosis – commonly referred to as “MS.” This month’s email issue of MS Clinical Care Connection from the Multiple Sclerosis Society has some interesting information about bladder dysfunction in MS patients.
According to the MS Society, bladder issues “are very common in MS even as a first symptom and affecting approximately 80% of patients (Holland N 2009, Crayton et al 2004).” It can cause numerous secondary problems, including urinary tract infections, urosepsis and upper urinary tract damage (de Seze et al 2007). Incontinence and related bladder symptoms can be a significant factor contributing to why someone cannot work or hold down a job. These issues need to be documented well to help prove how severe and frequent the symptoms would impact a person’s ability to work.
The most common bladder/urinary problems are:
- detrusor overactivity (spastic bladder or failure to store), which produces symptoms of urgency and frequency and may cause urge incontinence
- detrusor-sphincter dyssynergia (DSD) (combined dysfunction) causes urgency, frequency and incontinence, as well as difficulty emptying the bladder, double voiding and urinary tract infections
- underactive or areflexic bladder (failure to empty) thought to be due at least in part to sacral damage with symptoms of overflow incontinence, incomplete emptying, urgency and UTIs (DasGupta & Fowler 2003).
The medical literature shows that bladder symptoms are under reported, under evaluated and under treated (Denys et al 2014). This is a fact that I see in my clients who are seeking disability benefits. It is extremely common for people to fail to mention or literally hide their incontinence and bladder issues from their doctors. Many people that I talk with are too embarrassed to share what is happening to them.
I frequently stress to my clients that you must tell you doctors about every problem you have, even if you do not think is related to what they are treating. Urinary incontinence or bladder issues are a good example. Many MS patients would never think that these problems are related to their Multiple Sclerosis. As the MS Society says, “Careful assessment with attention to medical and psychological complications is necessary at every visit to identify problems, avoid complications and determine the correct course of treatment, including the potential need for formal urological evaluation. Addressing mobility issues, fluid intake and medication adjustments may be first steps in managing bladder symptoms.”
DISABILITY CLAIM TIP: Telling all of your physicians about all of your symptoms, limitations, and restrictions not only helps them diagnose and treat your condition, but it also helps you document the information needed to prove your disability claim.