3 minute read
BLADDER HEALTH
BY MATT JACKSON, PH.D.
DIS-LIST For most, when we hear the words multiple sclerosis (MS), we think about vision problems, muscle spasms, or dizziness, but how about bladder health? Urination probably isn’t the first thing that comes to mind, but 90% of people with MS experience symptoms from poor bladder function. 1,2 We’re not just talking about incontinence either. People with MS are 6 times more likely to get a urinary tract infection (UTI), and one study reviewed death certificates of people with MS and found that almost 10% died from a UTI. 1 So, when it comes to important health complications from MS, it is worth talking about bladder health.
MS is an autoimmune disease that damages the central nervous system and forms pockets of scar tissue called plaques. It typically takes about 6 to 8 years after an MS diagnosis 1 for plaques to form on the upper spinal cord, disrupt communication between the brain and bladder, and cause spasms in the bladder muscles. 3 The urges to urinate can be frequent, intense, and uncontrollable, especially at nighttime. 1–3
The first treatments are typically antimuscarinic drugs that reduce muscle spasms in the bladder, such as oxybutynin (Ditropan). 3 For some, these drugs may alleviate bladder symptoms altogether, but for others, side effects may be intolerable— dry mouth, constipation, drowsiness, and memory problems—especially when using these drugs for years. 3 Also, some people with MS could have more severe side effects. Antimuscarinic drugs are widely prescribed by doctors, and there have been many trials detailing safety and side effects. But only a few small studies have tested side effects in people with neurological disorders such as MS. 3
If prescription drugs don’t relieve symptoms, what are the other options? You could inject Botox into the bladder every three months or surgically implant an electrical device into the spine, but both options carry serious risks with limited evidence of effectiveness. 3 Another option is to insert a catheter through the urethra and into the bladder four to six times per day, but this can introduce bacteria and cause tissue damage. 3 It’s no wonder that some people with MS are turning to cannabis as an alternative. In the 1990s, anecdotes claimed cannabis could treat bladder symptoms in MS. In response, researchers investigated these claims with two placebo-controlled, randomized clinical studies in the 2000s. 4,5 The results showed that cannabis extracts reduced bladder overactivity, 5 nighttime urination, 5 and episodes of incontinence 4 with few adverse side effects. 4,5 Cannabis extracts were twice as effective as placebo, 4,5 and patients taking cannabis were three times more likely to say their overall bladder health improved. 5
These clinical studies puzzled scientists, and research in the past decade has tried to explain how cannabis could possibly alleviate bladder symptoms. Scientists have studied human tissues and found cannabinoid receptors throughout the nervous system and the bladder. Then by introducing drugs into rats that activate those receptors, we have discovered that the ECS can regulate bladder capacity, bladder pressure, urination volume, and urination frequency; 6 all detailed evidence that supports the use of cannabis extracts. 4,5
Unfortunately, we cannot reverse neurological damage and cure MS. Instead, our immediate focus is treating bladder symptoms, minimizing complications, and improving quality of life. However, 60% of people with MS have said that conventional treatments did not improve their quality of life whatsoever. 2 There are few alternatives on the horizon except for cannabis, 3 and we have a collection of clinical studies and scientific research that support using cannabis for bladder symptoms in MS.
