Some substances irritate the bladder and make urinary problems worse. Caffeine is a common bladder irritant, and it may be found in more than just your morning coffee.

You can try cutting back on caffeine and see if you notice a difference in your symptoms. Other bladder irritants you may want to avoid include alcohol, tobacco, artificial sweeteners, and spicy foods.

“I’ve found that if I have NO caffeine at all (only decaf coffee and no chocolate), I only get up once per night to pee,” shared a MyMSTeam member.

Aside from coffee, caffeine can be found in:

• Chocolate
• Energy drinks and supplements
• Medications
• Soda
• Tea

Some research suggests that dried cranberry powder may help with overactive bladder symptoms in people without MS.

Here’s what MyMSTeam members say about cranberry juice:

• “I struggle with a frequent need to urinate, and drinking cranberry juice helps a lot.” 
• “I usually have to resort to drinking this juice for two to three months to get my bladder back on track. I have decided to make it a regular item on my grocery list.”
• “I would have UTIs every six weeks. I started taking cranberry supplements in April, and I haven't had one UTI. My bladder function has never been better.”

Research on cranberry products for preventing UTIs is mixed, and cranberry cannot treat an infection once it starts. Talk with your healthcare provider if you have UTI symptoms or are thinking about trying cranberry juice or supplements.

If urinary issues are a common part of your day, keep them in mind when it’s time to get dressed. You may want to pick clothing that’s easy to remove quickly or that helps hide accidents.

You can also keep spare clothing in your car or bag, so you have peace of mind in case you need to change.

In addition, what you wear under your clothing can make a big difference. MyMSTeam members have discussed the products that work for them:

• “I wear underwear that has built-in padding, and then I also wear a daily pair just in case I don’t make it.”
• “I wear incontinence underwear and also put a pad in them since I don’t have any feelings until I feel the warmth of the urine coming out.”
• “Wear two ‘pee pads,’ one beneath your crotch and another up the back of your panties to catch urine when you aren't quick enough.”

If you use incontinence pads as part of your MS care, ask your insurance company whether it offers coverage or discounts.

The pelvic floor muscles support your bladder and help control urination. Pelvic floor physical therapy may help strengthen these muscles and improve bladder control. Your MS specialist can help you decide whether pelvic floor PT may be useful and provide a referral.

“I have urge incontinence (leaking urine before getting to the bathroom),” wrote a MyMSTeam member. “I’ve been doing physical therapy to help strengthen my muscles (Kegel exercises), and that has helped my bladder issue a little.”

If lifestyle changes and other treatments aren’t working, your doctor may recommend medications. Depending on their symptoms, people with bladder problems may need medication to relax certain muscles or nerves, or to help them sleep through the night. Examples include oxybutynin, tolterodine, or baclofen.

Here’s what MyMSTeam members have said about different medications:

• “I take medication at night to help me sleep. If not, I’m up multiple times during the night to pee. It works about 75 percent of the time.”
• “I take medication that really helps. It somehow works so my bladder will empty with ease.”

Always take medication exactly as prescribed. Don’t start, stop, or change a medication without talking with your doctor.

Botulinum toxin (sold as Botox and other brands) can be an alternative treatment for people with urinary incontinence. A healthcare provider injects the medication directly into the bladder. The treatment must be repeated when its effects wear off.

A catheter is a thin, flexible tube that can be used to drain your bladder. At first, inserting a catheter yourself may sound intimidating. But many people with MS say self-catheterization has brought them relief.

Several MyMSTeam members recommend this option:

• “I have self-catheterized for the past three years, and it has changed my life!!!” 
• “Try to get past your worries about catheters. It takes a while to get used to, but it doesn't hurt.” 
• “The catheter is the greatest invention since the wheel. Solved all my UTI and emptying problems. I know you think it’s painful, but it’s not.”

You’ll need some training and supplies to start self-catheterization. Using clean technique is important because improper catheterization can introduce bacteria and cause a UTI. Your healthcare team will show you how to lower this risk.

If you feel like you’ve tried everything, you may need to think about another level of care. Surgery or devices can be the right choice for those who haven’t had luck with other treatments.

“I went through several medications trying to get bladder incontinence under control,” explained a MyMSTeam member. “Finally, I went to a urologist and discussed a bladder pacemaker. As of today, I have not had one UTI and am back to wearing regular underwear all day long. This has given me restored confidence in life.”