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"The best piece of advice that I've received to manage my MS is to take care of myself."

Shiela, MS LifeLines Ambassador

Living with RRMS since 2002

Taking Rebif® since 2003

Bowel or Bladder

Some MS lesions can block or delay nerve messages that control the bladder. This can cause bladder problems. Bladder problems, which occur in at least 80% of people with MS, can usually be managed.

Bladder symptoms may include:

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  • Frequency or urgency of urination
  • Hesitancy in starting urination
  • Frequent nighttime urination (known as nocturia)
  • Incontinence (the inability to hold in urine)

The most common bladder problem is called "spastic" bladder. That's when the bladder is unable to hold the normal amount of urine or does not empty properly. This can leave urine in the bladder and possibly lead to infection.

Constipation is another concern for people with MS. Constipation may be caused by too little fluid intake. It also may be caused by your intestinal tract slowing down. If you have become less active, you may become constipated. Certain medications used to control bladder symptoms may also cause constipation.

Dealing with bladder/bowel problems

One way to treat a bladder problem is to change your fluid intake (eg, limit fluid intake a few hours before bedtime, cut out caffeine). Also, your health care provider can prescribe medicine. It is important to get examined and treated early, so that you can avoid any complications, like bladder infections.

Here are some tips to help you deal with bowel and bladder problems:

  • Drink at least 6 to 8 glasses of fluid (preferably water) daily.
  • Include plenty of fiber in your diet. Fresh fruits and vegetables, whole grain breads, and cereals all contain fiber.
  • Use medicines such as stool softeners as recommended by your health care provider.
  • Establish a regular time and schedule for emptying the bowels.
  • Wait no more than 2 to 3 days between bowel movements.
  • Enemas, suppositories, and laxatives may be used to help a bowel movement—talk with your health care provider before using any of these options.

Your health care provider can help you establish an effective bowel management program. Occasionally, it may be necessary to consult a gastroenterologist. He or she is a health care provider that specializes in treating the stomach and bowel.

Brought to you by EMD Serono, Inc. and Pfizer Inc., the co-marketers of Rebif® (interferon beta-1a) in the US EMD SeronoPfizer

Prescribing Information - Medication Guide

This information is intended only for residents of the United States.

Rebif is used to treat relapsing forms of MS to decrease the frequency of relapses and delay the occurrence of some of the physical disability that is common in people with MS. Rebif is not approved for the treatment of chronic progressive multiple sclerosis. Rebif is available by prescription only in 22 mcg and 44 mcg pre-filled syringes and a titration pack.

Before beginning treatment, patients should discuss with their doctor the potential benefits and risks associated with Rebif. Let your doctor know if you have a history of depression, seizures, liver disease, thyroid problems, and blood count or bleeding problems or if you have had previous allergic reactions to medications. Tell your doctor about all medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Rebif and other medicines may affect each other causing serious side effects. Talk to your doctor before you take any new medicines. Rebif is not recommended for women who are or plan to become pregnant.

Potential serious side effects of Rebif include depression, liver problems, risk to pregnancy, injection site problems and severe allergic reactions. Allergic reactions are rare and may be associated with difficulty breathing and loss of consciousness, which requires immediate medical attention.

The most common side effects with Rebif are injection site reactions, flu-like symptoms (fever, chills, muscle aches, tiredness), depression, abdominal pain, increased liver enzymes, and blood cell count decreases. Let your doctor know immediately if you have any of these symptoms or feel sad, tired, hot or cold, experience hives, rashes, bruising, yellowing of the skin, or a change in body weight (gain or loss).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

This information is not intended to replace discussions with your healthcare provider. For additional information about Rebif, please consult the Medication Guide or Prescribing Information and talk to your doctor. You can also call toll free 1-877-44-REBIF (1-877-447-3243). Rebif is available by prescription only.

MS LifeLines is an educational support service for people living with MS and their families. MS LifeLines and MS LifeLines Ambassadors are sponsored by EMD Serono, Inc. and Pfizer Inc.

Rebif, Rebiject II, and MS LifeLines are registered trademarks of EMD Serono, Inc. or its affiliates.

MS in Balance is a service mark of EMD Serono, Inc. or its affiliates.

Copyright 2008 EMD Serono, Inc. All rights reserved.