Multiple sclerosis Part 5



Fatigue and tiredness
If extreme tiredness is experienced, your doctor shall asses this initially and check out the reason for it is any thing other than MS like poor diet or medication. In case it is because of MS, medication like amantadine is prescribed even though its effects are limited. Energy saving techniques and exercise will also be recommended.
Bladder problems
Tolterodine or oxybutynin are anti-cholinergic, will be prescribed in case you have a overactive bladder. This helps in passing urine predictable. Desmopressin is recommended for frequently passing the urine. Incase of underactive bladder wherein the bladder isn’t emptying properly, a catheter can be fitted. It is a tiny tube inserted in urinary opening which drains excess urine. In case bladder problem gets severe, a continence specialist is referred who recommends bladder exercise or electrical treatment to bladder muscles.
Bowel problems 
By changing your daily diet or laxatives moderate to mild constipation cab be treated.
In case of severe constipation, enema or suppositories may be needed to treat it. It involves medication in liquid form which rinses through colon and rectum, softens the stools and flushes it out. Anti-diarrhoea medication can be used to treat bowel incontinence.
3. Treatment to slow the progression of MS:
Curing is not yet possible in MS as of now. Treatments are available to decrease the severity and number of relapses.
Disease-modifying medicines
These can be injected under the skin or into your muscle, these can be prescribed by neurologist who should also be a part of neurological rehabilitation team.
Disease modifying medicines are unsuitable to some with MS, prescribed only to treat secondary progressive MS(SPMS) and relapsing remitting MS(RRMS), as people with MS(SPMS) and MS(RRMS) get highest relapses.
Various types of disease-modifying medicines are mentioned below:
Beta interferons (Avonex, Rebif andBetaferon )
Three brands licensed to use of beta interferon are; Avonex, Rebif and betaferon. Beta interferons reduces severity and number of relapses in MS.
Avonex : Once a week it is injected in your muscles,
Betaferon : injected everyday under the skin, Rebif : injected under the skin thrice a week. These all can also cause side effects like, flu symptoms for 2 days once they are injected. All these are licensed and can be used by relapsing remitting MS (RRMS) . People with secondary progressive (SPMS) can use only Betaferon.

Beta interferons are unsuitable for people under 18 years of age, women who breast feed and are pregnant. It should not be taken by both men and women at least three months before conceiving. In case you fall pregnant while consuming beta interferon, you need toconsult your doctor immediately.
Glatiramer acetate
Licensed brand of glatiramer can be used in UK. It is also called as Copaxone. This is not effective on severity of relapses in MS, even though it can decrease relapses to some extent. Every day copaxone is injected under the skin. It doesn’t cause any side effects. In few cases tighness in chest can be caused. It can be used by people with relapsing remitting MS (RRMS). Similar to beta interferons, this is not suitable for people below 18 years of age, or breat feeding mothers or pregnant women.

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