Symptom Management

Urinary Tract Infections

By MSF Staff and reviewed by the Multiple Sclerosis Foundation Medical Advisory Board

If you experience urinary urgency or frequency, a burning sensation when urinating, abdominal or lower back pain, elevated body temperature, increased spasticity, or dark, foul-smelling urine, a urinary tract infection is probably present.

Between 70 and 90 percent of people with MS develop some bladder dysfunction over the course of the disease which places them at increased risk for UTIs. Chronic UTIs are prevalent, particularly among women with disabilities. They are primarily associated with disorders characterized by neurogenic (related to nervous tissue or impulses) bladder, such as multiple sclerosis. Contributing factors are believed to include difficulty in maintaining adequate cleanliness, restricted fluid intake with the hopes of reducing trips to the bathroom or to avoid searching for accessible rest rooms, indwelling or contaminated catheterization, infrequent urination and excessive sweating with prolonged sitting in a wheelchair.


Increasing fluid intake and getting plenty of rest are vital elements to reducing and treating UTIs. Maintaining acidic urine can also help to prevent UTIs. This is because the organisms that cause infections do not grow as easily in acidic environments. Acidity can be increased by adding more protein to your daily diet (meat, fish, fowl, eggs and gelatin). Add cranberries, cranberry juice, plums and prune juice, as well. Drink cranberry juice at frequent intervals throughout the day as vitamin C is processed and excreted quite rapidly by the body.

In her book Multiple Sclerosis: The Questions You Have – The Answers You Need, Dr. Rosalind Kalb recommends decreasing your intake of citrus fruits and juices (grapefruit, orange, lemon, and tomato) and reducing your intake of milk products and beverages or antacids containing sodium carbonate or sodium bicarbonate. Potatoes should also be eaten sparingly. Long-term, low dose antibiotics (Sepra® or Bactrim®) may be prescribed by your doctor to suppress bacterial activity and reduce the risk of infection. 

A person with a UTI may experience a pseudo-exacerbation. Although no underlying disease activity exists, the infection and accompanying elevation in body temperature may cause other MS symptoms to flare up temporarily. Once the UTI is treated, however, these symptoms should subside.

 “The key to bladder management,” says Dr. Kalb, “is accurate knowledge about what is causing the problem followed by appropriate action to minimize complaints and control symptoms.”

(Last reviewed 7/2009)