Hi. I'd like to thank Trudy for inviting me to take part in her project to help other patients who live daily with bladder and bowel disease. Although I am not a patient, and do not experience disease symptoms myself, I will be a part of this journey — one of sharing, discovery and encouragement.

First, let's start with a Definition:
Neurogenic Bladder is the "impaired function of the urinary bladder due to disruption of either the central or peripheral nervous system" affecting the ability to control urination [Medical Subject Heading: MeSH Definition, National Library of Medicine, http://www.ncbi.nlm.nih.gov/mesh/?term=neurogenic+bladder]

Reading through Trudy's entries, I am struck by her openness and eagerness to help others who deal with neurological effects on their lower urinary and G.I. tracts on a daily basis. Her entry on (10/02/2012) mentions Brain Fog, which I was curious to learn more about and so I will start the Medical Literature section of the blog with a bit more information on this topic, from what is in the current literature.

Trudy describes "Brain Fog" as "difficulty concentrating, completing tasks, and feeling spacey, confused or lost . . . ." It has been described in the medical literature as "exaggerated mental fatigue" or "slow thinking, difficulty focusing, confusion, lack of concentration, forgetfulness or a haziness in thought processes." This "Mild Cognitive Impairment", is found included amongst the symptoms of Chronic Fatigue Syndrome (CFS). Trudy is correct — in that it is the feeling you get when your brain is not at the top of it's game — like being sleep-deprived, jet-lagged, early in the morning before your first cup of coffee or when you are pregnant (brain can't focus) — a hazy feeling. The difference is that this condition persists in people with "Brain Fog" in an exaggerated manner, at least as they perceive it. I have not found Brain Fog included in the symptoms of any medical studies specifically related to Neurogenic Bladder (although Trudy mentions a source connecting Fecal Incontinence and Dementia); it is associated and often present in patients who are experiencing clinical Depression and/or anxiety (Afari and Buchwald, 2003). As it turns out, the common factors in both Chronic Fatigue Syndrome and Neurogenic Bladder is their chronic nature and reports of depression. Indeed, Trudy describes clinical Depression as a constant struggle for those with Neurogenic Bladder/Bowel.

Even so, there have been studies that both confirm and contradict that depression is the cause of Brain Fog. Studies indicate that symptoms may be due to decreases in cerebral blood flow (CBF) — exacerbated by a "stressor" and resulting in the decreased ability to readily process information (perceived as fatigue), which sounds reasonable. One's perception of the symptoms is often exaggerated compared to the actual degree of impairment of conducting tasks (cognitive activity), is important to note. "Graded Exercise therapy" has been used to treat Chronic Fatigue Syndrome effectively (Edmonds et al., 2004; Price et al, 2008) and Ocon, 2013 suggests that "Brain Fog" may likewise benefit from physical exercise.

In other words, staying active physically helps to clear your brain, and perhaps helps increase blood flow (and thus oxygen) to the brain. Physical activity is often a key factor to maintaining good Health (of both the body & mind), of which I believe most Care-givers would agree.

I invite readers to submit their questions about topics relating to Neurogenic Bladder/Bowel so I can dig through the Medical Literature, and provide summary responses in future posts. Feel free to comment on any posts, as well, to turn this into a conversation.

Submit your Questions via the "Ask A Question" section of the blog.

Until next time . . .

The Biosleuth


1: Afari N, Buchwald D. Chronic fatigue syndrome: a review. Am J Psychiatry. 2003
Feb;160(2):221-36. Review. PubMed PMID: 12562565.

2: Edmonds M, McGuire H, Price J. Exercise therapy for chronic fatigue syndrome.
Cochrane Database Syst Rev. 2004;(3):CD003200. Review. PubMed PMID: 15266475.

3: Ocon AJ. Caught in the thickness of brain fog: exploring the cognitive
symptoms of Chronic Fatigue Syndrome. Front Physiol. 2013;4:63. doi:
10.3389/fphys.2013.00063. Epub 2013 Apr 5. PubMed PMID: 23576989; PubMed Central PMCID: PMC3617392.

4: Price JR, Mitchell E, Tidy E, Hunot V. Cognitive behaviour therapy for chronic
fatigue syndrome in adults. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD001027.
doi: 10.1002/14651858.CD001027.pub2. Review. PubMed PMID: 18646067.

The contents of this blog are for support, encouragement & informational purposes only and do not replace advice from health care professionals.