Constipation is a particular concern among people living with MS, as is loss of control of the bowels. Diarrhea and other problems of the stomach and bowels also can occur.
Causes of constipation include insufficient fluid intake, reduced physical activity and mobility, and decreased or slowed “motility” (movement of food through the intestinal tract). Certain medications, such as antidepressants or drugs used to control bladder symptoms, might also cause constipation. Loss of bowel control in MS could be neurologic in origin or related to constipation, and it should be evaluated by a physician or nurse.
Bowel dysfunction can cause a great deal of discomfort and humiliation, and could aggravate other MS symptoms such as spasticity or bladder dysfunction. A healthcare provider can help establish an effective bowel management program. Occasionally, it might be necessary to consult a gastroenterologist, a physician specializing in the stomach and bowel.
Guidelines for Bowel Regularity
Bowel regularity generally can be maintained by following a few simple guidelines:
- Drink adequate amounts of fluids—at least 48 ounces or 6 to 8 glasses of fluids daily.
- Include plenty of fiber in the diet. Fiber can be obtained from fresh fruits and vegetables, whole grain breads and cereals, and dietary additives such as powdered psyllium preparations.
- Use stool softeners as recommended by your physician.
- Establish a regular time and schedule for emptying the bowels. Wait no more than two to three days between bowel movements. Enemas, suppositories, and laxatives can be used in moderation to facilitate a bowel movement. Continuous or regular use of laxatives is generally not recommended.