Multiple Sclerosis: Bowel Problems Linked to Multiple Sclerosis

Because MS interrupts or slows the transmission of signals to and from the brain, the electrical impulses to the muscles that are involved in emptying your bowel can become disrupted.

What Types of Bowel Problems Affect People With MS?

Constipation, bowel incontinence (loss of bowel control), and diarrhea are problems that affect people with MS.

1. Constipation

Constipation is characterized by infrequent bowel movements (usually fewer than two bowel movements per week), or by frequent straining to void fecal matter.

Constipation is very common among people with MS. In general, poor diet (including consuming less than 20 grams of fiber per day), lack of physical activity, and depression all affect the digestive system. Medications and supplements may also contribute to constipation.

With MS, constipation may be caused by an interruption of impulses to the brain that signal the need for a bowel movement. MS may also prevent pelvic floor muscles from relaxing. These muscles are used to help void fecal matter. Also, MS may block the natural increase in activity of the colon following meals.

2. Bowel Incontinence

Bowel incontinence is the loss of voluntary bowel control. A person suffering from bowel incontinence may not be able to reach the bathroom fast enough. The most common causes include long-term constipation, severe diarrhea, stress, hemorrhoids, nerve or muscle damage, and overuse of laxatives.

3. Diarrhea

Diarrhea is frequent, loose, or watery stools. It is sometimes the result of allergies or sensitivity to spicy foods or dairy products, contaminated water or food, a change in activity level, or viral, bacterial, and parasitic infections.

Diarrhea can also be the signal of another problem. If it becomes frequent or continual, see your doctor. In some cases, your doctor may recommend that you see a doctor who specializes in treating bowel problems (gastroenterologist).

How Can I Maintain Regular Bowel Movements?

• Increase your fluid intake. Try to drink 6-8 glasses of water daily. If you're having MS-related urinary problems it may be tempting to cut back on your fluid intake, but this makes constipation worse. Lack of water may harden the stool, making it more difficult to pass. And increased pressure from the stool on parts of the urinary system may actually increase bladder problems. Drink something hot as the first beverage in the morning, such as hot water or hot apple cider or drink ½ to 1 cup of prune juice in the morning to stimulate a bowel movement.
• Increase your fiber intake. Eating plenty of fresh fruits and vegetables and whole grain breads and cereals is the best way to increase the amount of fiber you eat. Add 2 to 4 tablespoons of unprocessed wheat bran to foods and drink plenty of liquids (liquids help bran to be effective). Try bran sprinkled over hot or cold cereal, casseroles or mixed with applesauce, pancake batter, pudding, muffin batter, milk shakes, or cookie dough. Your doctor may also recommend that you take a fiber supplement such as Metamucil.
• Try to maintain regularity. Establish a regular time for emptying the bowels. Plan trips to the bathroom immediately after meals since eating is a natural stimulus for having a bowl movement. Try to wait no more than 2-3 days between bowel movements.
• Exercise. Activity such as walking helps normalize bowel function.
• Use stool softeners. Only do this under the direction of your doctor.