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Multiple Sclerosis and Bowel Problems

Medically Reviewed by Melinda Ratini, DO, MS on April 27, 2022

If you have multiple sclerosis (MS), your bathroom habits may not be what they used to be. You might have bowel movements a lot more, not as much, or it may be harder to go. Talk to your doctor about these troubles. They can suggest ways to make things regular. But there are also simple ways to adjust your habits to make bathroom visits more predictable.

Bowel Problems You Might Have With Multiple Sclerosis

Constipation. It’s very common for people with MS. The disease can interrupt the messages nerves send to and from the brain that signal that it’s time for a bowel movement. MS can also keep pelvic floor muscles from relaxing, which helps your body get rid of stool. Also, it can stop the natural increase in activity of your colon after you eat.

Other things that may be associated with MS, such as a poor diet (including not getting enough fiber), too little exercise, and depression can all affect the digestive system. Medications and supplements also can cause constipation.

Loss of bowel control. This problem means you may not be able to reach the bathroom fast enough. The most common causes include long-lasting constipation, severe diarrhea, stress, hemorrhoids, nerve or muscle damage, and using laxatives too much.

Diarrhea. It usually happens because of allergies or sensitivity to spicy foods or dairy products, bad water or food, a change in activity level, or an infection. Diarrhea can also signal another problem. If it you have it often or all the time, see your doctor. In some cases, they may tell you to see a doctor who specializes in treating bowel problems, called a gastroenterologist.

Irritable bowel syndrome (IBS). Sometimes called spastic colon, IBS is the name for several conditions that cause alternating diarrhea and constipation. Other symptoms include gas pains and abdominal cramps. Scientists don’t fully understand IBS or its causes. But it’s a common condition, and is thought to be even more so in those with MS. Some research has found that about 20% of people with MS have symptoms of IBS. That’s more than twice the rate in the overall population.   

Inflammatory bowel disease (IBD). The two most common types of this immune system disorder are ulcerative colitis (UC) and Crohn’s disease. UC affects the lining of your large intestine. Crohn’s can happen anywhere in your digestive tract from your mouth to your anus. Inflammation from IBD damages your digestive tract, leading to symptoms like belly pain, long-lasting diarrhea, weight loss, and fatigue.

Some studies indicate that people with MS are up to 50% more likely to get IBD than others, and people with IBD have an equally increased risk of developing MS. It’s not clear exactly why. But genes and shared environmental risk factors for MS and IBD, such as smoking and a cold climate, may play a role.

How to Get Bowel Movements Back to Normal

  • Drink more fluids. Make sure you get enough water every day. You might be tempted to cut back on it if your MS gives you bladder problems. But that makes constipation worse. Make your first beverage of the day something hot, such as hot water or apple cider, or drink 1/2 to 1 cup of prune juice in the morning to get things moving.
  • Get more fiber. The best way is to eat plenty of fresh fruits and vegetables and whole-grain breads and cereals. Add 2 to 4 tablespoons of unprocessed wheat bran to hot or cold cereal or casseroles, or mix it with applesauce, pancake batter, pudding, muffin batter, milkshakes, or cookie dough. Be sure to drink plenty of liquids, which help the bran work inside you. Your doctor may also recommend that you take a fiber supplement.
  • Stick to a schedule. Set a regular time when you’ll go to the bathroom. Try going right after meals since eating is a natural way to prompt a bowel movement. Try to wait no more than 2 to 3 days between bowel movements.
  • Exercise. It’s a great way to get your digestive tract going.
  • Use stool softeners. But only if your doctor says it's OK.

How to Control Diarrhea

  • Drink more liquids to make up for what your body is losing. Try water, lemonade or fruit-flavored drinks, fruit or vegetable juice, broth, milk, or soup.
  • Talk with your doctor or dietitian about how much fiber you should eat.
  • Eat soft foods that have a lot of liquid, such as sherbet, yogurt, and pudding.
  • Ask your doctor whether changing your medications might help relieve the diarrhea. But don’t try to take less or stop taking them before you talk to them.
  • Don't take over-the-counter drugs for diarrhea without talking to your doctor.

Show Sources

SOURCES:

National Multiple Sclerosis Society: "Bowel Problems."

National Multiple Sclerosis Society: "Bowel Dysfunction," “Bowel Problems: The Basic Facts.”

University of Pittsburgh Medical Center Physician Resources: “Irritable Bowel Syndrome and Multiple Sclerosis: What’s the Connection?”

Annals of Clinical and Translational Neurology: “Multiple sclerosis and inflammatory bowel disease: A systematic review and meta-analysis.”

Journal of Neuroscience: “Multiple sclerosis and inflammatory bowel diseases: a systematic review and meta-analysis.”

CDC: “What is inflammatory bowel disease (IBD)?”

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