From The MS Information Sourcebook, produced by the National MS Society.
Constipation is a particular concern among people with MS, although diarrhea, incontinence (or loss of control), and other problems of the stomach and bowels can also 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, may also cause constipation. Loss of bowel control in MS may be neurologic in origin or related to constipation, and should be evaluated by a healthcare provider generally a physician or nurse).
Bowel dysfunction can cause a great deal of discomfort and humiliation, and may aggravate other MS symptoms such as spasticity or bladder dysfunction. A healthcare provider can help establish an effective bowel management program. Occasionally, it may be necessary to consult a gastroenterologist, a physician specializing in the stomach and bowel.
Guidelines for Bowel Regularity
Bowel regularity can generally be maintained by following a few simple guidelines:
- Drink adequate amounts of fluids, at least 48 oz. or 6-8 glasses of fluid 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 may be used in moderation to facilitate a bowel movement. Continuous or regular use of laxatives is generally not recommended.
Clinical Bulletins for Healthcare Professionals
Holland NJ, Halper J (eds.). Multiple Sclerosis: A Self-Care Guide to Wellness (2nd ed.). New York: Demos Medical Publishing, 2005.
—Ch. 7 Bladder and Bowel Management
Kalb R. (ed.) Multiple Sclerosis: The Questions You Have; The Answers You Need (3rd ed.). New York: Demos Medical Publishing, 2004.
—Ch. 4 Nursing Care to Enhance Wellness
Kalb R. (ed.). Multiple Sclerosis: A Guide for Families (3rd ed.). New York: Demos Medical Publishing, 2005.
—Ch. 11 General Health and Well-being
Schapiro R. Managing the Symptoms of Multiple Sclerosis (5th ed.). New York: Demos Medical Publishing, 2007.
—Ch. 11 Bowel Symptoms