Multiple Sclerosis Symptoms: Bowel Problems

Problems in bowel movements—either constipation or diarrhea—can accompany MS.

Constipation
Diarrhea

Constipation1

Constipation is more frequently experienced by people with MS than diarrhea. Constipation can also aggravate spasticity. In fact, constipation can cause one of the most distressing bowel symptoms, bowel incontinence. Don’t delay in treating bowel problems, because it can lead to other problems (such as bladder problems resulting from the pressure of built-up stool on the urinary system).

Constipation can be caused by a number of factors. Lack of physical activity—brought on perhaps by fatigue or immobility—can disrupt the digestive system. Depression, poor dietary habits, spasticity, and medications can also be culprits. And, MS itself can be responsible. The loss of myelin in the brain or spinal cord can interfere with signals indicating that it’s time for a bowel movement. Finally, many people with MS who have bladder problems drink less fluids as a way to urinate less often—and this leads to constipation. This is such a common reason for MS-related constipation that your first step may be to seek medical help for your bladder problem.

Tips 1,2

Your doctor may prescribe medications to help manage this symptom, so it’s important to bring this issue up at your next appointment.

Exercise. Do a regular program of physical exercise, but always consult your doctor about starting any sort of exercise regimen
Try for regularity. Schedule a regular time for bowel movements about 20–30 minutes after meals, especially breakfast
Drink fluids. Try to drink at least 6 to 8 glasses of fluid daily
Include fiber in your diet. Make sure to eat fresh fruits and vegetables, whole grain breads and cereals, and dietary additives such as powdered psyllium preparations
Use stool softeners. Talk to your doctor about how often you should take these. Some of your choices are:
- Liquid sugar concentrates are a natural way to help to soften the stool
- Oral agents/fiber supplements
Keep track of what medications you are taking. Bring your doctor a list of every medication you take. The following types of medications can contribute to the development of constipation:
- Antihypertensives
- Anticholinergics
- Analgesics/narcotics
- Sedatives/tranquilizers
- Tricylic antidepressants
- Some antibiotics
- Antacids

Diarrhea1

Diarrhea is less common than constipation in people with MS. But it often comes with a loss of control, which can be very upsetting. Diarrhea can also mean there is another problem, such as gastroenteritis, a parasite infection, or inflammatory bowel disease. Be sure to see your doctor if you experience persistent diarrhea.

Tips2

Your doctor may prescribe medications to help manage this symptom, so it’s important to bring this issue up at your next appointment.

Cut back on alcohol and caffeine. These can irritate the bowel
Review medications with your doctor. They may be a factor in causing diarrhea
Take fiber supplements. These include Metamucil®, Benefiber®, or Perdiem®. These are taken without additional fluid when used to treat diarrhea