MS and Constipation
There are many invisible symptoms of Multiple Sclerosis (MS) which are, arguably, just as debilitating as more obvious symptoms, such as mobility or gait problems.
Issues with the bladder or bowel, for example, can be all consuming and can have a huge impact on day-to-day life.
I have suffered for many years with constipation and it can leave me feeling uncomfortable and isolated. People find it embarrassing to admit to and talk about, and it can be difficult to find support and advice in the usual places.
I get so much information and help on social media and have found out the most about MS from friends I’ve met online. We never discuss bowel issues though and I suspect this is exacerbated by my Britishness!
What Is Constipation?
You are suffering with constipation if you "go" less than 3 times a week. Feces become hard and difficult to pass, which can be uncomfortable and requires excessive effort.
This can be accompanied by bloating of the abdomen, pain and discomfort, loss of appetite, and fatigue.
It’s no wonder constipation can make us feel miserable, especially when we’re living with all the other symptoms of MS.
What Causes It?
As with many MS symptoms, it’s not clear why constipation occurs in MS, but researchers have identified a number of factors which may be happening, sometimes at the same time.
- Sluggish bowel: some people with MS experience this and it can cause waste to pass through the colon more slowly than others. The longer it takes the waste to travel, the less water is absorbed, so the harder the stools can become.
- Weakness: weakness and lack of co-ordination in the anal muscles and pelvic floor can cause difficulties.
- Reduced sensation: a lack of awareness that you need to go can lead to stools remaining in the back passage for longer, making it harder to go.
Medication can also make things worse. I take an opiate based pain killer sometimes — and I find I’m constipated for days afterwards — so I must weigh the pros and cons of relieving the pain caused by MS.
Due to bladder issues, I’m also guilty of restricting how much water I drink, which sometimes has a huge impact on constipation.
Research has shown that up to seven out of 10 people with MS suffer with constipation, and it’s also a huge problem in the general population, so what can be done to help?
Treatments and Remedies
The best way to ease constipation is to create stools that are the right consistency to easily pass. This means they need to be not too hard and not too soft. Here are some useful tips to make them just right!
- Eat regularly: eating stimulates the bowel, so eating regularly can keep things moving. The optimum time for emptying the bowel is half an hour after eating and this is strongest after breakfast, so skipping meals can cause the bowel to become sluggish.
- Diet: eat plenty of fiber. Fiber can be found in fruit and vegetables as well as whole-grains. We need around 30g of fiber to maintain healthy bowel function. You can easily add fiber by adding linseeds or flaxseeds to your food, as well as increasing fruit and vegetables. Make these changes gradually though to avoid bloating or wind.
- Increase fluids: people with MS restrict fluid intake to manage bladder problems, but the body will then absorb as much fluid from food as possible to compensate for this, causing stools to become harder. It’s recommended that we drink 1.5 liters of water a day, so it’s worth seeking help for bladder issues to avoid restricting your fluid intake.
- Avoid alcohol and caffeine, as these can make constipation worse because they can draw excess fluid from the colon.
- Exercise: many people with MS have mobility problems, making exercise difficult and leading to long periods of inactivity. This can make the bowel more sluggish; so, get moving to get things moving! Even if all you can do is seated exercise, this can help increase muscle function, causing constipation to be improved.
- Laxatives: many products exist that soften the stools, so if all else fails ask your doctor or pharmacist for the best products available.
I have a friend with MS who had the opposite bowel issue. She would lose control of her bowels at a moments notice, making her a prisoner in her own home. I can’t imagine how awful it would be to lose control of my bowel in a public place or at work.
I would rather have constipation than loss of control, but I do get so uncomfortable when my constipation is bad. It’s funny because we all do it, so why is it so difficult and embarrassing to talk about? I wold recommend talking to other people with MS to get further hints and tips and to start the conversation.