Linking Multiple Sclerosis and Constipation
One of the most common, yet most difficult, symptoms to discuss is problems with the bladder and bowels. These embarrassing, invisible symptoms aren’t talked about freely on social media or in the multiple sclerosis (MS) community generally, so the sufferer can be left feeling isolated and helpless.
For this article, I’m going to concentrate on constipation but there are, arguably, worse bowel problems to deal with.
I have a friend with MS who doesn’t have any visible symptoms at all, but can’t leave the house most days due to bowel incontinence. She must make sure she’s “been" at least once before she goes out or she’s in grave danger of losing control in public.
This has happened to her on numerous occasions and, quite frankly, I can’t think of anything worse to happen to a person! I don’t think I’d trade my lack of mobility with that problem and am relieved I have the opposite issue of constipation to tackle, as there are things that can help.
Causes of Constipation
Much is known about how MS causes bladder issues, but little is understood about its impact on the bowels.
It could be down to nerve damage, as the colon muscles can become weak and sluggish and the gut slows down. This can cause waste processing to take longer, making stools harder to pass, causing constipation.
Nerve damage can also mean the body is unable to interpret sensations in the area of muscles responsible for “going" and might affect reflexes and control.
Medication can also be a factor, as some common MS drugs can cause constipation. Baclofen, for spasticity, and painkillers containing codeine can cause constipation, and medication to ease constipation may lead to loose stools and the dreaded bowel incontinence.
Coincidently, I’ve recently stopped taking baclofen as my neurologist suggested I try a different drug for neuropathic pain. I have noticed a difference in a week and haven’t been constipated at all.
Bladder problems may also lead to reduced fluid intake, which can make constipation worse. Fatigue can lead to less exercise, which also exacerbates the problem. Depression and anxiety can also have an impact.
So what can be done to alleviate the symptoms?
Tips for Coping With MS and Constipation
Diet
As usual, my research for this article started with social media. I like to ask MSers on Twitter and Facebook what they think, and the overwhelming response to the problems of constipation was diet.
Lots of people noticed a worsening of symptoms after eating badly for a few days and improvements came when they were more careful about what they ate. Some foods that were recommended were as follows:
- Vegetables
- Fruit
- Nuts
- Prunes
Hydration
People also talked about the importance of staying hydrated and drinking plenty of water. This is particularly difficult for MSers who have bladder problems though, and I’m definitely guilty of restricting how much I drink to ward off the inevitable increase in trips to the bathroom.
Unfortunately, though, warding off one problem can exacerbate another so we can’t win!
Supplements
There are remedies and stool softeners we can take to make going easier, such a Senna, Lactulose and Fybogel. I use Lactulose as a last resort and I find it can help get things moving and provide much needed relief if things have got particularly bad.
I’ve heard horror stories from people though and you need to be careful you don’t overuse these products as your problem could soon turn into incontinence! A small dose every now and again works for me.
Exercise
One MSer on Twitter swears by yoga to help reduce constipation, and I’ve written about the benefits of Pilates to help relieve symptoms.
Lots of us are guilty of not exercising enough and I think it has a huge impact on our insides and metabolisms. Consider manageable exercise classes or look at websites such as MS Society and MS Trust for exercises to help.
Medication Review
The more I think about it, the more I think baclofen may have been to blame for my constipation. I follow all of the above tips, yet at times I’ve had such problems.
Now that I’ve been off the drug for around two weeks I’ve noticed such an improvement that it’s hard not to see a connection. We blindly take our medication as they can help so many symptoms, but it’s worth reviewing what you take if the above tips don’t work for you.
If nothing helps it’s worth talking to your healthcare team and seeing a continence specialist, as there may be other things that can help and it’s good to rule out any other medical causes.
Good luck!