Bowel problems linked to multiple sclerosis
Around half of all people with multiple sclerosis experience constipation. This may be due to MS nerve damage affecting signals between the brain and the bowel disrupting bowel emptying.
A less common symptom may be bowel incontinence.
The two symptoms may be linked, but experiencing constipation doesn’t necessarily mean a person with MS will also develop bowel incontinence.
Some MS medication may also cause bowel problems and there may also be some emotional and psychological factors.
Constipation is characterised by infrequent bowel movements (usually fewer than 3 bowel movements per week) or by frequent straining to void faecal matter.
Constipation is very common among people with MS. In general poor diet without enough fibre, lack of physical activity and depression all affect the digestive system. Medications and supplements may also contribute to constipation.
With MS, constipation may be caused by an interruption of impulses to the brain that signal the need for a bowel movement. MS may also prevent pelvic floor muscles from relaxing. These muscles are used to help void faecal matter. MS may block the natural increase in activity of the colon following meals.
Bowel incontinence is the loss of voluntary bowel control. A person suffering from bowel incontinence may not be able to reach a toilet fast enough. The most common causes of bowel incontinence in the general population include long-term constipation, severe diarrhoea, stress, haemorrhoids, nerve or muscle damage, and overuse of laxatives.
Diarrhoea is frequent loose or watery stools. It is sometimes the result of allergies or sensitivity to spicy foods or dairy products, contaminated water or food, a change in activity level, or viral, bacterial, or parasitic infections.
Diarrhoea can also be a sign of another problem. If it becomes frequent or continual, seek medical advice. In some cases your doctor may recommend that you see a doctor known as a gastroenterologist, who specialises in treating bowel problems.
How can I maintain regular bowel movements?
- Increase your fluid intake. Try to drink six to eight glasses of water daily. If you're having MS-related urinary problems, you may be advised to cut back on your fluid intake, but this can make constipation worse. Lack of water may harden the stool, making it more difficult to pass. And increased pressure from the stool on parts of the urinary system may actually increase bladder problems.
- Increase your fibre intake. Eating plenty of fresh fruits and vegetables and wholegrain breads and cereals is the best way to increase the amount of fibre you eat. A doctor may also recommend that you take a fibre supplement.
- Try to maintain regularity. Establish a regular time for emptying the bowels. Plan trips to the toilet immediately after meals since eating is a natural stimulus for having a bowl movement. Try to go no more than two to three days between bowel movements.
- Exercise. Activity such as walking helps normalise bowel function.
- Use stool softeners. But do this only after seeking medical advice.
Ask your doctor whether adjusting your medication might help relieve the diarrhoea, but do not change your medication without first talking to your doctor.
Don't take over-the-counter (non-prescription) medicines for diarrhoea without first talking to your doctor.