Bowel Dysfunction

Constipation is a particular concern among people with MS, although diarrhoea, 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 health care 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 health care provider can help establish an effective bowel management program. Occasionally, it may be necessary to consult a gastroenterologist, a physician specialising 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 1.5 - 2 litres or 6 - 8 glasses of fluid daily.
• Include plenty of fibre in the diet. Fibre 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.

Source - NMSS Information Resource Center and Library. Compendium of Multiple Sclerosis Information (CMSI). © 2003, National Multiple Sclerosis Society. Reproduced with permission.