MS & Bowel Problems: what you need to know

If you find that you get constipated due to MS, it can result in a variety of different symptoms:

• Straining

• Hard pellet stool

• Abdominal pain

• Infrequent bowel actions

• Sense of incomplete emptying

• Excessive wind

• Bloating

It is unlikely that you would experience all of these symptoms with constipation, but some people might experience a combination of them.

Diarrhea can be caused by having a stomach bug, through infection, from medications, antibiotics or food poisoning just like those who do not have MS.

However, bowel incontinence is often a result of constipation where stools become so impacted that there is leakage around them. So you might need to wear a hidden pad or plug due to leakage, rather than diarrhea.

It is important that you prioritise your emotional wellbeing when you have MS, as losing motivation or feeling low can cause constipation. If you feel upset, embarrassed or stressed by MS bowel problems this can also exacerbate the problem. The mind-body connection is powerful.

Managing bowel problems with MS is key in taking back control over your body and not letting it stop you from enjoying life to the fullest.

It’s not easy to approach a professional about bowel issues, but your doctor, neurologist or continence advisor will be able to help. If you combine this advice with positive lifestyle changes with the Overcoming MS Program you will be improving other MS symptoms as well.

Fortunately, there are some lifestyle changes you can make to manage constipation when you have MS, along with consulting your doctor. These include making sure that you have:

✔ A balanced diet

If you eat a balanced diet with lots of fiber it will help your bowel movements regularly. There are certain foods which can help relieve mild constipation, including:

• Fruit (eg dried fruit, figs, pears, prunes, apples, rhubarb) 

• Vegetables (eg spinach, artichoke, sweet potato)

• Seeds and nuts (including linseeds, chia seeds and flaxseed)

• Cereals (oat bran, whole-grain rye bread)

If you have severe constipation, the fiber in some foods such as unprocessed bran could lead to uncomfortable bloating, so it is important to consult your doctor.

✔ Plenty of water

It is important to remember that your daily fluid requirements will increase when you increase your fiber. 

If you have MS bladder problems you may consciously or subconsciously reduce your fluid intake. Some people find that coffee helps to activate the bowel, but caffeine can irritate your bladder and is a diuretic so don’t rely on coffee for your fluid intake. 

✔ Regular exercise

If you have MS spasticity or MS fatigue you may have become less active, and that cause constipation. But it is vital that you incorporate exercise into your daily routine as this improves many MS symptoms, including constipation. Exercise will stimulate your abdominal muscles that in turn stimulate movement in the colon. 

Some people with MS climb mountains, win medals at the Paralympics or run marathons which is fantastic and inspirational – if you are not that way inclined, regular exercise might simply mean doing an activity that you find fun. Whether it is joining a yoga or tai chi class to encourage bowel movement, or sailing, bowling, horse riding or swimming for a full body workout, take a look at our exercise options for inspiration.

The great thing is that there are exercises to do at all levels which will help with a number of MS symptoms. The key is for the activities and exercises to be enjoyable and regular so that you will see the positive results to help you to stay motivated.

✔ A medication review with your doctor

Some medication can cause constipation, including:

• Anti-spasticity drugs

• Medicine designed to treat heart problems or high blood pressure

• Antidepressants

• Drugs used to treat MS bladder problems

• Codeine

• Heartburn medication

There are also changes you can make and successful treatments which will allow you to manage bowel incontinence and regain control. 

You can:

✔ Improve your stool consistency 

✔ Train your muscles to provide better control

✔ Eliminate controllable lifestyle choices that make bowel incontinence worse

This includes:

✔ Experimenting with your diet

Try to include foods that make stools firmer in your diet:

• Ripe bananas

• High fiber foods

• Arrowroot

• White marshmallows

• Mashed potato

There will also be some foods which make you produce a looser stool and this will also take some experimentation to find out which foods irritate and you can avoid. Common examples include:

• Caffeine

• Dairy products

• Chocolate

• Spicy food

• Alcohol

• Artificial sweeteners

✔ Regular exercise

Keeping to a healthy weight will alleviate the pressure on your pelvic floor and reduce bowel incontinence.

You can also do regular pelvic floor exercises along with a technique called biofeedback,which can help strengthen the muscles used to control the opening and closing of your bowels.

✔ Meditation

Strategies to reduce anxiety and stress are vital for your health and wellbeing and stress can worsen bowel incontinence. In fact, meditation is so important that it is one of the central elements of the Overcoming Multiple Sclerosis Program.

Making lifestyle changes to help with bowel problems will also help to alleviate any stomach pain felt from constipation or diarrhea.

The Overcoming MS Program incorporates MS diet recommendations that are scientifically researched and will not only help any bowel problems, but other symptoms of MS too.

Making sure that you eat plenty of fiber, engage in regular physical activity and drink more water will see improvements with bowel problems. This will relieve any stomach pain or discomfort, making you feel happier and more relaxed.

Some people with MS experience bowel problems, while others never do, but it is comforting to know there are ways to manage it if you do experience these symptoms so that it doesn’t impact your life.