Constipation & Loss of Bowel Control

Causes of Bowel Incontinence and Constipation

Bowel dysfunction — such as constipation and loss of bowel control —can cause a great deal of discomfort and embarrassment. Multiple sclerosis can cause a loss of myelin in the brain or spinal cord. This may prevent or interfere with the signals from the bowel to the brain indicating the need for a bowel movement and/or the signals from the brain to the bowel that maintain normal bowel functioning. Other causes of constipation, sometimes associated with MS, include:

Insufficient fluid intake
Reduced physical activity and mobility
Decreased or slowed “motility” (movement of food through the intestinal tract)
Side effects of certain medications

Bowel dysfunction can also aggravate other MS symptoms such as spasticity or bladder dysfunction. If you are experiencing problems with incontinence or constipation, talk to your MS provider.

Managing Bladder and Bowel Issue

Promote Bowel Regularity

A healthcare provider can help you establish an effective bowel management program. Occasionally you might need to consult a gastroenterologist (a physician specializing in the stomach and bowel), but a few simple changes can often improve bowel regularity.

High Fiber Diet to Promote Bowel Movements

Include plenty of fiber in your diet. Fiber, a plant material that doesn’t fully break down in digestion, can be obtained from fresh fruits and vegetables, whole grain breads and cereals. You may also try dietary additives such as powdered psyllium preparations. If your mobility has been affected by MS, you may need as much as 30 grams of fiber a day to help with bowel function.High fiber food options include:

Almonds
Apples
Broccoli
Brussel sprouts
Carrots
Chickpeas
Pears
Lentils
Oats
Quinoa
Split peas
Strawberries

Fluid Intake

Drink at least 48 ounces (6 to 8 glasses) of fluid daily. Meeting your fluid goal may mean drinking whether you are thirsty or not. Whenever possible, choose options like water and avoid drinks with a lot of sugar or caffeine.

Physical Activity to Avoid Bowel Dysfunction

Regular exercise helps with motility (how digestion happens in the lower intestines). Walking, swimming and even chair exercises can help. Try to establish a regular schedule for emptying the bowels (bowel training/retraining).

Medications for Bowel Problems Associated With MS

Discuss any treatments for bowel problems — such as stool softeners, bulk-forming supplements, enemas, suppositories or manual stimulation — with your healthcare provider. It may take several weeks to know if these remedies are working.Continuous or regular use of laxatives generally is not recommended. Overusing laxatives can lead to problems such as diarrhea, dehydration, electrolyte abnormality and even constipation. It can also cause long-term and potentially permanent damage to the digestive system, including chronic constipation and damage to the nerves and muscles of the colon. As with most symptom management plans, a multi-level strategy with a combination of medicinal and non-medicinal strategies is most helpful.

Ask an MS Expert: Managing MS Bowel and Bladder Symptoms

Constipation and Loss of Bowel Control Due to Multiple Sclerosis

Causes of Bowel Incontinence and Constipation

Promote Bowel Regularity

High Fiber Diet to Promote Bowel Movements

Fluid Intake

Physical Activity to Avoid Bowel Dysfunction

Medications for Bowel Problems Associated With MS

Additional Resources for Constipation and Loss of Bowel Control