Famished but Full: Digestive Problems and Their Relation to MS

We who have MS are accustomed to experiencing sometimes daily changes in our body. We cope with pain, mobility problems, limb weakness, fatigue, and many other symptoms. It comes with the territory. Consequently, it’s hard to recognize changes as those worthy of a visit to the doctor.

After we’ve had MS for a period of time, we become educated about most of the symptoms MS patients can experience. So I consider myself a minor expert on the subject and a major one on my own case, having lived with MS for nearly twenty years. I’m sure many of you do, too.

From time to time, something confounding gets our attention: An unfamiliar stitch in the side or pain in an area where there never was pain before. We know our bodies well enough to know this kind of pain or that uncomfortable twinge doesn’t feel like our usual MS symptoms. Still, we give it the benefit of the doubt. We wait it out, hoping it is just our wacky nerves misfiring and causing phantom sensations which will eventually subside and disappear.

Ravenous hunger is the last thing I would connect with MS. Developing a swollen, bloated belly after eating a very modest amount of food is another. Excessive flatulence, constipation, painful gas, and a feeling of being so full that my ribs hurt and will shatter at any moment are some others. I have suffered these symptoms chronically, every day without fail for more than four years.

As usual, I got online and typed my symptoms into the search box. Two things kept popping up time and again. According to the internet, it’s either Irritable Bowel Syndrome (IBS) or cancer. Hmm. The internet does have its limitations. As a differential diagnostics expert it makes a lovely patchwork quilt—and a poor substitute for a good old-fashioned doctor visit.

I delayed that doctor visit for more than four years, having had other fish to fry. Instead, I employed Occam’s Razor—the theory that the most likely solution to a problem is the simplest one—and treated my symptoms as though I had IBS: Upped the fiber in my diet and took stool softeners and laxatives. But I did not improve.

The problem with Occam’s Razor is that multiple sclerosis throws a tire iron into the gears of heuristics, bringing the whole enterprise to a screeching halt. For example, I once had symptoms of maxillary sinusitis and was soon cured with amoxicillin. But a month later, a troublesome symptom—burning in my ears, sinuses, throat and mouth—had come back. Over the next six months I returned to my doctor several times for more antibiotics. But the burning persisted. A visit to an ENT and a CT scan of my sinuses revealed no infection. The diagnosis was neuropathic burning. This is MS-related. I just live with it now.

Let’s go back to the digestive problems and back to the internet once again. A recent search revealed a condition called gastroparesis. The NIH describes it this way:

Gastroparesis, or delayed stomach emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether … It can cause weight loss or weight gain … Constant hunger/food craving might be from the poor absorption of nutrients caused by chronic slowed digestion.1

The vagus nerve (cranial nerve X) which starts in the medulla oblongata (lowest part of the brainstem), extends down through the carotid and jugular to the stomach and ends at the anus. Multiple sclerosis and other autoimmune diseases can damage the 10th cranial nerve, thereby partially paralyzing the stomach. More women than men are afflicted with gastroparesis.2

This is not to say that I’ve diagnosed myself with the above condition. There can be other causes for my symptoms such as systemic yeast and food allergies. I’ll be seeing my primary care doc soon and sort it out from there.

If you have MS and are experiencing digestive problems, see your doctor.

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