The Straight Poop on Bowel Dysfunction
Last updated: May 2018
If you suffer from constipation, sudden urges to move your bowel that make you desperately hobble to the toilet, fecal leakage between bowel movements—or the entire list, like I do--then you are in good company. As many as 68% of people with MS can be afflicted with these distressing symptoms.
Bowel incontinence affects a not insignificant percentage of those without MS, too—most notably, younger women who have given birth and aging adults. The causes are varied, but for those of us with MS, spinal cord damage is the one of the main culprits.
Constipation is the more common problem among people with MS. Here’s a list of symptoms that count as constipation:
- infrequent bowel actions
- hard pellet stool
- abdominal pain
- sense of incomplete emptying
- excessive wind
These symptoms can be caused by non-MS-related conditions such as lack of activity, inadequate intake of fluids, poor diet, not eating enough, and medications, all of which can afflict the non-MS population, too. People with neurological diseases who sustain spinal nerve damage can suffer a loss of sensation and function in the lower parts of the bowel. In this case, we can miss the signals that tell us our bowels are full and need to be evacuated. A spastic sphincter, located near the anus, can keep stools from leaving the body despite our best efforts to go, just as a spastic leg muscle might stay tight and cause problems.
There are lifestyle changes we can try to help alleviate constipation and reduce its recurrence. For example, sitting for too long can cause a number of problems in the hind end, including hemorrhoids. Just popping up from our chairs at least twice every hour can alleviate a number of ails besides activating our lower digestive tracts.
Here’s a short list of lifestyle suggestions published by reputable health sites along with my personal comments on whether they’ve worked for me:
Eat regularly for regular bowel movements. The less I eat, the fewer bowel movements I have. Makes total sense. But I get constipated when I eat 3-4 times a day, too. Sustaining regularity can be more complicated for people with MS. After trying other methods, my final solution to constipation is taking a laxative. It can take up to three days to work.
We need to drink 1-2 quarts of fluid and eat 20-30 grams of fiber to stay regular. That’s 32-64 ounces of fluid per day. If you have a spastic bladder like I do, drinking that much fluid can be a real challenge to your peeing habits. I take Vesicare to reduce frequent urges and improve emptying, and it works pretty darn well. Drinking 64 ounces cancels out the benefits of Vesicare, as I once found out the hard way. Drinking 32 oz. makes me go pretty frequently, too, so less is better. Dietary fiber is a huge challenge, too. If you have upper and/or lower GI tract problems like I do, consult a doctor. I’ll be seeing a gastroenterologist in April.
Bowel incontinence is probably the most stressful, worrisome symptom we can have in our lower halves. The fear of having an accident in public makes a lot of people stick close to home. And though there are special undergarments available to keep the accident from leaking out of our pants, there is the task of trying to clean up and smell good. Experts advise us to leave the house prepared with a change of underwear and clothes, moist wipes, and a product that removes the odor of feces. While it is helpful that such products are available, it does little to assuage our anxiety over losing control of our bodily functions.
Using the methods suggested by experts to better control our bowels can go a long way to improving our quality of life and our health in general. If those methods don’t bring satisfactory results, you might have a digestive condition that needs investigating. Though it does seem tiresome to see a doctor for one more thing while we have so many other symptoms to manage, digestive health is a key component in managing autoimmune diseases. And let’s face it, when it comes to pooping, we all want it to happen when we’re ready.
What does advocacy mean to you as someone living with multiple sclerosis? Please select all that apply: