Bowel Dysfunction

Bowel dysfunction refers to the inability to control bowel movements, including problems with the frequency and consistency of bowel movements. This symptom can be a source of embarrassment and humiliation, as well as discomfort, so it’s very important to work with your doctor, or a gastroenterologist, to evaluate the cause of your problem and come up with solutions.

Specific bowel dysfunction problems common in MS include constipation, incontinence, loss of muscle control or weakness, slow motility, and diarrhea.

What are some the causes of bowel dysfunction in MS?

Constipation may result from not getting enough fluids, loss of mobility and reduced physical activity, and a slowing of the movement of food (motility) through the gastrointestinal tract.

Constipation can be caused by nerve damage or be a side effect of medication such as antidepressants or bladder control drugs.

Loss of control of bowel movements may be caused by nerve damage or aggravated by constipation.

Diarrhea is less common than other bowel function problems in people with MS.  Diarrhea can happen when a person is constipated and loose stool from higher up in the colon leaks out around hardened stool that is backed up in the rectum.

What can I do to help myself stay regular?

Here are some simple steps you can take to increase bowel regularity.

  • Drink fluids : Make sure you drink at least 48 ounces (6 to 8 glasses) of fluids daily
  • Increase fiber intake:
    • Your diet should include plenty of fiber, which can be obtained from fresh vegetables and fruits and cereals and breads made with whole grains
    • You should also use a dietary fiber supplement such as powdered psyllium (your doctor or pharmacist can help suggest one)
  • Use stool softeners: Your doctor may recommend using a stool softener
  • Establish regular schedule:
    • Make sure you establish a regular time and schedule for bowel movements, with no more than 2 to 3 days between movements
    • You can use enemas, suppositories, and laxatives in moderation to help with bowel movements (make sure to consult with your doctor about using laxatives)

What are some examples of high-fiber foods?

A diet high in fiber will help you stay regular and is useful in controlling constipation. High fiber foods help move digested food through your gastrointestinal tract and out of your body. There are a wide variety of foods that are high in fiber. Cruciferous vegetables, such as cabbage, cauliflower, turnips, rutabagas, broccoli, and Brussels sprouts, are a good source of dietary fiber, as are fruits, such as apples, berries, grapes, and pears. Additionally, nuts and seeds, popcorn, legumes, such as peas, beans, and lentils, and products that contain whole grains, such as breads, pastas (100% whole wheat pastas), cereals, oats, rye, corn, rice (brown), and barley, are good sources of fiber. You can add a dietary fiber supplement such as unprocessed bran to your cereal, baked goods, and beverages to increase your fiber intake. Also, limit your intake of foods that are known to contribute to constipation, such as low-fiber foods, processed meats, and cheese.

What are some tips for starting a high-fiber diet?

If you aren’t used to eating a high fiber diet, introduce the foods listed above slowly into your diet. Your goal should be to get 25 to 35 grams of fiber daily. Every two or three days, try adding an additional serving of a high fiber food to your regular diet, so that your gastrointestinal tract can adjust to the change in diet and prevent excess gas. Ultimately, you should eat at least three servings of raw fruits or vegetables each day.

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Written by: Jonathan Simmons | Last reviewed: May 2015.