Introduction:
Constipation is prevalent among those affected by multiple sclerosis (MS). If this problem is not tackled properly, it may lead to an increase in the symptoms of MS and other problems, like bladder problems. There are different ways to be used to resolve constipation, especially among those with MS.
What Is Constipation?
Constipation is a condition in which a problem occurs with passing stool. Those with constipation pass stool fewer or three times a week. They encounter problems while passing out the stool.
Constipation occurs when low dietary fiber, a lack of exercise, or a low fluid intake are consumed. It may be caused by other underlying conditions or certain medications.
Long-term or chronic constipation may require the underlying condition to be treated to relieve constipation.
Constipation is considered common, and it is estimated that more than 2.5 million people are affected by constipation in the U.S. (United States) every year. Constipation is caused when excessive water absorption occurs in the large intestine from the waste formed after the absorption of nutrients in the upper digestive system.
Symptoms of constipation include:
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Passing stool fewer or three times a week.
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Presence of hard stool.
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Straining needs to be done during bowel movements.
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Experiencing blockage in the rectum.
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A feeling of not emptying complete stool from the rectum.
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It may be necessary to empty stools from the rectum by pressing over the stomach or using a finger to remove them.
Constipation may affect mood, willingness to participate in activities, and diet.
Multiple sclerosis (MS) is an autoimmune condition that affects the brain and spinal cord. The symptoms of MS include issues with mobility and vision, difficulties with memory, speech, and cognitive issues, problems with the functioning of the bladder and bowel, as well as sexual dysfunction. According to the studies conducted, it was found that MS accompanies at least one gastrointestinal problem. These include constipation, fecal incontinence, and dysphagia.
Constipation can result in many other problems. Regular bowel movements help in excreting toxic substances or poison from the body. If these movements are not regular, toxins enter the bloodstream, making the person sick. Constipation can affect a person’s mood, interest in participating in activities, and diet. It may affect everything in the body.
Studies have found that almost 50 percent of individuals with MS suffer from constipation, and 25 percent may experience recurrent bouts. Constipation is considered to be an uncomfortable condition among individuals with MS. If constipation is not resolved, it may worsen the symptoms of MS.
MS causes constipation by limiting the movements of the intestine. MS is a health issue, in which the immune system destroys the nerve sheaths of nerve cells in the brain and spinal cord. This impairs nerve signaling and the way parts of the body function. This impairment of nerve signaling occurs in the digestive tract.
This condition may lead to neurogenic bowel dysfunction among those with MS. In neurogenic conditions, the intestine does not contract to move the stool. Hence, the stool moves slowly through the large intestine. This causes the impaction of stools at some of the junctions. These grow larger, harder, and more difficult to pass through.
Research has shown that neurogenic bowel dysfunction is common among individuals with MS, and it is estimated that 39-73 % are affected by this condition.
Lifestyle factors that include physical activity may be reduced among MS patients due to spasticity, progressive weakness, and fatigue. These symptoms get worse as the disease progresses. Apart from this, those affected by MS have to avoid water intake due to neurogenic bladder dysfunction. This causes dehydration and adds to constipation.
Medications that are used for the treatment of MS can cause constipation. These include antidepressants, painkillers, and anticholinergics.
What Are the Remedies for Constipation With MS?
Constipation with MS should be treated in the same manner as constipation. It may involve exercise, diet, and medications.
Over-The-Counter Medications:
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Fiber Supplements: These are bulk-forming laxatives. These are psyllium and methylcellulose.
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Stool Softener: These laxatives are like docusate, and they tend to add oil and water to stools.
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Lubricants: These are mineral oils that are ingested through the mouth to make the stools slippery.
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Osmotic Laxatives: These help retain water in the intestines. These include polyethylene glycol and magnesium chloride.
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Stimulant Laxatives: These laxatives are bisacodyl and senna. These speed up the contractions of the intestines.
Prescription Medications Used for Constipation:
Lubiprostone: These medications help increase fluid secretion in the intestines.
Linaclotide: These help speed up intestinal motility. They also help in promoting fluid secretion.
Plecantide: This drug increases contractions and fluid secretion in the intestines.
Tips to manage constipation with MS outside the doctor’s office:
Good Fluid Intake: Taking sufficient water helps fight against constipation. There is a link between dehydration and constipation. Hence, the regular intake of water and the recommended amount help with constipation. A daily intake of 1-2 liters of water is recommended.
Fiber-Rich Diet: A fiber-rich diet helps with constipation. Examples of fiber-rich diets are fresh vegetables, fruits, and whole grains. The doctor may recommend fiber supplements as well. Red meat and dairy should be avoided, as they cause constipation.
Activity and Exercise: According to experts, inactivity is the leading cause of constipation. Physical exercise helps an individual to be regular, but in the case of MS, the person may find exercise difficult. Those can walk regularly and keep themselves regular. Taking help from a physical therapist may help.
Regular and Comfortable Routine: Scheduling time for going to the bathroom helps with bowel movements. It helps either to train or refrain from bowel movements.
Conclusion:
Constipation is a condition that affects many systems in the body due to problems with bowel movements. Constipation most commonly occurs in MS-affected people. If not properly treated, it may worsen the symptoms of MS. Though it feels embarrassing to discuss constipation, it needs to be addressed, and help should be sought from a healthcare professional. It can be tackled by adopting lifestyle changes and medications.
