Multiple Sclerosis is characterized by a number of different symptoms ranging from mild sensory symptoms such as tingling, burning and itching to major symptoms such as weakness, paralysis, and bladder and bowel control. Learning how to manage and live with these symptoms is an important part of living an active life with MS.

Many people with MS experience problems with regular bowel movements (BM). Diarrhea and constipation are the two most common bowel malfunctions associated with MS. Diarrhea is less common, but is significant in that sufferers do not receive any warning of a diarrhea attack. Treatment for diarrhea involves giving substance to the stools without causing constipation. A product such as Metamucil, taken with as little water as possible, is often an effective bulk former. Taking a product of this type works by absorbing excess water in the stool. If controlling the frequency of attacks is a problem, the use of other medications may be required.

Constipation is characterized by the passing of small amounts of hard, dry bowel movements usually less than three times a week. Constipation can make a person feel bloated, uncomfortable and sluggish. Rather than relying on medication, consciously developing a routine for bowel movements has proved very effective in treating constipation. For instance, setting aside 15 minutes after breakfast every other day for a BM could result in a non-rushed routine (the most effective time to have a BM is after a meal). It is not necessary to have a BM on a daily basis but four to five days without one is the limit.

Constipation can be treated in a number of ways. Increasing fluids and fiber in the diet is often the first step. Adequate fluids give the stool proper consistency and assist in the elimination of stools. To promote a BM in the morning, try drinking two glasses of hot water before breakfast or drinking a glass of prune juice at night. Fiber aids in the frequency and consistency of stools. Fruits, vegetables, nuts, popcorn, whole grain breads and cereals and wild rice are all good sources of fiber. Unprocessed bran (which can be found at grocery and health food stores as well as pharmacies) may be necessary to supplement the diet and can be mixed with other foods such as applesauce, soup and yogurt. Abdominal discomfort can result from consuming too much unprocessed bran therefore it is recommended to start off with a small amount and gradually increase as needed. A dietician can help create a balanced diet suited to an individual’s needs with bowel conditions in mind.

Stool softeners work by drawing water from the body’s tissue into the bowel, decreasing the hardness of the stool and promoting elimination of the stool. Stool softeners tend to work within 24-48 hours and consistent use yields the best results. They are non-habit forming and can be found in pharmacies.

Oral stimulants (laxatives) provide a chemical irritant to the bowel that increases bowel activity. Avoid harsh laxatives that can be habit forming. Mild laxatives, such as milk of magnesia, are gentler on the bowel and induce a BM overnight or within eight to twelve hours. Rectal stimulants (suppositories) also work by providing a chemical irritant but further treat the constipation through localized mechanical stimulation and lubrication which promotes elimination of the stool. Suppositories usually work in 15 minutes to one hour.

While the use of over-the-counter remedies is effective, especially in the treatment of chronic constipation, the first course of action should be a change in diet. When followed routinely, a balanced diet rich with fluids and fiber can be instrumental in promoting and maintaining regular bowel habits.

this information was used with permission from the nmss.org