Constipation and MS

While it is well known that multiple sclerosis (MS) can impact the bladder, causing symptoms such as urinary incontinence, the condition can also impact the bowel. In this case, constipation is more common than bowel leakage, impacting around 50 per cent of people living with MS. This is due to MS lesions sometimes affecting the nerve signals to the bowels and altering sensation in the area. Constipation can further be caused by several factors including medications, reduced physical activity and diet. While many people feel uncomfortable raising these issues with their health care team, it is important to learn to manage these symptoms, to minimise the impact they may have on daily life.

Physiotherapist Vanessa Leung has some quick and easy tips that you can incorporate into your daily routine, to help ease constipation.

What are some ways to manage my constipation?

‘Staying active is very important and of course has benefits beyond your bowel symptoms,’ Vanessa says.

‘By increasing physical activity, it can stimulate intestinal contractions to allow food to move more easily through the large intestine.

‘Activities like walking, swimming, running and strengthening exercises can help. Sedentary behaviour, like sitting and lying in bed for prolonged periods can often exacerbate constipation symptoms.’

Vanessa says diet is also a factor. ‘Monitor your diet – increase your fibre intake with plenty of soluble (veg, fruit, legumes, oat bran, barley etc.) and insoluble fibre (the skins of fruits and vegetables, nuts and seeds, wholegrains etc) and appropriate water consumption. You should aim for 2 litres of water per day.’

The way you sit on the toilet can also impact your ability to have a bowel movement. In MS, due to weakness of muscles around the lower limb, it can often pull your pelvis one side more than the other.

‘Consider your position on the toilet. Ensure your pelvis is even or symmetrical to allow your bowels to open properly without kinking of the rectum. You can place a stool under your feet to assist this.

‘Avoid slumping while on the toilet. Your torso should be upright or leaning slightly forward, in cases of any spasticity in your hip flexor muscles you may need to lean backwards.

‘Also try and avoid straining to empty. Aim to empty within 5-7 minutes.’

Vanessa says it can also be worthwhile chatting with your health care team about the side effects of any medications you may be on.

‘Some drugs and medications have side effects that can cause constipation, so it can help to know if this is contributing to the problem.’

To chat to an MS Plus physiotherapist, contact Plus Connect 1800 042 138 or email connect@msplus.org.au

More information on bladder and bowel incontinence