Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentDiagnosisWhen to See a Healthcare Provider
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Diagnosis
When to See a Healthcare Provider
One of the more uncomfortable and unpleasant symptoms ofmultiple sclerosis (MS)isconstipation. Studies suggest that at least 50% of people living with MS experience constipation and that 25% have recurrent bouts.
While constipation can affect anyone, the underlying causes can be different in people with MS. Not only is constipation more likely to be persistent or recurrent, but it can often be very painful.
This article takes a look at the causes of constipation in people with MS, as well as the ways that this common but frustrating symptom can be treated or prevented.
Verywell / Emily Roberts
Symptoms of Constipation With MS
The symptoms of constipation in people with MS are really no different than constipation in anyone else. Where they can differ is in their frequency.
In some people with MS, constipation will gradually worsen as the disease progresses. Others withrelapsing-remitting MS(in which MS symptoms come and go) will have recurrent bouts of constipation.
Constipation is diagnosed when there are at least two of the following symptoms in at least 25% of bowel movements:
Types of MS and How They Are Treated
Causes of Constipation With MS
There are two factors involved with having normal, healthy bowel movements. Firstly, the stool must continuously move through the intestines. Secondly, there must be enough water in the stool to ease the passage of the stool. If one or both of these factors is impaired, constipation can occur.
Neurological Factors
Multiple sclerosis (MS) is a disease in which the immune system attacks and destroys the protective covering of nerve cells in the brain and spinal cord. This affects nerve signaling and the way that parts of the body function, including the digestive tract.
In people with MS, this can lead toneurogenic bowel dysfunctionin which the intestines do not contract as they should to keep stools moving. As a result, stools will travel slowly through the intestines and impact as they hit certain junctions, growing larger and harder to pass.
Lifestyle Factors
An important component of normal bowel function is physical activity, such as walking or exercising. Because MS can cause progressive weakness, fatigue, andspasticity(spastic movements), people will often become less active as the disease gets worse,
On top of this, it is common for people with MS to cut back on drinking water due toneurogenic bladder dysfunction(the nerve-related loss of bladder control). This can lead to chronicdehydrationwhich only worsens constipation.
Which MS Medications Cause Constipation?
Constipation is a side effect of many of the drugs that people with MS take to control their symptoms, including:
Causes of Chronic Constipation
How to Treat Constipation With MS
The treatment of constipation in people with MS is largely the same as anyone else. It involves the combination of exercise, diet, and medications if needed.
Over-the-counter medications used to treat constipation include:
Prescription medications used to treat constipation include:
In people with advanced MS, bowel movements may be so restricted that stools may need to be physically removed with an enema ordigital disimpaction(in which a gloved finger manually removes stool).
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Prevention
Constipation is common in people with MS, but the good news is that there are things you can do to prevent it or at very least reduce its frequency.
Among some of the more useful tips:
When Is Constipation Considered an Emergency?
Are There Tests to Diagnose the Cause of Constipation With MS?
Constipation can often be diagnosed with a review of your symptoms, diet, and medical history. But, when MS is involved, it can get even more complicated given the possible causes.
If you have MS, your healthcare provider may want to do a complete physical exam. They may also order tests to evaluate your bowel function, such as:
Common Signs That MS Is Progressing
One of the biggest concerns about constipation in people with advanced MS is the risk of abowel obstruction. The loss of intestinal motility can become so profound the mass of hardened stool can cause tears and bleeding as it passes through the intestine, causingbowel perforation.
Do not hesitate to rush to your nearest emergency room if you experience signs of bowel perforation, including:
Summary
Constipation can affect anyone, but, in people with MS, it can often be chronic and worsen over time. It is largely due to the loss of bowel function as MS progressively damages nerves throughout the body. Lifestyle factors, such as dehydration and physical inactivity, can also contribute.
Diagnosing constipation in people with MS may involve a battery of tests to identify problems with intestinal motility. The treatment may involve over-the-counter or prescription drugs as well as changes in diet and exercise. An enema can also help if needed.
Can Stress Trigger Multiple Sclerosis?
A Word From Verywell
Chronic constipation should never be considered “normal.” Irrespective of whether you are older or younger, see your healthcare provider if the symptoms are chronic, severe, or worsening.
In the end, all you may need are a few lifestyle adjustmens to make things the. But, at other times, constipation may be a sign of something imminently more serious, such ascolon cancer.
How to Cope and Live Well With MS
Urinary Symptoms of Multiple Sclerosis
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Preziosi G, Gordon-Dixon A, Emmanuel A.Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies.Degener Neurol Neuromuscul Dis.2018;8:79–90. doi:10.2147/DNND.S138835National MS Society.What causes MS?Jani B, Marsicano E.Constipation: evaluation and management.Mo Med.2018 May-Jun;115(3):236–40.Bharaucha AE, Lacy BE.Mechanisms, evaluation, and management of chronic constipation.Gastroenterology.2020 Apr;158(5):1232–49.e3. doi:10.1053/j.gastro.2019.12.034Pouli S, Kozana A, PapakitsouI, Daskalogiannaki M, Raissaki MM.Gastrointestinal perforation: clinical and MDCT clues for identification of aetiology.Insights Imaging.2020 Dec;11:31. doi:10.1186/s13244-019-0823-6
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Preziosi G, Gordon-Dixon A, Emmanuel A.Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies.Degener Neurol Neuromuscul Dis.2018;8:79–90. doi:10.2147/DNND.S138835National MS Society.What causes MS?Jani B, Marsicano E.Constipation: evaluation and management.Mo Med.2018 May-Jun;115(3):236–40.Bharaucha AE, Lacy BE.Mechanisms, evaluation, and management of chronic constipation.Gastroenterology.2020 Apr;158(5):1232–49.e3. doi:10.1053/j.gastro.2019.12.034Pouli S, Kozana A, PapakitsouI, Daskalogiannaki M, Raissaki MM.Gastrointestinal perforation: clinical and MDCT clues for identification of aetiology.Insights Imaging.2020 Dec;11:31. doi:10.1186/s13244-019-0823-6
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Preziosi G, Gordon-Dixon A, Emmanuel A.Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies.Degener Neurol Neuromuscul Dis.2018;8:79–90. doi:10.2147/DNND.S138835National MS Society.What causes MS?Jani B, Marsicano E.Constipation: evaluation and management.Mo Med.2018 May-Jun;115(3):236–40.Bharaucha AE, Lacy BE.Mechanisms, evaluation, and management of chronic constipation.Gastroenterology.2020 Apr;158(5):1232–49.e3. doi:10.1053/j.gastro.2019.12.034Pouli S, Kozana A, PapakitsouI, Daskalogiannaki M, Raissaki MM.Gastrointestinal perforation: clinical and MDCT clues for identification of aetiology.Insights Imaging.2020 Dec;11:31. doi:10.1186/s13244-019-0823-6
Preziosi G, Gordon-Dixon A, Emmanuel A.Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies.Degener Neurol Neuromuscul Dis.2018;8:79–90. doi:10.2147/DNND.S138835
National MS Society.What causes MS?
Jani B, Marsicano E.Constipation: evaluation and management.Mo Med.2018 May-Jun;115(3):236–40.
Bharaucha AE, Lacy BE.Mechanisms, evaluation, and management of chronic constipation.Gastroenterology.2020 Apr;158(5):1232–49.e3. doi:10.1053/j.gastro.2019.12.034
Pouli S, Kozana A, PapakitsouI, Daskalogiannaki M, Raissaki MM.Gastrointestinal perforation: clinical and MDCT clues for identification of aetiology.Insights Imaging.2020 Dec;11:31. doi:10.1186/s13244-019-0823-6
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