Constipation describes irregular, infrequent and difficulties in bowel movements. It is a common symptom of multiple sclerosis but is also associated with many other conditions. It can also be a problem in otherwise healthy individuals.

Constipation is one of those unspoken problems that can cause a lot of discomfort, embarrassment and even pain (it drives me insane!). It can often feel like you are trying to push out the entire bedroom wardrobe including the corners when all you get for your efforts are a couple of rabbit droppings!

Most people with MS have a slowed passage of food through the guts and there are a variety of reasons for that. Officially, constipation is defined as having fewer than two bowel movements per week or having to strain unduly more than 25% of the time, although I am wary of such rigid definitions.

In MS, constipation can be caused by a variety of factors including slowed reflexes originating in the brain, digestive tract or anus, spasticity and incoordination of bowel muscles, lack of physical activity due to immobility, depression, inadequate intake of liquids and a diet that is low in fibre.

It's important to take action against constipation and many of the treatments are fairly straightforward such as increasing your intake of liquids (see below). Excessively solid stools can impact and become so large that they can no longer be passed out. Diaorrhea can creep around the stool and cause fecal leakage, which, needless to say, is very embarassing. Straining too hard can cause haemorrhoids which can itch, burn and bleed.

Fortunately, there are a variety of simple measures you can take to alleviate constipation:

• Increase your intake of liquids. Often people with MS also have urinary problems which make them fearful of increasing their liquid intake but this will make constipation worse. Consult your doctor if you have this worries.
• Increase your intake of dietary fibre.
• Make sure that you are getting enough exercise. Obviously, many people with MS are rendered fairly immobile by the condition but a degree of exercise is often possible and exercise is also important in other ways. The MS Trust have an excellent booklet on the subject called "Exercises for people with MS" by Liz Betts. You can download it from this web page, http://www.mstrust.org.uk/?section=aboutms&content=newbooks
• Try not to leave more than two or three days between bowel movements.

Constipation links:
Bowel Problems linked to MS
Bowel Dysfunction
Exercises for people with MS

MS Glossary
All About Multiple Sclerosis