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Focus on constipation

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Focus on constipation

Bowel problems are a common symptom of MS and can have a big impact on your everyday life.

In this blog, specialist physiotherapist and MS Trust trustee Christine Singleton shares some advice on constipation and MS.

Constipation and the effects it has on people with MS is more common than you might think. Did you know more than 50% of people with MS experience constipation? If you have constipation you're not alone, but you may feel alone as this is a very personal condition that can be difficult to talk about to family or friends. Although it’s not exactly a topic for social occasions it's definitely a conversation to have with your GP, MS nurse, consultant or therapist. It's important to talk about how constipation is affecting you so that you can be given advice and help to prevent the problem becoming chronic.

Here's a list of some common symptoms you might experience with constipation:

  • You may want to go to the toilet but when you get there nothing happens. Sometimes people sit on the toilet for a long time which in itself is uncomfortable.
  • Most people with constipation pass fewer than 3 episodes of stools a week and some can even go for 7 to 10 days without passing stools. This can leave you feeling bloated and uncomfortable.
  • The stools you pass may be lumpy, hard and dry, difficult and painful to pass and very large which can mean that you are worried about going to the toilet due to the pain it may cause.
  • Some people strain when going to the toilet which can cause piles which are themselves painful.
  • Some people who have been to the toilet and passed stools still feel that they need to go again.

All the above are signs of constipation and if you have had these signs for 3 or more months then you have chronic constipation.

Chronic constipation can cause additional problems and impact your day-to-day life.

  • Many people avoid going out because they are worried about being somewhere and not knowing where the toilet is located.
  • For many their toilet habits take over their lives and also affect their partners and family members.

Many factors can lead to constipation and having MS doesn’t mean you'll definitely experience it. Your diet and eating patterns, such as what you drink, how much and when, all influence how your digestive system works. Exercise is also important for a healthy gut but some people with MS find it difficult to exercise because of physical limitations. However, many people don't recognise that just doing your daily routines and activities is exercise. Exercise can be done in many ways including when lying down or sitting in a chair, standing holding onto the back of a tall chair, short walks, as well as going to a gym to use exercise equipment. The exercise videos by Mr Motivator on the MS Trust website have some useful ideas and are worth looking at particularly with a friend to get them moving too.

Constipation can cause your other symptoms of MS, such as spasticity, to get worse or be more troublesome. It is well known that constipation can affect your self-esteem, energy levels, mood, relationships, sexual activities and your ability to work.

Generally for people with MS the problem of constipation is related to the length of time it takes for food to pass through your gut, rather than for any obstruction or disease process within the gut itself. Constipation can also be a side effect of medication you're taking.

It's important to have a check-up with your GP to ensure your constipation is not being caused by another medical problem. This is particularly important if you have blood in your stools or blood stained underwear. If all likely causes for your constipation have been investigated and nothing has been found then your MS nurse, GP or therapist can help by first working with you to understand what may be influencing your bowel activity to give you constipation. They may give you advice and some education on how best to improve your constipation condition. If the advice and education do not fully help they can suggest other treatments.

Please do not feel you are alone and be confident to seek help when you need it. Organisations like the MS Trust have information on their website and in their publications. They can also direct you to other places for assistance.

I am doing some research on a different non-invasive form of treatment for constipation, which uses electrical stimulation to make the tummy muscles contract. This new treatment is showing some promise but needs further investigation, so to help my research I would like your help to understand what living with constipation means for you and your family.