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What causes constipation in people with multiple sclerosis?
Last reviewed: 17.10.2021
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As a symptom of multiple sclerosis (MS), constipation does manifest itself frequently. It can be chronic constipation, and maybe a temporary condition - it comes and goes. You can spend whole months proving your own "wrong" in determining the symptoms of constipation. This can become a painful phenomenon. But it is better to know exactly if you have constipation with multiple sclerosis than to suffer silently from this problem, instead of receiving empathy and medical care.
Do not suffer in silence - go to the doctor
Among the surprisingly diverse set of symptoms associated with multiple sclerosis, constipation should be one of the biggest disadvantages of this disease.
The most important thing is that you are looking for help in solving this problem. Waiting and silent patience of pain in the anus and the inability to go to the toilet for a long time is a bad idea, as it can lead to damage to the rectum or its obstruction. It is possible that the treatment of constipation with multiple sclerosis will be easy and simple, but you must first consult a doctor to diagnose this disease.
[What do you feel?
Everyone has constipation and in theory everyone seems to know what it is. However, there is a more precise definition in sensations than simply "I can not go to the toilet." It includes such sensations and facts
- Two or less bowel movements per week
- Feeling as if you did not eliminate all the feces from the intestines, and spend on the toilet for at least 25 minutes
- You strain when defecating for more than 15 minutes, and then again and again
- You have a lumpy or hard stool, and defecation is painful.
How often do constipation occur with multiple sclerosis?
It is difficult to say how many people with multiple sclerosis have constipation experience, statistical data are, as a rule, greatly underestimated. This is due to many factors, such as the false shame of patients who are afraid or ashamed to report constipation to their neurological doctors, and do not want to go to the proctologist or gastroenterologist.
However, it is estimated that between 50% and 75% of people with multiple sclerosis experienced constipation at least once in life. This is the most common bowel disease that people with multiple sclerosis face.
How to avoid constipation?
Two conditions for multiple sclerosis include a healthy, regular bowel movement
- The chair must move through the intestine
- There must be enough water in the stool
According to medical records, these are very interrelated things. When the stool slows in traveling through the intestine (especially the large intestine, in particular, the last, lower part of the large intestine), the water is not absorbed into it, the stool becomes firm. When the passage of stools slows down too often, too much water is absorbed by the bowel and the stool becomes hard and difficult to pass.
Constipation in multiple sclerosis can be caused by one of the following factors (or their combinations)
Neurological disorders
As already mentioned, the stool must necessarily move forward, and not stagnate in the rectum. In people with MS (multiple sclerosis), damage to the nervous system can block parts of the brain that are designed to receive or transmit signals to empty the intestines.
In other words, you can not get a brain signal that you "must go to the toilet" - or you are not able to effectively relax and produce an act of defecation when necessary. Involuntary movements that push the stool out of the rectum, especially the lower part of the digestive tract, can also be difficult.
Again, these problems are exacerbated by the fact that if certain functions of the nervous system are disturbed, the calves are too difficult to get out because of prolonged stagnation in the rectum.
Limited physical activity
An important component of intestinal motility (movement of digested food through the intestine) is physical activity, for example, walking. Many of us are not able to move around and walk a lot for many reasons: due to laziness, because of weakness, spasticity, sensory ataxia or usual fatigue. Especially this problem can bother people with multiple sclerosis. And then such a person may be disturbed by constipation.
Side effect of drugs
Constipation is a side effect of many drugs that people with multiple sclerosis are forced to take to control their symptoms. These medications include
- Antidepressants, especially tricyclic antidepressants, including: amitriptyline (Lolita, Endep.), Desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil-PM), nortriptyline
- Painkillers, especially those that contain morphine or codeine, as well as other narcotic drugs such as tramadol
- Drugs to eliminate bladder dysfunction or diarrhea, they are also called anticholinergics, including Norpanth, Pro-Ballet, tolterodine (tablets and capsules), dicyclomine (Bentyl).
- Drugs to eliminate spasticity (increased muscle tone), including inaclofen and tizanidine
Insufficient drinking water consumption
Some people with multiple sclerosis significantly reduce fluid intake, especially when traveling on a short or long trip to nature, where getting to the toilet can be difficult. But it is very important to drink plenty of water and other fluids throughout the day, if a person suffers from constipation. In addition, people with multiple sclerosis also have a higher risk of getting urinary tract infections, so they need to be careful about the fluids that they take during the day.