Featuring Barry A. Hendin, MD

MSAA’s Chief Medical Officer

Question: Many individuals with MS experience bowel issues, most commonly constipation. How may this symptom be addressed through lifestyle and dietary changes?

Answer: Gastrointestinal symptoms are common in people with multiple sclerosis. These can range from upper gastrointestinal symptoms, such as trouble swallowing, abdominal discomfort, and acid reflux, to lower gastrointestinal symptoms, such as constipation, diarrhea, and fecal incontinence.

Constipation is probably the most common of these symptoms, affecting more than half of people with MS at some time or another. There are many possible factors involved in causing constipation. MS lesions, particularly in the spinal cord, can directly affect intestinal motility, which is the body’s ability to automatically transport substances such as food and waste. Additionally, diminished activity or exercise can contribute to constipation. Dehydration and a diet without adequate fiber add to the problem. Some medications, including muscle relaxers and pain medications, can also contribute.

Although medications such as stool softeners and laxatives can be useful, lifestyle and dietary changes should be the first approach. This involves increased hydration, increased dietary fiber, increased exercise, and increased physical activity. Regularly scheduled bowel movements, along with allowing adequate time to have those bowel

movements, is also useful. Conservative changes in diet and lifestyle are usually able to manage symptoms of constipation, however, when these conservative therapies are inadequate, it may be helpful to obtain a gastroenterology consultation. For more information, please visit MSAA’s website section focusing on bowel problems.

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Barry A. Hendin, MD, is a neurologist and Director of the Arizona Integrated Neurology MS Center. He is also Director of the Multiple Sclerosis Clinic at Banner University Medical Center and Clinical Professor of Neurology at the University of Arizona Medical School.

MSAA’s Ask the Expert series received a Merit Award from the 28th Annual Digital Health Awards!