Bowel Symptoms in MS: Causes, Treatments, & Exercises

Do you find yourself unable to take on daily activities without the fear of bowel symptoms taking over?

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Today, I want to dive into a crucial yet often overlooked topic: bowel function, especially concerning Multiple Sclerosis (MS). Bowel issues are common (not only for those with MS) but for many of us as we navigate our bodies growing older.

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Unfortunately, there's a lot of embarrassment and discomfort surrounding this topic; it shouldn’t be this way. Let’s break the silence, understand the challenges, and explore effective treatments and exercises.

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What Causes Bowel Symptoms in MS?

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MS affects the central nervous system disrupting its normal function. Bowel symptoms in MS mainly occur because the protective coating around nerves (myelin) in the brain, especially in the frontal lobe, gets damaged. This damage disrupts the normal communication between the brain, spinal cord, and bowels, causing them to malfunction.

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Other than impacting your confidence to take on daily life, bowel symptoms place a greater risk of falls and injuries. For example, hurrying to the bathroom can cause accidents, especially if MS has also impacted your ability to move. Fortunately, there are many solutions to help mitigate bowel issues and feel much more comfortable.

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Common Bowel Symptoms in MS
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Before we get into strategies, I want to break down common bowel symptoms in MS to help narrow down your plan to find relief. While everyone is unique, here is a list of what you may have experienced:

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• Constipation: The most common bowel symptom in MS, often due to dehydration from bladder dysfunction. Reduced fluid intake to manage urinary symptoms can exacerbate constipation.

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• Incontinence: Some individuals experience bowel incontinence, where they can't control bowel movements.

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• Urgency: An unexpected and sudden need to have a bowel movement.

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• Hesitation: Difficulty in initiating bowel movements, different from constipation.

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• Diarrhea: Although less common, some people with MS may experience diarrhea.

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Diet and Hydration Strategies

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Proper diet and hydration play a large role in managing bowel symptoms in MS. Adding these strategies to your daily routine can significantly improve bowel regularity and overall digestive health.

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• Stay Hydrated: Adequate fluid intake is essential. Aim for one and a half to two quarts of water daily. This helps prevent dehydration-related constipation and supports overall bowel function.

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• Increase Fiber Intake: Consuming 20 to 30 grams of fiber daily from fruits, vegetables, and beans can improve bowel regularity. Ensure you drink plenty of water with increased fiber intake to avoid worsening constipation.

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• Eat Breakfast: Your bowels are most active in the morning. Eating a healthy breakfast can stimulate bowel movements and help regulate your digestive system throughout the day.

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• Avoid Certain Foods and Drinks: Identify and avoid foods and drinks that may trigger bowel symptoms, such as caffeine, alcohol, and high-fat foods. Keeping a food diary can help track and identify potential triggers.

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Exercises to Improve Bowel Function

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While the idea of exercise to treat MS bowel symptoms may sound ineffective, I can attest many of my clients have achieved a lot of success. The exercises I will walk you through today work on strengthening the muscles needed to help control your bladder to make daily life feel easier.

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If you’re looking to see endless podcasts, exercises, and support for your MS symptoms, check out my YouTube channel - Dr. Gretchen Hawley - for additional guidance.

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Diaphragmatic Breathing (Belly Breathing)

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• Technique: Sit comfortably, place your hands on your belly, inhale through your nose allowing your belly to expand, and exhale through pursed lips, drawing your belly in. Repeat 15-20 times, focusing on breathing as deeply as possible.

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Seated Clamshell

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• Technique: Sit tall with feet and knees together, open your knees as wide as possible without moving your feet, and squeeze your glutes at the end of the movement. Repeat 10-15 times.

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Ball Squeeze

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• Technique: Place a small ball or your fists between your knees, squeeze your knees together, and relax. Repeat 10-15 times.

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Figure Four Stretch

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• Technique: Cross one ankle over the opposite knee, sit tall, and hinge forward to stretch the outer hip. Stretch for 20-30 seconds, feeling your body deepen into the movement as it grows more comfortable with the stretch.

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Seated Child’s Pose

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• Technique: Sit with your hands on your knees, drape your body forward into a relaxed slouch, and let your belly hang loose. The child’s pose doesn’t require a specific timeline to see results just lean into it as both a stretch and time to relax and connect with your body.

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I’ve Tried All These Strategies With No Relief. Is There Anything Else I Can Do?

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If you’ve tried all the diet and exercise strategies you can with no bowel relief, the next step is to talk to your trusted healthcare professional for their expertise. Since they know your body best, their recommendations will be more tailored to your needs. 

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That being said, here are a few ideas to go into your appointment with solutions to discuss:

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• Pelvic Floor Physical Therapy: Specialized physical therapy can assess and treat pelvic floor dysfunction. This therapy can involve both internal and external techniques to address tight or weak pelvic floor muscles.

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• Medication Management: Depending on your symptoms, medications can help. For constipation, laxatives may be prescribed, while anti-diarrheal medications can manage diarrhea. Adjusting other medications that might contribute to bowel symptoms is also essential. Talk to your neurologist or healthcare provider to see what changes might work for you.

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• Timed Emptying: This involves retraining your bowels by attempting to use the bathroom at scheduled times throughout the day, helping to establish a more regular pattern.

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You Can Be In Control of Your Bowel Symptoms 

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Discussing bowel symptoms openly can lead to better management and a huge improvement in quality of life. Don't hesitate to talk to your healthcare provider about any symptoms you’re experiencing. With proper evaluation and a personalized treatment plan, including the right exercises, you can effectively manage bowel symptoms related to MS.

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Remember, you're not alone in this journey, and there are effective strategies to help you lead a comfortable and active life.

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If you want to receive a wealth of information from me (plus many other MS specialists!) read my book: The MSing Link. This guide is specifically meant to make the symptoms of MS feel more manageable, allowing you to regain control and live life to the fullest.

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Do you have any further questions on how to help your MS bowel symptoms? Please let me know in the comments or DM me on Instagram @doctor.gretchen. 

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