Constipation is common in people with multiple sclerosis (MS). Discover ways to manage it, from dietary changes to over-the-counter products.

If you have multiple sclerosis (MS), there’s a good chance you have bladder and bowel problems, which include constipation.

It’s important that you discuss constipation with your doctor. Unresolved constipation can actually worsen other MS symptoms, including bladder problems.

How does multiple sclerosis cause constipation?

If you have MS, constipation can develop as a result of neurogenic bowel dysfunction (NBD), which means that a nerve problem is preventing the bowel from functioning normally.

Research shows that NBD is quite common in MS, affecting 39–73% of people with the condition. The National Multiple Sclerosis Society states that constipation is the most common bowel issue for people with MS.

Below are seven home remedies that can help resolve or even prevent constipation.

A high fiber diet can help resolve constipation. It can also reduce your risk for a number of other conditions, including heart disease and diabetes.

The Dietary Guidelines for Americans recommend that women aim for 22–28 grams (g) of fiber each day and men aim for 28–34 g. Recommendations will vary by age.

The American Heart Association (AHA) recommends getting fiber from food as opposed to supplements whenever possible. Whole grains, such as whole wheat, oats, and brown rice, are a great place to start.

Other good sources of fiber include:

  • fresh fruit, such as apples, raspberries, and bananas
  • legumes, such as split peas, lentils, and beans
  • nuts, such as walnuts and almonds
  • vegetables, such as artichokes and broccoli

You might still have constipation even after adding vegetables and whole grains to your diet. In this case, bulking agents can also help.

Bulking agents are sometimes referred to as fiber supplements. They can increase the volume of your stool, making it easier to pass the stool.

Examples include:

  • calcium polycarbophil (FiberCon)
  • methylcellulose (Citrucel)
  • psyllium (Metamucil)
  • psyllium-senna
  • wheat dextrin (Benefiber)

To ensure the desired effect, make sure you read the directions for whatever bulking agent you try. You’ll often be instructed to take the supplement with at least one glass of water or another clear liquid.

It’s often best to take these supplements at night for a more regular morning bowel routine. Make sure to continue drinking plenty of fluid throughout the day.

One of the most helpful ways to ease constipation is to simply drink more fluids, especially water.

For many years, the general guideline for adults was to aim for at least 8 cups or 64 ounces (oz) a day. There are no strict guidelines now and recommended water intake will vary due to factors like body size, diet, and activity levels.

A 2016 survey conducted by the Centers for Disease Control and Prevention (CDC) looked at daily water intake in U.S. adults from 2009 to 2012. The survey found that the average man consumed 117 oz, or almost 15 cups, of water via food and liquids. The average woman consumed 93 oz or almost 12 cups.

If your water intake is very low, that could be contributing to your constipation.

Did you know?

Drinking warm water, especially in the morning, can also help you manage constipation.

Regular exercise can help reduce constipation or even prevent it from happening in the first place. Exercise stimulates the abdominal muscles, which in turn may stimulate movement in the colon.

Research has suggested that abdominal massage may help improve the symptoms of constipation.

Moving more can also improve other MS symptoms and boost your mood.

Fatigue and other factors can make it difficult to exercise. If this is the case for you, start with low impact exercises such as brisk walking or water aerobics. Every kind of activity counts.

Be sure to speak with your doctor before beginning a new exercise routine.

If you’re still looking for more options to treat your constipation, stool softeners can be beneficial. They can decrease the pain and strain of bowel movements and help alleviate some discomfort.

Docusate (Colace, Dulcolax) and polyethylene glycol (MiraLAX) are two options that do not require a prescription. Both work by increasing fluid or fat in the stool, making it softer and easier to pass.

Laxatives are not a long-term solution but may provide temporary relief. Using them regularly can actually change the tone and feeling in the large intestine. This can lead to dependency, meaning you start to need a laxative for every bowel movement.

Laxatives can be used to speed stool along without irritating your intestines. Talk with your doctor first if you think you might benefit from laxatives.

Getting into a routine can also help relieve bowel discomfort.

For example, visit the bathroom 20–30 minutes after eating to take advantage of your body’s natural gastrocolic reflex. The gastrocolic reflex triggers your bowel to contract and can make it easier to pass a stool.

What is the best laxative for multiple sclerosis patients?

Often, doctors suggest using bisacodyl and sennosides (Ex-Lax, Perdiem, Senokot). However, your doctor can recommend the laxative that’s right for you.

What does it mean to have mucus in my stool with MS?

When stool becomes stuck, it can cause bowel irritation, which can lead to the anal release of mucus.

What other digestive problems can occur with MS?

Other than constipation, a person living with MS can also experience diarrhea, an irritable bowel, and loss of bowel control.

If constipation is new for you, you should consider telling your doctor. Only a medical professional can let you know whether there’s something else going on.

Other symptoms that require a call to your doctor immediately include:

  • blood in your stool
  • severe pain with bowel movements
  • unexplained weight loss