Because bowel complications are so common with multiple sclerosis (MS), the keys to comfortable bowel management are preventing the problems in the first place and developing a regular bowel regimen. But, remember, “regular” doesn’t necessarily mean “daily.” Instead, it just means at an interval that’s normal for you (probably every one to three days).
The following strategies will help you keep things moving along:
Drink six to eight glasses of liquid per day.
Eat a diet that’s high in fiber, such as raw fruits and vegetables, nuts, seeds, and whole grain cereals and breads.
Pick a consistent time of day for a relaxed bowel movement. The ideal time is about 20 minutes after a meal (breakfast is generally best because you’re at home before the start of your busy day), when your natural gastro-colic reflex is working to move contents through the bowel.
Sometimes, even the best regimen in the world doesn’t solve the problem. If this is the case for you, medications can be useful. But the trick is to use the least potent one that does the job — you don’t have to bring in the canons if a BB gun will do.
Work closely with your doctor or nurse to find the program that works best for you. Some combination of the following over-the-counter strategies may be the most helpful:
Daily use of a high-fiber product like Metamucil or Citrucel may be sufficient to promote regular bowel movements.
Regular use of a stool softener like Colace can help with hard, dry stools.
If the first two aren’t sufficient, a laxative, such as Miralax, Pericolace, or Perdiem, can help manage constipation. Stronger laxatives should be avoided if possible because they’re generally habit-forming.
Glycerin suppositories may be sufficient to stimulate a bowel movement. If that isn’t effective, a Dulcolax suppository may do the trick.
Enemeez Mini-Enema is a lubricating suppository that safely stimulates bowel action.
You can occasionally use Fleet or other enemas to address a major blockage, but you shouldn’t use them on a regular basis because your bowel may become dependent on them.