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Not constipation - It's the muscles

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    Not constipation - It's the muscles

    Everyone talks about constipation but it's really not my problem. (Just as a side point, I've never had any stomach problems at all in my life). I'm constipated but I'm really not. I don't need oatmeal or prunes or any of those OTC drugs or Natural cures. If I take any of those they give me diarrhea cause I just need to eat normally like I always did. I don't need to drink more or hold the water or let the water flush... The problem is the pushing muscles. Even diarrhea can't push itself out. (Yes, [I've seen this mentioned here before so I'm not the only one], I have to wrap my finger in toilet paper and actually start things going or even pull it out - it's disgusting and I don't want to live like that).

    So are there ways to exercise those pushing muscles? I don't need ways to soften the stool. I don't want diarrhea and it doesn't help either. How can I get the muscles to work? (and I don't want them working too much either - I want to keep control).

    So is there a solution?
    Dx 1/86 at age 23
    Copaxone 1993 - 2011 (except when I was pregnant or nursing)
    Tysabri - 2011 - present

    #2
    Hi DonnaD,

    A "neurogenic bowel" is fairly common in MS, and what you are experiencing is just one way it causes constipation (technically, it's still considered that). The muscles you are referring to are the anal sphincter muscles. In order to defecate, they have to relax. (The ability to squeeze does the opposite, which holds things in). Tensing up while trying to go only makes the problem worse, so do your best to relax.

    In MS, nerves that control your sphincters can be damaged, and the muscles can’t work the way they should. (Damage to the nerves that sense stool in your rectum can also make it hard to know when you need to use the bathroom.) You can read more here: http://www.bladderandbowelfoundation...e-sclerosis-2/ and http://www.mssociety.org.uk/sites/de...-MS-Oct-13.pdf

    There are possible solutions to strengthening these muscles, that may or may not work for someone who has MS. But, they are worth a try. Kegel excercises (pelvic floor exercises) http://www.mayoclinic.org/healthy-li...s/art-20045283 , pelvic floor physical therapy, or biofeedback therapy http://www.ncbi.nlm.nih.gov/pubmed/21825891 may prove helpful.

    But, it's also important to learn an effective bowel management program, the earlier the better, IMO. In my experience, it's not something stressed enough in the U.S. for MS. (It always addressed in rehab with patients who have spinal cord injuries.) Depending on how regular you are, it might take awhile to establish a routine that works for you. Here's an informative link (Ireland), and you might benefit from reading 10.3 - 10.7 on pages 24-26: https://www.spinal.co.uk/userfiles/p...b_no_crops.pdf
    As disgusting as what you've been doing may seem, it's actually one of the things recommended (using a lubricated glove) . (On a side note, suppositories may eventually loose their effectiveness, so it's best if they can be used as sparingly as possible.).

    The ‘gastro-colic reflex’ is an automatic response, triggered by food or drink entering the stomach, which increases movement along the colon. Taking advantage of this reflex may help push things along about 20 - 30 minutes after eating or drinking (preferably something warm), and tends to be strongest first thing in the morning. You may also find putting something under your feet so your knees are above hip level will help.

    A neurostimulator is kind of like a pacemaker for the bowel. It is surgically implanted, and sends an electrical signal to get those muscles to work. But, depending on the amount of damage caused by MS, it may or may not be effective. http://www.medtronic.eu/your-health/constipation/

    You might want to consider consulting a GI doctor, who can guide you through whatever is necessary to help you to gain better control over this problem.

    Please let us know what worked for you. Good luck
    Last edited by Kimba22; 04-23-2015, 12:14 AM. Reason: changed url
    Kimba

    “When you change the way you look at things, the things you look at change.” ― Max Planck

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      #3
      Thanks - I'm going to look into all the links you posted here
      Dx 1/86 at age 23
      Copaxone 1993 - 2011 (except when I was pregnant or nursing)
      Tysabri - 2011 - present

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        #4
        Great information, Kimba! Thanks...
        Jim S.

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