Coping with MS Constipation: Reader Tips

Check out what has helped other people with MS stay regular...

Constipation is a very common symptom of multiple sclerosis (MS). It is also one that we are pretty reluctant to talk about, even though it can be extremely uncomfortable. Some people with MS even report that severe constipation has been a trigger for their "MS hug" and some spasticity.

When I have searched the Internet for "constipation relief tips," I have usually come up with the fairly generic missives to "Eat more fiber!" "Exercise!" "Drink more water!" Usually next to the text, there is a picture of a smiling 20-year-old in exercise clothes holding an apple.


I asked readers with MS to share some of their tips for relief of MS-related constipation. Here are some of the responses that I received: 

  • Massage has definitely helped. So has a daily tablespoon of coconut butter (organic, unrefined, extra virgin, expeller pressed), stomach-firming exercises like crunches, and drinking plenty of water. Managing the ratio between calcium and magnesium intake is also important for me. Too much calcium fosters constipation.Too much magnesium results in loose stools.
  • I bought a juicer, so I now juice fruits every day. it took 3 months to help my bowels, but now I don’t need the glycerine suppositories or other medication that I was prescribed. My bowels feel normal again. I try to use 5 different fruit and occasional vegetables, and I feel no fear of not going.
  • Drink more water with psyllium fiber!
  • I use “Senna-S”, which is a stool softener with a laxative combined. It works great for me.
  • Instant oatmeal & 1/2 cup fresh pineapple every day and lots of water throughout the day work for me!
  • I have always had constipation. Was it MS or the result of an ugly 1970s diet when we knew nothing practically about nutrition and almost everyone’s parents still smoked? Up the raw fruits, vegetable, and fiber-dense foods. Exercise to the best of your abilities. Even when you do everything you can, constipation can really be a bugger! Of course, like a lot of MSers, I urinate every second. I have often remarked that I should pour my pot of coffee directly into the toilet and eliminate the “middle man." Maybe frequency of urination, another MS staple, has deprived me of precious liquid that rightly belongs to my bowel movement!
  • My constipation issues started when my MS began when I was about 14 years old. It got really bad several years ago. I have to take several medications and supplements to relieve my severe constipation: Amitiza 24mcg and Colace 50mg, both twice daily; fish oil 1400mg, and a probiotic (that also has a prebiotic) taken once daily. Oddly enough, drinking a Chocolate Boost Plus nutritional supplement daily helps my constipation. I have a friend who is a licensed massage therapist who showed me how to correctly do a colon massage. So, if all the above fails to help my constipation, I will do the colon massage which usually works well.
  • Most MSers are deficient in magnesium. I found that a daily magnesium supplement solves all constipation issues (dosage is an individual thing… must experiment). Magnesium is also effective (along with potassium) in reducing or eliminating spasticity and it is beneficial for those who tend to have sleeping problems. I eat daily fruits and vegetables, and drink ample water, but without the magnesium, there is NO amount of stomach massage or exercising that can make me ‘go’ regularly.
  • Magnesium in the soft gel form is the only thing that has worked for me. Start off with 1 400 mg capsule and see if that works in the morning or evening, I needed one at each time of day. Everyone is different! “Happy emptying!"
  • I eat 5 to 6 prunes daily and also eat 1 tablespoon of ground flax seed daily, along with lots of water and some exercise. This keeps me totally regular!
  • I have found something that works for me to help with constipation. I now take 500 mg magnesium (2 pills) each day with a meal and find that I am now as regular as I have been in years. Have not had to use Milk of Magnesia or Miralax or any other meds for over three months. Have recommended it to other friends who are also having great results. The dosage may need to be adjusted for each person: I started with 250 mg and worked up to 500. This is the best thing I have found for the problem. No side effects and no mess!!
  • I have only had this issue the last couple of years and I have had MS for at least 10 years. I am trying to get more exercise and drink more water. I would love to hit the prunes, but am also diabetic and prunes are a bit too concentrated in the sweet factor. I am surprised to hear about magnesium! I was an RN and worked for years in the acute care setting and in home health care and helped others deal with this issue, but never once heard about magnesium. I will certainly give this a try and I will hope things come out right!
  • I document on my Copaxone daily journal whether I used my prescription laxative daily or twice daily. If I notice that I haven’t had a BM in 4 or 5 days I will give myself an abdominal massage but usually, my stomach has already informed me from my severe stomach pain. But then, I also take four other medications on a daily basis to help my chronic constipation. Medicare wasn’t going to pay for this prescription laxative. But when I provided to them all of the other OTC laxatives have tried and things I have done to find relief (including telling Medicare I use colon massage too), they finally approved the prescription. Still, after all the laxatives used, I still have to use colon massage to help me. I have a friend who is a massage therapist. She told me to follow the same path as the colon, much like you described. I do it this way: from the right side of the navel, out to the edge of my right hip bone, down toward the pelvic bone, then across a little to the left side and up toward the left hip bone, up to the waistline and repeat. My massage is not with small circles or strokes but quick, firm pressure. I guess each has to experiment with this to determine the best massage. I use this massage whenever—not waiting until two hours after eating because I don’t have BM’s like normal people anyway. I don’t have BMs in the AM; they usually happen in the PM. Mine not after eating, but usually at almost midnight, or some strange hour.
  • I take about 200 mg of magnesium and 1000 mg of fish oil capsules every evening. Calcium tablets give me constipation so I get my calcium from almond milk. Being lactose intolerant and gluten sensitive, I avoid cow’s milk and have taken wheat out of my diet. Interestingly, since doing so, I’ve found many of my bowel issues have miraculously cleared up. I now make my bread using ground flaxseed meal and almond flour. You can find lots of good low carb recipes for these online.
  • I too suffered from severe constipation. Nothing worked. I had a transit test and it showed that after 5 days the medicine (little silver things that show up in X-rays) most were still in the stomach area, and a few in the upper bowel. It was painful and the only way I could get anything out was (I know this sounds gross) I had to manually remove what I could reach. It was determined that my large intestine was paralyzed, my central nervous system is out of whack. I ended up having surgery to remove my large intestine. I should be having 6-7 movements a day now (that would be normal) but I still have difficulty. 
  • I use 1 scoop of Miralax in my coffee in the morning and use a fiber supplement called “Unifiber” that I can get at my local pharmacy (I also have purchased it online). What I love about Unifiber is that it’s only insoluble fiber, the type of fiber that helps move things along in the gut, which is what I need. Metamucil and other fiber supplements like it contain both soluble and insoluble fiber. The soluble fiber interferes with the absorption of medications, and the instructions on Metamucil say to take it 2 hours before or after taking prescription meds. Well, I take meds 4-5 times a day, so it became really hard to figure out when to use it! I was very happy when I discovered Unifiber since I can take it along with my morning meds. So with exercise, plenty of water, lots of veggies and fruit, the Miralax and Unifiber helped me get out, and stay out, of the “trap” of constipation.
  • I’ve tried additional fiber, prune juice, Miralax, drinking what seemed like at least a gallon of water a day, extra fruit, magnesium, and other “tricks” that didn’t help. A friend, who doesn’t have MS, recommended a particular herbal tea, Meridian Herbal Trim tea, that contains TZE-BEI and MALVE VERTICELLATA. At last, something works! I use one tea bag and three cups of boiling water. I let it steep for five minutes. I drink one cup of it hot, refrigerate the rest, and then have only about a half cup a day. The first couple of days, I went a couple of times a day. Haven’t been using it long enough to have seen a “pattern” for how long it takes to experience the results. Mostly I’m just pleased that something works!
  • I find that since I started a gluten-free and dairy-free diet the constipation is a lot better.

Bottom Line: For me, constipation is one of those things that is much better to prevent than to try to treat once it gets uncomfortable. As mentioned in many of the tips above, once you find something that works for you, do it consistently for best results.

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