As you know multiple sclerosis (ms) causes many different symptoms and issues within the body, and ms, specifically, can cause digestive issues, including bladder dysfunction and bowel dysfunction. Particularly, almost 2/3 of those suffering from ms have at least one digestive ms symptom for certain stretches of time. This is because the digestive system, and especially the bladder and intestinal functions most function through the central nervous system. Damage to the nerves in these areas can lead to some of the following most common issues:
- Dysphagia (problems swallowing)
- Heartburn
- Nausea
- Dyspepsia (abdominal pain, bloating, and quick feeling of fullness)
- Diarrhea
- Constipation
- Incontinence
- Bladder dysfunction
Dysphagia
- Dysphagia is a fancy term for problems swallowing. About a quarter of those suffering from ms have this problem. It is thought to be because ms has caused an impairments in the muscles needed to coordinate with one another to allow for proper swallowing. There are a few ways to help with swallowing, and they include, (a) seeing a speech pathologist to provide physical therapies to help with swallowing, (b) taking smaller bites and chewing really well before swallowing, (c) drinking more slowly, and (d) bending your head forward to better open your esophagus while swallowing.
Heartburn
- Heartburn is pretty self-explanatory. It’s a burning sensation that typically occurs around the heart. That’s why it’s called heartburn. Sometimes it leaves a sour taste in one’s mouth and causes abdominal and chest pain. About 15% of people with ms suffer from heartburn. I am one of them; however, I am not exactly sure if my ms causes my heartburn or heartburn just runs in my family or I am too stressed with work and life. A lot of doctors like to propose taking acid suppression pills, but those can have quite a bit of dangerous effects, such as throat cancer if taken on a prolonged basis. It may not be likely, but for me, it is not worth the risk. Instead, digestive bitters or HCL pepsin can be very helpful, and these are a lot less dangerous. These help your body produce stomach acid to break down and digest your food better, which helps avoid acid reflux. Recently, I had such bad heartburn and acid reflux, I began to have prolonged chest pain. I had various echos and EKGs to check out my heart, but everything came back normal. So, we figured I just have heart burn. I began taking HCL pepsin on a regular basis, and my heartburn and chest pain is now under control. Also, because HCL pepsin and digestive bitters generally help with digestion, it is also helpful to ms patients suffering from these other digestive issues, such as constipation.
Nausea
- Usually when someone is nauseous, they throw up. About 10% of people with ms suffer from nausea that does not turn into throwing up. This could be because of the ms medications or some other unknown causes. Tecfidera causes nausea in quite a few ms patients—especially when Tecfidera is started. I take Tecfidera, and this doesn’t happen to me. However, I always take it on a full stomach. Also, there are a few natural ways to get rid of nausea. These include ginger and peppermint oil.
Dyspepsia
- Dyspepsia is a fancy term for abdominal pain, bloating and feeling full quickly. About 1/3 of those suffering from ms have this issue. Sometimes this happens to me. I think it’s because those with ms have a lot of inflammation, and a way to fix this problem is to try to limit the inflammatory foods that we eat. This is why I went gluten free. Also, eating smaller meals and avoid fried and spicy foods can also help.
Diarrhea
- Diarrhea is comprised of very loose or watery bowel movements. An increase in the frequency of bowel movements can also be considered diarrhea. Suffering from diarrhea is not as common of an ms side effect as constipation. However, chronic constipation can also cause diarrhea surprisingly. What can happen is that the stool becomes so impacted in the intestine that there is a leakage around it. This is definitely tmi and more than I ever needed to know about this, but hopefully, this is somewhat helpful. I think the best way to counteract diarrhea is to take a very high-quality probiotic on a regular basis that helps regulate your digestions and bowel movements. I have said this before, but my absolute favorite is the megasporebiotic by micro biome labs. It has made it so that my digestion is regular and consistent, because like many other ms patients, ms affected my digestion and bladder sadly.
Constipation
- Like heartburn, most people know what constipation means. It means you have hard or infrequent bowel movements. About 40% of those with ms suffer from constipation at some point. Constipation can happen with ms patients due to an interference with the intestinal material needed to move through the colon or diminished coordination of the intestinal, anal and rectum muscles. It can also happen from lack of exercise and the medications that are taken to control the progression of disease activity. As we know, those with ms suffer from fatigue, and fatigue causes you to move less often. This can cause constipation. Eating more fibrous foods and have a well-balanced diet can help with this and trying to exercise and move more often can also help, but if there is a real issue with muscle communication, some sort of physical therapy is necessary.
Incontinence
- Incontinence can be the inability to hold in your bowel movements or urine depending on the issue. This can happen because the effects of ms in ms patients cause defects in motor functions including damage to the pelvic floor or rectal and anal muscles. Taking a probiotic can really help with this, because it can regulate our digestion and bladder such that you have more time to access a bathroom before it is urgent, and it can make it so your bowel movements are better formed. This helps lessen the likelihood that there will be an accident. Also, like noted above, physical therapy can help strengthen the pelvic floor and other intestinal muscles.
Overall, about 2/3s of people with ms experience bowel dysfunction, including constipation, diarrhea, and incontinence. If this is you, I definitely recommend trying a really good quality probiotic to help.
Bladder Dysfunction
- Bladder dysfunction can include frequent urination, urgency, and dribbling. Conversely, it can also include hesitancy or urinary retention. This is similar to incontinence, but it is not as drastic and disruptive to your everyday life. This feeling of urgency was one of my first symptoms prior to being diagnosed with ms, but since going on Tecfidera and taking my previous probiotic, I generally have this sensation under control.
Generally, the first step is figuring out if any of the above common issues are affecting you. They are all a lot more common than you would think, so it is not something to be embarrassed about or worried you are alone. You are definitely not alone. It is important to talk about it and figure out if medication, supplements, physical therapy, change in diet or exercise would help alleviate some of the discomfort, so that you can live as normal of a life as possible. And, if all of those solutions do not work, it might be worthwhile to look into your gut health. Sadly, those of us with ms have different gut microbiome than “normal” people. It’s unclear if ms caused this difference or this difference is what caused ms. Regardless, people with ms have less prevotella histicola bacteria in their gut, which makes the gut imbalanced. Your gut is the center of all digestion, so if your gut imbalanced, that could be the reason you are having digestive issues and inflammation for that matter. A few ways to balance your gut are listed below:
- consuming more fiber (i.e. fruits, veggies, beans, and nuts)
- drink less alcohol
- eat fermented foods (i.e. kimchi, yogurt, kefir, pickles, and sauerkraut)
- try to limit stress (i.e. rest, yoga, meditation, exercise in general, and journaling)
- use antibiotics sparingly
- consider taking a probiotic supplement (i.e. microbiome labs megasporebiotic)
The above solutions can help balance your gut, which can help alleviate digestion issues due to ms. Also, I want to note that I am very far from being a doctor. So, this is not medical advice, and you should talk with your own doctor before beginning to take anything. I am just simply sharing the information I have learned over these past 4 years of having ms in the hopes that I can help even just one person.
Here’s to being well preserved.
Always,
Taylor
