Irritable Bowel Syndrome and Multiple Sclerosis – What is the Connection?

If you’ve been diagnosed with multiple sclerosis (MS) you might be surprised to learn that you’re more likely to develop irritable bowel syndrome (IBS).

Learn about the connection between these two conditions, the kinds of treatment available, and some advice from Dr. David Levinthal, director of the UPMC Neurogastroenterology & Motility Center and assistant professor of medicine in the Division of Gastroenterology, Hepatology, and Nutrition at the University of Pittsburgh.

What Links Multiple Sclerosis to Irritable Bowel Syndrome?

MS is an inflammatory disorder that targets a person’s central nervous system — the brain and spinal cord. It’s there that the link between MS and IBS begins.

“Because the brain and spinal cord influence your gut’s actions and sensations, MS-based disruptions of sites in the brain or spinal cord could impact gut function and thus cause symptoms,” Dr. Levinthal says.

Physicians at UPMC are conducting research to figure out why up to 40% of MS patients suffer from constipation and abdominal pain that meet the symptom criteria for IBS.

“This research will also help physicians to understand the mind-body connection in general,” he adds, “at the same time defining better treatment options for patients with MS who suffer from gastrointestinal issues.”

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What Gut Complications Do Some MS Patients Face?

Constipation is one of the most common and impactful challenges facing patients with MS. This may occur for a few reasons. MS could impact a person’s neural control of the gut. Alternatively, impairment in skeletal muscle function could impact the ability to have a normal bowel movements or influence the efficiency of the colon’s transit of stool.

“For example, bowel movements require abdominal muscle contractions to generate the force of ‘expulsion,’ and weak abdominal muscles make it much more difficult to expel stool,” Dr. Levinthal says. “It is also well-known that the colon’s actions are impacted by activity level, and many MS patients suffer from impaired mobility that can lead to constipation.”

Another common issue that MS patients experience is trouble with swallowing, which can limit dietary choices and, in some cases, even lead to choking episodes or inadvertent passage of food or drink into the lungs. This can occur because MS affects brain function, thus disrupting the nervous system regulation of the refined patterns of muscle coordination needed for swallowing.

What Treatment Opportunities are Available for MS Patients with Constipation?

Dr. Levinthal suggests adding fiber to your diet if you’re experiencing constipation. Prunes are one such high-fiber food that can help to change the consistency of stool and speed its passage through the colon. Medications are also available that can help to stimulate the gut for easier bowel movements.

“There are also physical therapy exercises and techniques to help with muscle coordination relating to swallowing and bowel movements,” Dr. Levinthal says. “Many patients with these issues benefit from discussion with speech and physical therapists.”

Another tip — as you’re eating, try:

  • Taking smaller bites, then chewing slowly.
  • Positioning your chin down to help with easier swallowing.
  • Elevating your knees above your hips to intensify your squatting while on the toilet to help improve the efficiency of having a bowel movement.

Before pursuing any treatment options, talk with your primary care practitioner, neurologist, or gastroenterologist about what techniques might work best for you.

For more information, visit our website. To schedule an appointment, call the UPMC Digestive Disorders Center at 1-866-442-7876 (4GASTRO) or request an appointment by completing this form.

About Digestive Disorders

The UPMC Digestive Disorders Center cares for a wide range of gastrointestinal (GI) conditions and diseases, from diagnosis to treatment. Whether your digestive condition is common or complicated, our experts can help. Upon referral from your physician, we coordinate your testing and treatment. If you have a complicated condition, we can refer you to one of UPMC’s digestive health centers of excellence. Find a GI doctor near you.