3 posts tagged “lifestyle choices”

MS constipation blues? See 12+ treatment options

Posted 2 days ago by

Feeling “irregular” on the regular? Constipation is a common issue for people living with multiple sclerosis (MS), affecting as many as 40% of patients. Over 15,000 MS members on PatientsLikeMe report experiencing bowel problems and of those, about 47% have reported it as “moderate” or “severe” – take a look here. With help from our team of in-house health professionals, we took a closer look at this taboo topic, as well as available treatments.

What’s going on with constipation?

Typically, constipation is defined as having fewer than three bowel movements a week. But only you know what’s “regular” for you — constipation isn’t just about bowel movement frequency and averages. It can also mean going #2 less often than what’s normal for you – or having stools that are hard, dry or difficult to pass.

Other symptoms that can come with constipation include incomplete evacuation of stool, abdominal bloating, cramping and straining. When constipation becomes chronic or interferes with your daily life, it may be time to seek treatment.

What’s the constipation/MS connection?

MS and some medications used to treat it may cause constipation. MS damages the nerve cells of the intestines and can slow down and impair the muscles that usually push food along. Constipation can also lead to bowel incontinence.

Constipation, the most common bowel complaint in MS, can be caused by poor diet or physical inactivity which can disrupt the digestive system. Symptoms like difficulty in walking, fatigue, spasticity and dehydration can also contribute to constipation. Medications used to treat MS – like antidepressants or bladder-control medications – can also cause constipation. These drugs block the chemicals in the brain that are responsible for involuntary muscle movement or contractions.

Decreased physical activity, poor diet, dehydration, genetics and other health conditions can also cause constipation.

What lifestyle changes can help?

Talk with your healthcare provider to decide whether and how to treat your constipation, keeping in mind all your medications and other condition(s). Also, ask about nutrition counseling and exercise ideas.

Here are some lifestyle tweaks to consider:

  • Establish a regular time of the day for bowel movements. Having a consistent time to go each day trains the body to regulate bowel movements.
  • Eat regular meals that include fruits and vegetables, whole grains and other high-fiber foods.
  • Avoid low-fiber, starchy foods like white bread. These can “plug up” your system.
  • Try drinking six to eight 8-ounce glasses of hydrating fluids (ideally water) per day.
  • Steer clear of alcohol or coffee – they can worsen constipation. Maintain an exercise routine, if possible. Regular physical activity can also help move things along.
  • Try keeping a diary to track symptoms, diet, medications and bowel movement (or lack thereof). See if there are any patterns that may give clues about the cause of your constipation.

How about OTC options?

If you think you need more than just lifestyle modifications to alleviate your constipation, talk to your health care provider about which (if any) over-the-counter (OTC) or prescription treatment options might be best for you – and how often to use them. You’ll find several treatments at the drug store, but they work differently, and some should be used sparingly. Your provider can help you decide which treatment would be best considering your symptoms, medical history and other medications you’re taking. Here are some OTC examples:

  • Emollient laxatives (also known as “stool-softeners”): These allow more water to mix with stool making it softer and easier to pass. Example: Colace (docusate)
  • Bulk-forming laxatives: These are mixed with an 8-ounce glass of water or juice. They contain fiber that will “bulk-up” the stool, which helps it move along. They also soften the stool by allowing more water to remain in it. This means softer, larger stool that is easier to pass. Examples: Benefiber (guar gum), Citrucel (methycellulose), Fibercon (polycarbophil), and Metamucil (psyllium)
  • Lubricant laxatives: These lubricate the intestines to help soften the stool and make it easier to pass. They should only be used for a short time because they can absorb vitamins, preventing absorption into the body. Example: mineral oil
  • Osmotic laxatives: These help draw water into the intestines to soften the stool. They may cause gas when first used. Example: Miralax (polyethylene glycol 3350)
  • Saline laxatives: These often have magnesium sulfate, magnesium phosphate or magnesium citrate in them. By retaining water in the colon, these drugs soften the stool, similar to osmotic laxatives. Examples: Milk of magnesia (magnesium hydroxide), magnesium citrate
  • Stimulant laxatives: These should be used sparingly because they can cause diarrhea/cramping and – if used long term – colon damage. They help stimulate the muscles of the intestines to move things along. Examples: Doculax (bisacodyl), senna, senna tea
  • Enema products: These stimulate the colon using a stream of fluid introduced via the rectum. The fluid also softens the stool, making it easier to pass. Some enemas include laxative ingredients, such as docusate sodium and mineral oil. Example: Fleet enema (saline enema)
  • Suppositories: These medications are inserted into the rectum. There are two types: Glycerin suppositories lubricate the rectum; bisacodyl suppositories stimulate movement. (Doculax suppositories)

Several combination products and prescription products are also available.

Some people with MS have noted that the Squatty Potty – an ergonomic footstool that helps position your body better for using the toilet – can help relieve constipation.

What treatments/lifestyle changes have you tried for constipation? Join PatientsLikeMe to chime in and help others in the community.

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Why these 5 Olympians with health conditions are #1 in our hearts

Posted 6 months ago by

The 2018 PyeongChang Olympic Games have come to a close. Did you happen to catch any of these 5 Olympians with health conditions (recently highlighted in The Mighty)? Their performances were inspiring — but their perspective on living with illness is what’s really golden.

U.S. pairs figure skater Alexa Scimeca-Knierim developed a rare, life-threatening gastrointestinal disorder that caused episodes of vomiting and severe weight loss and has been hard to diagnose. She had three abdominal surgeries and has shown her scars on Instagram.

After a long and painful recovery, Alexa was able to return to skating. “My whole outlook changed,” she told Team USA. “I was grateful to have the chance to fall instead of stressing out over falling or not. Was a fall as big of a deal as a drain getting pulled out of me? No, not at all. I was grateful.”

In PyeongChang, Alexa and her husband/skating partner, Chris Knierim, took home the bronze medal in the figure skating team competition and placed 15th in the pairs competition.

Alexa shared this photo with SELF for a video about her health problems and extraordinary road to the Olympics.

American long-track speed skater Brittany Bowe sustained a concussion when she collided with another skater in 2016. Later, after fainting multiple times, she was diagnosed with post-concussion syndrome and a lesser-known condition called “POTS” or postural orthostatic tachycardia syndrome. POTS can be a years-long or potentially lifelong condition, and it affects the body’s ability to control blood pressure or heart rate as it should when you stand up, which can cause dizziness, lightheadedness or fainting.

“There would be times where people I’d not seen in a while [would say], ‘Oh you look great, you look so healthy…’ And I’m just dying inside because I know my head isn’t on my shoulders where it normally sits,” Brittany said in a video she shared on Instagram. (Her comments reminds us of what many patients with invisible illness hear from “the normals”: “But you look so good!”). She received specialized care and coaching for people with POTS and was able to qualify for the 2018 Olympics.

Canadian snowboarder Spencer O’Brien started feeling serious joint pain and stiffness in late 2012, and she originally attributed it to normal wear and tear from her sport. It took until 2014 to get the right diagnosis (rheumatoid arthritis) — and she went through bouts of depression before finding out what was wrong.

“A big lesson I learned during that experience was to be an advocate for my health,” Spencer told The Inertia. “I think our intuition is so strong, like I knew something was wrong with me beyond the injuries, and I did voice that, but we ran a number of tests, which came back clean.” She had to push for additional tests, which pointed to RA and helped her get on the right track with her treatments so she could continue her sport.

U.S. cross-country skier Kris Freeman was diagnosed with type 1 diabetes in 2000 (at age 19) after a routine blood test run by a U.S. ski team physiologist. PyeongChang was his fourth Olympics appearance. During the 2006 Olympic Games, The New York Timesprofiled Freeman and his unique treatment/training regimen. (Little known fact: Insulin is on the anti-doping list, and athletes who need it for medical treatment, like Kris, have to apply for a waiver — “one more hurdle that comes with managing diabetes,” The Times noted.)

“The last few years have been tough with some pretty public setbacks with my diabetes,” Kris told Lilly Diabetes (he’s a speaker at their diabetes summer camps for kids). “But, I’ve been able to stay positive and maintain my nutrition and overall diabetes management, which has helped me tremendously. I want to show everyone, especially children, that they can and should keep reaching for their dreams.”

Marc Oliveras, an alpine skier from Andorra, was diagnosed with lupus (SLE) in 2014 and took a break from his sport so he could treat the autoimmune disorder, which was affecting his skin, kidneys and blood. “After a long recovery and a difficult summer, where I had to start first knowing the unknown [my disease], being able to compete is already a reward,” he said in his athlete profile.

It’s worth reading The Mighty’s article to the end, because the author reminds people living with health conditions that everyone’s illness and situation is different: some people may have milder forms of a disease, respond better to treatment, or have better access to world-class care.

Also, the media tend to share a boiled-down or glossed-over features on athletes triumphantly “overcoming” their condition, rather than showing the everyday challenges or realities of managing their condition while training for their sport. Fortunately, athletes like the ones above are raising awareness: they’ve lived, breathed and trained with their condition, and they feel grateful to even be able to compete. That kind of perspective is pure gold.

Do any of these quotes or stories strike a chord or inspire you? Join the conversation on PatientsLikeMe.

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