MS and bowel incontinence

More than 14,000 members living with MS report bowel problems (difficulty in passing feces including constipation, bowel incontinence [loss of bowel control], and diarrhea). So, what’s the deal with bowel incontinence and MS? What can you do to manage symptoms?

We checked in with Meaghan Zisk, RN MPH, a nurse and Health Data and Patient Safety Clinical Specialist here at PatientsLikeMe, to learn a little bit more.

What’s incontinence?

  • Bowel incontinence is the loss of bowel control leading to accidentally passing solid or liquid stool from the rectum. You may also hear of the term urinary incontinence, which is the loss of bladder control and an involuntary leaking of urine.
  • Nearly 18 million U.S. adults, or about 1 in 12, experience bowel incontinence at some point.
  • Although it can affect any age, it primarily affects older adults.
  • There are some things that can increase the risk of bowel incontinence:
    • Frequent diarrhea
    • Urgency, which means you feel like you don’t have time to get to a toilet to have a bowel movement
    • A disease or injury that damages the nervous system
    • Poor overall health
    • A difficult childbirth with injuries to the muscles or ligaments that help support the rectum

Bowel incontinence and MS:

  • While a little less common than other bowel problems like constipation, many patients living with MS experience bowel incontinence.
    • One study of 221 patients with MS found that 54% had constipation while 29% experienced bowel incontinence.
    • Other studies suggest that as many as 5 out of 10 people with MS experience a bowel accident at some time.
  • Okay, so what’s the connection?
    • Constipation may lead to bowel incontinence because stool backs up in the rectum, which is called an impaction, and loose diarrhea passes around it.
    • People who have mobility problems may have difficulty reaching a toilet quickly when they need to have a bowel movement.
    • People with MS may have trouble feeling when they need to go due to decreased nerve sensation in the rectum.
    • Nerve issues associated with MS may also prevent pelvic floor muscles, which help with having a bowel movement, from relaxing.

What can you do?

  • Drink plenty of fluids (at least 8 glasses of liquid) and get the right amount fiber (usually about 20-35 grams a day) things to maintain regular bowel movements.
  • Plan a bowel routine. It can help with regularity and feeling relaxed and comfortable. A bowel routine involves planning to have a bowel movement at a certain time, usually shortly after a meal or hot beverage. Eventually, the body becomes used to a regular bowel control pattern.
  • Certain medications or treatments could be useful depending on the problem. For example, an antidiarrheal medication might be needed to help slow down the bowels. Fiber supplements can help with providing bulk to the stool, and enemas or suppositories may help if constipation is also a factor.
  • Pelvic floor exercises to strengthen the muscles or biofeedback retraining to increase awareness of sensations in the rectum may help manage bowel incontinence.
  • More tips:
    • Carry a cleanup bag when you go out
    • Locate public restrooms before you need it
    • Wear absorbent pads in your underwear
    • Use fecal deodorants

Talk to your doctor:

  • Bowel incontinence may be a difficult symptom to discuss with your doctor but there are many options for managing incontinence and it is important to have a full assessment to figure out what would work best for you.


Have you experienced bowel incontinence? Does it affect your social life? Share how you cope with the physical and emotional symptoms in the forum.

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