4 posts tagged “dietary recommendations”

MS constipation blues? See 12+ treatment options

Posted 2 months 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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Zoodles! Let’s dish on lupus/food + swap recipes

Posted 3 months ago by

If you’re living with lupus, have you found any particular foods that affect you and your condition — for better or worse?

Member Jeanette (JeanetteA6872), a member of the 2018 Team of Advisors who’s living with systemic lupus erythematosus (SLE), shares which ingredients she tries to include or avoid in her diet, plus three of her favorite recipes (psst—one involves zoodles!).

Food Q&A with Jeanette

Jeanette says she turned to dietary changes when she stopped taking Plaquenil due to severe side effects, including retina damage. “I had nothing to lose — I signed up for Tony Robbins’ Unleash the Power Within [a self-help program] that made me look at myself and my relationship with food differently,” she says. “I started logging my food intake for a few weeks on and off, I noticed how some of my favorite foods were causing me some issues ranging from stomach pains to full inflammation. That’s when I started paying close attention to what my body was telling me and I needed to do something about it.”

Here’s what else she shared with us in a recent Q&A. Everyone is different, so these foods and dietary changes may not affect you and your lupus the same way. Talk with your doctor or a registered dietitian about finding foods that work for you.

Have you noticed any specific ways that your diet or certain foods affect your symptoms?

I didn’t go on any specific diet at first, I started eliminating certain foods like sugar (which was causing major fatigue and pain), garlic (causing major inflammation in my knees), eggplants (fatigue and pain in my feet), bean sprouts (stomachaches) and alfalfa (full inflammation and full flare) — some of the known foods that lupus patients shouldn’t eat [learn more at lupus.org].

Then I noticed how meat was causing me fatigue and I noticed inflammation directly in my knees. I tried giving up red meat for two weeks, and I felt good and noticed a reduction of pain. Then I gave up chicken the following two weeks and felt even better. It was so amazing that I decided to give it up for good. After the first few months without meat, my doctor started noticing my blood work was improving drastically, so she began reducing my medications since I was no longer flaring or feeling pain. After a full year she reduced all of my medications to zero and even stopped my infusion.

I notice that if I eat too many potatoes like French fries, baked potatoes or mashed potatoes, as well as tomatoes, salsa, mushrooms and peppers, ice cream and cheese, I feel a little stiffness, so I know it’s too much. I really try to avoid processed and fried foods in general as I immediately notice stiffness.

I do still eat gluten and dairy products, just not every day. Everything in moderation works best, I’ve noticed. If something bothers me this week, I know not to repeat it.

Are there any foods that you try to eat often?

I don’t eat many of the same foods daily. I drink my shakes, but I like a variety of foods from pastas, salads, homemade cauliflower crust pizza, rice and beans, and I started eating fish again, so that’s more protein. There are meat substitutes like Gardein, Beyond Meat and black bean burgers that make great meals.

With the new eating style, I knew I needed to find some type of supplement for my vitamins and minerals because you get so many different vitamins from animal products and I wasn’t eating the same way as before. I tried Herbal Life, then Shakeology, then Modere, and none agreed with me because I have so many allergies. So I gave Isagenix one last try. It was perfect for me. Wow — my blood work started coming back so good, my doctor asked me what my secret was, since I [also] started working out and feeling even more amazing. I feel as if my life is back.

Do you have a few favorite recipes you’d like to share?

(Click on the links for a printable version of these recipes picked by Jeanette!)

Veggie scramble – This veggie-packed egg dish is scrambled in coconut oil and topped with avocado and tomato

Citrus fish tacos – Lettuce leaves serve as the “tacos” in this tilapia recipe, complete with mango salsa

Creamy zucchini pasta with shrimp – “Zoodles” (julienne-peeled zucchini “noodles”) and an avocado-basil “cream” sauce? Yum!

Which foods do you eat or avoid with your lupus in mind? Please add a comment below or join PatientsLikeMe to chime into this forum discussion!

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