Constipation & nutrition

Constipation and Nutrition
Many people with multiple sclerosis have bowel problems[1].  Most commonly in the form of constipation.  Good bowel health is really important and worth the effort to make some dietary changes which can significantly help.
  1. Fiber can assist with relieving constipation. There are two types of dietary fiber - soluble fiber and insoluble fiber. Most adults get less than half the fiber they need each day.  Insoluble fiber is found in skins of fruit and vegetables, seeds, whole grain bread and brown rice. You should increase these foods in your diet if you are constipated. Soluble fiber (potato, bananas, white rice, white bread, oats) should be limited when you are constipated. Here are some key fiber tips:
  • Increase fruits and vegetables
  • Keep skins on fruit and vegetables
Increase whole grains, wholemeal breads, cereals, muesli, nuts, pastas, oats, beans, and lentils.
  • Drink more fluids especially water as you increase fiber.  This is important as sometimes fiber can slow down bowel movements if it is not accompanied by enough water.
  • Increase fiber slowly to prevent bloating and intestinal discomfort.
Consider supplementing with bulking agents such as psyllium seed husks (lots of water must be taken with psyllium or they will make constipation worse), bran, or oat bran
  • Add ground linseeds/ flaxseeds to your cereal each day.  This way you are getting great omega 3s and fiber.
Add more fiber in your diet by sprinkling fiber onto your cereal, adding in your muffins, pancake mix, casseroles and smoothies.
  1. Prioritise the urge to move your bowels.  Do not postpone, go immediately to the toilet. 
  2. Consider having a "dose of fiber" at the same time each day to establish a routine.
  3. Make your first beverage of the day something hot, such as hot water or apple cider, or drink 1/2 to 1 cup of prune juice in the morning to get things moving.
  4. Take probiotics or eat more fermented food to colonise your bowel with healthy bacteria.  This has been shown to help with constipation.
  5. Eat regularly as this is good stimulation for the bowels.
  6. Eat prunes and figs to help draw fluid into the bowels.
  7. Have porridge in the morning or a good quality muesli.
  8. Cows milk can contribute to constipation in some people with milk protein intolerance or allergy.  Limit your dairy products if you think this is an issue. 
  9. Adopt correct toileting position: 
 correct toileting position
[1] Multidisciplinary association of spinal cord injured professionals. Guidelines for the management of neurogenic bowel dysfunction in individuals with central neurological conditions. London: Multidisciplinary association of spinal cord injured professionals. 2012:


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