Constipation in MS can result from the absence of normal increment in colonic motility after eating. Chia et al found that paradoxical puborectalis contraction is present in MS patients and can lead to constipation. Other nonneuro-logical factors that contribute to constipation are lack of exercise arising from immobility, inadequate dietary fibre and hydration, and the effects of certain medications such as anticholinergics used to control irritative bladder symptoms and tricyclic antidepressants.
The pathophysiological causes for fecal incontinence in MS patients are related to poor voluntary squeeze pressure , abnormal rectal sensation and obstetric injury causing weakness of the anal sphincter (a peculiar contributing factor in multiparous women with MS). No statistically significant correlation was detected between gastric emptying abnormalities and the Expanded Disability Status Scale score in the current study. In agreement with our results, Minderhoud et al and Chia et al found that severe constipation could occur in patients with little general neurological disability due to MS. You will always come across offered by a reliable pharmacy.