Neurogenic bowel dysfunction (NBD) is a common symptom of multiple sclerosis.1 This is because MS causes damage to parts of the central nervous system that are responsible for regulating the gastrointestinal tract. It is not uncommon if you live with MS to experience some form of bowel dysfunction, and so, if bowel issues are a part of your life, you are not alone.
More than 7 out of 10 people living with MS will experience bowel issues at some point in time.1
Digestion is the breakdown of food into smaller and smaller bits, until they can be absorbed and assimilated into the body. The bits that are not absorbed are then expelled from the body as waste.
Throughout the digestive process, the brain sends and receives signals from the bowel.
The bowels function in the latter half of the digestive process, after food has passed through the stomach. After being mixed with stomach juices, food is passed to the small intestine, which absorbs the nutrients, vitamins, and minerals. The large intestine, also known as the colon, then takes over, absorbing the remaining water and salt. This makes the stool firmer and easier to pass.2 Wave-like movements push stool through the intestine towards the rectum.2
When the stool reaches the end of the colon, it is stored in the rectum. As the rectum fills, nerve signals tell the brain when it is time to poo.3 The internal sphincter then relaxes automatically when it is time to empty the bowel, allowing stool to move to the anal canal, ready for expulsion. The external sphincter then relaxes when defaecation is appropriate.
If MS interferes with the communication between your bowel and brain, bowel issues may arise.
MS can disrupt the neurological pathways that directly control bowel functions. This is what can lead to bowel issues. NBD can emerge in people living with MS in many ways but can normally be grouped into two areas.
The severity of symptoms can fluctuate over time, and constipation and stool leakage may or may not be experienced at the same time.1
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