What common digestive problems are there in Multiple Sclerosis (MS)
Multiple Sclerosis is a neurological autoimmune condition that affects the brain and spinal cord; the immune system attacks the protective coating around the nerves called the myelin sheath. This results in the body’s communication system deteriorating. Once diagnosed, MS stays with you for life, however, there are treatments that can help you manage your symptoms.
In the UK, over 100,000 people are diagnosed or have MS, and symptoms usually start in people in their early 20’s and 30’s and progress more in their 40’s and 50’s. The symptoms of MS do not develop until damage to the myelin sheath has occurred; this means that when the neurological symptoms are present, some damage is irreparable.
Symptoms of MS include fatigue, difficulty mobilising, vision problems, incontinence, irregular bowel habits, numbness or tingling in different parts of the body, muscle stiffness and spasms, problems with balance and coordination, and problems with thinking, learning and planning.
MS starts in 1 of 2 general ways; relapses or gradual progression. Someone with relapsing-remitting MS will have episodes of new or worsening symptoms, known as relapses, and symptoms gradually worsen over time. In primary progressive MS, symptoms gradually worsen and accumulate over several years, and there are no periods of remission, though people often have periods where their condition appears to stabilise.
Your digestive system is home to different types of bacteria, fungi, and viruses. The main role is to help the immune system by absorbing nutrients and removing toxins. Factors including lifestyle, diet, antibiotics, and stress can disrupt the balance. Research suggests that two strains of gut bacteria ( Acinetobacter and Akkermansia) is four times higher in people with MS - these are known to increase inflammation. Also, the gut bacteria Parabacteroides was lower in people with MS and this strain reduces inflammation.
Below are some of the common digestive issues that those with Multiple Sclerosis suffer with:
Acid reflux
Bowel dysfunction - caused by muscle spasms that impacts signals between the central nervous system and the digestive system.
Persistent hiccups - due to spasms in the diaphragm due to damage to the vagus nerve
Adverse effects of medication that cause heartburn, bloating, nausea, diarrhoea and constipation
Gastroparesis is a disorder that slows or stops the movement of food from the stomach to the small intestine. Healthy stomach muscles that are controlled by the vagus nerve contract and break up food to move it along the gastrointestinal tract. When the vagus nerve is damaged, the stomach walls stop working normally resulting in ni food moving slowly from the stomach to the small intestine, and in some cases, it stops moving altogether. Individuals can experience weight loss or even weight gain and crave food due to the poor absorption of nutrients. Individuals with Multiple Sclerosis have a damaged vagus nerve which partially paralyses the stomach. Scientific studies looked at the relationship between vitamin D deficiency and the digestive system as a way to better understand how MS develops; findings showed deficiencies in vitamin D can impact the ability of the intestines to absorb calcium. This could potentially result in the development of gastroparesis; as the digestive system needs adequate amounts of calcium in order for the smooth muscles of the intestine to contract properly.
Although there is no treatment for Multiple Sclerosis, there are things you can do to manage the symptoms and prevent them from flaring frequently.
Fibre - the indigestible part of plant foods that acts as a brush inside the intestines to sweep waste matter through. A lack of fibre can lead to food moving more slowly through the digestive tract. Also, when stools are not bulked by fibre they do not likely to stimulate the digestive systems evacuation mechanism in the digestive system.
Fluid - water is an important component of a well-formed stool. Lack of fluid intake can causes stools to become dry and more difficult to pass.
Balance gut flora - roughly 30% of stool is bacteria and the gut dysbiosis can have a significant effect on the consistency and frequency of bowel movements. An overgrowth of bad bacteria or yeast in the gut or infection by parasites could lead to constipation.
Increase digestive function -healthy digestion requires each stage working effectively before food passes on to the next. A lack of stomach acid, low levels of digestive enzymes, or lack of bile can result in improperly digested food in the intestines. This can slow transit time and contribute to constipation.
Physical activity - 30 minutes of moderate physical activity maintains muscle mass and retains energy levels
Vitamin D - 15 minutes of sunlight should be sufficient to meet your daily vitamin D requirements, otherwise supplement!
Manage stress - stress increases MS symptoms, figure out what makes you relaxed by trial and error.
In addition to the above, a nutrient-rich, diverse diet is key to ensure your microbiome is full of all the beneficial bacteria, as well as essential vitamins necessary. Speak to one of our Nutritionists or Functional Medicine Practitioner to get more information on how to get your vitamins and nutrients from food, or taking supplements can help you meet your needs and improve your health.