ents such as protein, carbs and
fats through nubby little fingers
(called villi) and sends them into
the bloodstream to nourish the
body’s cells. What’s left goes to
the large intestine, which sucks
out water and electrolytes—the
salts and minerals that keep the
body’s electrical systems hum-
ming. The depleted remainder is
dumped into the rectum, where
it presses on the bowel walls and
anal sphincter. Soon the brain
is asked to open the hatch. The
movement takes muscles. In
good health, people can com-
mand those muscles to stay shut
until they get to an elimination
station. Once there, they relax
them and, well, you know the
rest.
When MS interferes
Unfortunately, MS damage
to nerve cells in the neck and
upper mid-back portions of the
spine can result in what doc-
tors call “upper motor neuron
bowel,” a pattern of slowed
movement (motility) and
constipation (a combina-
tion of both hard stools and
infrequency). Waste moves
more sluggishly through the
system, allowing the body
to pull out more water,
drying the stool and causing
constipation. Adding to the
problem, MS can make the
external anal sphincter stiff and
spastic so it won’t relax on cue.
People with MS often don’t say anything
until their G.I. problem gets really bad;
coaxing the system to work well again
requires time and effort.
