Combating Constipation

Kate Bednarz, RD

Constipation is a common side effect of ALS for several reasons:

food1. Decreased physical activity slows down muscle contractions of the intestine.
2. Swallowing difficulty can lead to changes in diet and fluid consumption.
3. Weakness in respiratory, chest and stomach muscles can result in inability to initiate bowel movements.

Diet, routine and position are the best ways to keep moving smoothly:

Diet:

  • Fiber and fluids are the necessary ingredients in an anti-constipation regimen.
  • Soluble fiber helps increase the frequency of the bowel movements and does not bulk up the stool. Examples are oatmeal, pulp of fruit (not the skin) beans or via supplementation such as Metamucil or Citrucel.
  • Fluids are provided by any non-caffeinated drink. If thin liquids promote a choking hazard consider drinking thicker liquids like slushes or milkshakes. A non-taste thickener can be added to thin liquids to make swallowing easier or pre-thickened products can be purchased
Routine:
  • Pick a time of day and stick with it.
  • Intestine contractions are naturally stimulated about 20 to 45 minutes after a light meal and are usually strongest after breakfast.
Position:
  • The correct position is to rest your feet on a footrest that is about a foot off the ground, such as a stool or walker rung, then lean forward.
  • Make sure your buttocks are the lowest part of you body.
Some additional ways to treat constipation (over the counter):

Laxatives:
  • Please exercise caution with laxatives. Even though they work quickly, they can result in dependence; example: Ex-Lax.
Stool softeners:
  • Keep the water content high or lubricate the stools making it easier to pass; example: Colace.
Stimulants:
  • Increase involuntary muscle contractions of the intestines, moving the stool along quickly; example: Senekot.
Other:
  • Other alternatives include drinking an herbal tea such as “Smooth Move”, taking mineral oil, and/or receiving an enema.