Any advice

My son has since his diagnosis been having problems with bowel control. Without warning he will lose control, which I know you will appreciate is very embarrassing. He no longer feels comfortable going out alone, in case it happens. If we go out in car we take emergency change of clothing in case of accidents. He has seen ms nurses and all they say is we can not do anything to help ?? I really don’t understand this do you ? He is on senna from gp and also takes Laxido. Any advice on different products out there to use or any advice would be appreciated

Hi. I have PPMS, and I’ve been bowel incontinent for 30 years. I have ‘proper’ firm stools rather than loose or constipated, but haven’t the least clue when they’re on the way - first thing I know about needing one is when it happens, which is a bit of a nuisance, and sounds as if it’s what your son is experiencing.

Can’t be cured, but can be managed - I still use the management method I first tried all that time ago, and wouldn’t recommend Laxido or senna preparations… A gun can only shoot you if it’s loaded, so I use a Micralax enema every couple of days, which empties me out - not loaded, no danger. Crucially, this acts from the bottom (literally) up, rather than from the top down, so I’m not involving (or compromising) my whole gut.

For additional security I sometimes then take Imodium to bung me up, as a sort of ‘belt and braces’ approach, but only if I’m doing something like taking a flight, to boost my confidence more than anything else. Using this strategy, I probably have an ‘accident’ 2 or 3 times a year, which I find bearable. Good luck!

He could try an irrigation system, like for eg Peristeen. It works by introducing water into the bowel via the rectum, and basically you sit there on the loo until all the water and poo is expelled. The idea is that to begin with you do it everyday, later people manage to use Peristeen every other day, or even less often. The less poo there is in the system, the less likely are accidents. Like thirstywork said, it’s a bottom up method rather than top down.

I also agree with thirstywork that Senna and Laxido alone wouldn’t necessarily help. In particular with the unexpected nature of incontinence, adding bowel softeners and laxatives could be problematic unless you have a way of emptying the bowel on demand, like micro enemas, irrigation, even glycerin suppositories.

I tried Peristeen (and micro enemas, and suppositories, and everything else under the sun) and for me it didn’t work, but that’s because I have the opposite problem, ie constipation rather than incontinence, so instead of a sphincter that will open unexpectedly, mine doesn’t open ‘naturally’ at all. I had a colostomy nearly 2 years ago as a result.

He could talk to his bowel and bladder nurse, if he has one. And if he doesn’t, ask for a referral from the GP.

Bowel incontinence is awful, embarrassing and like so many other MS symptoms, it stinks!

Sue

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Thank you both for your advice