ALS from Both Sides


Constipation in ALS


Although we joke about constipation, it is a miserable experience and should never be taken lightly in the ALS patient. Loss of appetite from frequent constipation leads to weight loss, weakness and dehydration. Constipation can progress to blockage in the intestines and nausea, vomiting, and abdominal distension. (Vomiting is very dangerous for a person who cannot turn over when lying on his back because it causes choking.) One early sign of blockage is often overlooked. Repeated small very loose or liquid stools may be ignored or thought to be sufficient when they are actually the result of a large amount of hard stool blocking the bowel with only liquid stool being able to pass around it. The blockage can become so severe as to require hospitalization and possibly even surgery to correct.


What is constipation?

That may sound like a foolish question, but many people think of constipation as having infrequent, dry, hard bowel movements. It is actually defined simply as having stools that are hard to pass. Many people have only a couple of bowel movements a week, but if they do so without straining, they are not constipated.

Normally food is liquified in the stomach by digestive juices and moves through the small intestine in liquid form. Nutrients are absorbed in the small intestine. Waves of muscle contraction called peristalsis moves the remainder along into the large intestine. In the large intestine, water is reabsorbed from the left over waste product, leaving just fecal material (stool) which is moved along and passed out of the body in a bowel movement.

Anything that changes the speed with which foods move through the large intestine interferes with the re-absorption of water and causes problems. Rapid passage causes diarrhea, slowed passage allows too much water to be reabsorbed, leaving hard, dry stool that doesn't move easily through the bowel. Common causes in ALS patients include:

Because so many things contribute to constipation in the ALS patient, the solution may change over time.

How to Prevent or Treat Constipation

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