Constipation is one of the most common complaints of patients with ALS. Lack of exercise, reduced mobility, combined with reduced fluid intake and loss of Valsalva action (abdominal straining), can promote the development of rapidly severe constipation. Others factors that may aggravate constipation are: reduced of food with high fiber content, Dysphagia-induced dehydration (patient is unable to swallow), medications like: muscle relaxants, sedatives and anticholinergics (like Elavil and Rubinol for excess saliva).

• Activity is encouraged to keep bowel moving
• Maintain adequate fluid intake
• Increase soft, fiber-containing foods
• Bulking agents like: Metamucil and FiberCon can be utilized
• Mild laxative therapy should be prophylactically initiated in bed-ridden ALS patients and those receiving opioids and the drugs mentioned above. For chronic constipation you may use Fleet enemas as per your doctor instructions.