Multiple Sclerosis (MS) is an incurable disease that affects the central nervous system. Nerves are surrounded with myelin, a sheath that assists nerve function. MS causes damage and inflammation to the myelin sheath, leading to dysfunction in nerve action, generally affecting the brain, spinal cord and optic nerves. There are four categories of MS. Some people suffer only mild attacks, with near complete remission between each attack. Some slowly progress through varying degrees of disability, with changes in severity and length of symptoms during each relapse. Others progress rapidly to complete disability without any remission periods.
Treatment is aimed at easing the individual’s symptoms. The type and degree of symptoms varies between individual sufferers. There are five clear health issues related to MS- loss of motor control, fatigue, neurological problems, continence issues and neuropsychological symptoms. Symptoms and their associated treatments will relate to each of these five health issue areas. A dietitian will be useful in aiding treatment for a number of these areas.
The fatigue of MS is often occurs on a daily basis. It may come on suddenly and worsens as the day progresses. Although diet alone cannot prevent the fatigue of MS, ensuring a well balanced diet that considers times of increased fatigue can certainly help improve daily life. A diet based on regular meals and snacks, that contain slow release (low glycaemic index) energy source will ensure stabilised blood sugars and energy levels throughout the day. Adequate vitamin B intake will also help optimise energy levels. This can easily be achieved through a diet that includes foods from all of the five food groups. The diet should also be high in fibre. Weight management should also be addressed, as being overweight or obese will further impact on fatigue.
The decline in motor control associated with MS often leads to difficulty in walking. Initially canes and walking devices may be required. Complete disability leads to the necessity of a wheel chair. Being overweight or obese will further compound the initial loss of motor control, making the adaption to aided walking more difficult. Loss of motor control in MS is also associated with balance problems. Being overweight will challenge balance. Preventing overweight, or initiating steps to reach a healthy weight range is important in the early stages of MS. A dietitian will be vital in implementing a healthy diet regimen aimed at regulated weight loss, whilst still taking into account other MS symptoms such as fatigue.
Dysphasia, or difficulty swallowing, more frequently occurs with advanced MS but can occur at any stage. Dysphasia brings with it a number of concerns. Food or liquid may enter the wind pipe and end up in the lungs, leading to infections. Sometimes concerns with eating may result in a decline in food, leading to malnutrition and weight loss. Ensuring a safe and adequate diet is important at any stage of MS. A dietitian can educate on texture of foods, rate of eating while emphasing adequate chewing of foods. Adequate energy is important even if this means the addition of liquid supplements. A dietitian can educate and discuss all options.
Constipation and less common diarrhoea can be problems amongst MS sufferers. There are a number of causes of constipation including a deliberate decrease in fluid intake due to incontinence issues, decreased mobility due to loss of motor control, certain medications and a decrease in actual functioning of the bowel muscle due to loss of motor function. Controlling constipation is important, as it can further impact continence issues and affect daily life. A dietitian should be consulted before dietary changes are made. An increase in fibre and fluid intake are advised but must be done in a slow and careful manner. The type of fibre is important, and a dietitian will educate on both food sources and supplement sources of fibre that will be of benefit.
Bladder dysfunction occurs in approximately 80% of MS sufferers; however it can be controlled quite well. Treatment includes changes in diet and fluid intake. A dietitian can help. Many people will instinctively decrease fluid intake if continence issues arise to prevent embarrassing accidents or discussions with doctors. This only leads to constipation, which can exacerbate incontinence problems as it puts pressure on the bowel. Adequate fluid intake is also important to prevent urinary tract infections and kidney stone formation. A dietitian can help establish the activity of the bowel and determine the times of the day where fluid intake is less likely to cause an issue. They will also advise on the preferred types of fluids. Excessive alcohol and caffeine are not advised, as both can stimulate urine production and have a dehydrating affect. It is important to remember that incontinence is a common issue that can be well controlled. Incontinence sufferers should not be embarrassed to discuss symptoms with a doctor or dietitian.
Added to site on : Monday, 19 November 2012