Prevalence and predictors of bowel dysfunction in a large multiple sclerosis outpatient population: an Italian multicenter study

Abstract

Introduction Bowel dysfunction (BD) is reported as a common and disabling symptom in multiple sclerosis (MS) patients. To date, no studies have explored the prevalence of these symptoms in a large multicenter outpatient setting. The aims of the present study are to assess: (i) the prevalence of BD in a large multicenter Italian MS population, and (ii) the correlation between clinico-demographic variables and the severity of BD. Methods Each of the nine participating center screened MS patients prospectively: 1100 subjects were enrolled. All patients underwent the Expanded Disability Status Scale (EDSS) and completed the Neurogenic Bowel Dysfunction score (NBDs). Multivariable linear and logistic regression models were used to assess the association between NBDs and several clinico-demographic variables. Results Fourteen percent of MS patients showed a moderate/severe BD (NBDs > 10); this percentage increased in patients with high disability, ranging from 26 to 32%. Moderate/severe BD was more frequent in MS patients with: progressive phenotypes, higher disability, older age, and longer disease duration. NBDs severity was predicted by female sex, ambulation impairment and bladder symptoms. Conclusion This study confirms the relatively high prevalence of moderate/severe BD in a large, multicenter, unselected, outpatient MS population. BD appears to be mainly associated to female sex and MS-related disability.

A multiscale assessment of bowel impairment in an Italian multiple sclerosis cohort

“…Another strength of our study resides in the use of Wexner scores for incontinence and constipation to separately assess the two main problems related to bowel dysfunctions. The aforementioned scales have been widely applied and validated in different settings, they are quick and easy to use and overcome one of the major limitations of several studies, in that constipation and fecal incontinence were not separately analyzed 6 , 17 .…”

Interplay Between Cognitive and Bowel/Bladder Function in Multiple Sclerosis

“…Therefore, there is an urgent need to adopt a common screening tool in order to calculate the prevalence for bowel and bladder disorders in MS patients and to introduce these tools as outcomes in trials aimed at treating sphincter disturbances. However, a large Italian study reported that the prevalence of bladder deficits was 42% and that of bowel deficits was 11% [ 35 ]. This finding is in line with our data and confirms that our population is representative of the Italian population, thus reinforcing our findings on the correlation between cognition and bowel/bladder dysfunction.…”

Assessment of factors associated with depression and anxiety among pwMS in Saudi Arabia

“…On the other hand, it is important to note that there are some invisible neuropsychiatric symptoms in pwMS that do affect their quality of life (QoL) and physical activity including fatigue [7,[16][17][18][19][20], dysphagia [21,22], sexual dysfunction [23,24], and bladder/bowel dysfunctions [25][26][27][28] in addition to mood disorders [20], cognitive impairments [20,[29][30][31][32], pain [33,34], and vision changes [20,35]. A study by Altmann et al indicated that sexual dysfunction is significantly predicted by EDSS but not by anxiety and depression [23].…”

“…A study by Altmann et al indicated that sexual dysfunction is significantly predicted by EDSS but not by anxiety and depression [23]. Alvino et al showed that bowel dysfunction was significantly higher in women and MS-associated disability measured by EDSS [25]. Recent studies showed that about 50% of pwMS experienced bowel dysfunction that can result in distress and humiliation [27,28].…”