Abstract
IntroductionBowel 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.MethodsEach 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.ResultsFourteen 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.ConclusionThis 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.
Highlights
Bowel dysfunction (BD) is reported as a common and disabling symptom in multiple sclerosis (MS) patients
The main findings of the present study was that 14.5% of the studied MS population suffered of moderate-severe Neurogenic Bowel Dysfunction score (NBDs) symptoms
The observed differences in the prevalence of NBD symptoms might be explained in several ways, including differences in (i) sample size [7], (ii) patients’ inclusion/exclusion criteria, (iii) data collection, and (iv) studied populations (i.e. MS phenotypes, disease duration, disability, etc.) [7]
Summary
Bowel dysfunction (BD) is reported as a common and disabling symptom in multiple sclerosis (MS) patients. 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. Conclusion This study confirms the relatively high prevalence of moderate/severe BD in a large, multicenter, unselected, outpatient MS population. Neurogenic bowel dysfunction (NBD) is a common and disabling feature of multiple sclerosis (MS) and appears to be associated with the presence of bladder dysfunction, high level of disability, and long disease duration[1], even if it is described in early phase of the disease [2, 3]. The detrimental effects of bowel symptoms, they are rarely investigated and frequently unrecognized and undertreated. [6]
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