The frequency of bowel and bladder problems in multiple sclerosis and its relation to fatigue: A single centre experience.

Sophia D. Lin,Phu Hoang,Tom Jarvis,Simon C. Gandevia,Jessica Louise Fletcher,Jane E. Butler,Claire L. Boswell-Ruys,Euan J. McCaughey

doi:10.1371/journal.pone.0222731

Sophia D. Lin, Phu Hoang + Show 6 more

Open Access

https://doi.org/10.1371/journal.pone.0222731

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Abstract

BackgroundBowel and bladder problems affect more than 50% of people with Multiple Sclerosis (MS). These problems have a large impact on quality of life and place a significant burden on health systems.ObjectivesThis study aimed to ascertain the frequency of bladder and bowel problems in a select Australian MS cohort and to investigate the relationships between level of disability, bladder and bowel problems, and fatigue.MethodsQuestionnaires on the nature and severity of MS symptoms were distributed to clients attending an Australian MS centre. Log-binomial regression and multiple linear regression models were used to investigate relationships between disability, fatigue, and bladder and bowel problems.Results and conclusionsOf 167 questionnaires distributed, 136 were completed. Bladder problems were reported by 87 (74.4%) respondents, whilst 66 (48.9%) experienced functional constipation and 43 (31.9%) faecal incontinence. This frequency in our select Australian MS population is similar to that reported globally. There was a significant correlation between level of disability and: bladder problems (p = 0.015), faecal incontinence (p = 0.001), fatigue (p<0.001) and constipation (p = 0.016, relative risk: 1.16). Further investigation into the causal relationships between various MS symptoms may be beneficial in the development of novel therapeutic strategies for people with MS.

Highlights

Multiple sclerosis (MS) is a life changing disease affecting approximately 2.3 million people globally, with prevalence continuing to increase.[1]
The aim of this study is to investigate the frequency of bowel and bladder symptoms in a selection of the MS population in New South Wales, and to explore the relationship between the most frequently reported symptoms in the Australian MS population–fatigue, disability, and bowel and bladder problems
It is reasonable to assume that all 18 responders that had a permanent indwelling catheter had significant bladder dysfunction, as permanent catheterisation is often employed in the management of bladder problems only after conservative and non-invasive management strategies have failed.[28, 29]

Summary

Introduction

Multiple sclerosis (MS) is a life changing disease affecting approximately 2.3 million people globally, with prevalence continuing to increase.[1] In Australia, estimated prevalence of MS is 23,700.[2] The impact of MS is profound, affecting the individual physically, mentally and financially It is associated with a poorer quality of life and results in considerable costs to both the individual and the community.[1]. MS-related factors such as use of anticholinergics or antispasmodics can lead to chronic constipation and faecal incontinence.[7, 8] The impact of these bowel and bladder problems is significant, and is one of the most common problems that limit the ability of people with MS to work and remain employed.[9] They can result in social inconvenience and isolation, decreased quality of life and increased morbidity.[10,11,12,13] the financial costs associated with MS-related bowel and bladder dysfunction are substantial.[11, 13]

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