Pathophysiology and management of bowel dysfunction in multiple sclerosis

Details

Serval ID
serval:BIB_C8A0A68E88F1
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Pathophysiology and management of bowel dysfunction in multiple sclerosis
Journal
European Journal of Gastroenterology and Hepatology
Author(s)
Wiesel  P. H., Norton  C., Glickman  S., Kamm  M. A.
ISSN
0954-691X (Print)
Publication state
Published
Issued date
04/2001
Volume
13
Number
4
Pages
441-8
Notes
Journal Article
Review --- Old month value: Apr
Abstract
The prevalence of bowel dysfunction in multiple sclerosis (MS) patients is higher than in the general population. Up to 70% of patients complain of constipation or faecal incontinence, which may also coexist. This overlap can relate to neurological disease affecting both the bowel and the pelvic floor muscles, or to treatments given. Bowel dysfunction is a source of considerable ongoing psychosocial disability in many patients with MS. Symptoms related to the bladder and the bowel are rated by patients as the third most important, limiting their ability to work, after spasticity and incoordination. Bowel management in patients with MS is currently empirical. Although general recommendations include maintaining a high fibre diet, high fluid intake, regular bowel routine, and the use of enemas or laxatives, the evidence to support the efficacy of these recommendations is scant. This review will examine the current state of knowledge regarding the pathophysiological mechanisms underlying bowel dysfunction in MS, outline the importance of proper clinical assessment of constipation and faecal incontinence during the diagnostic work-up, and propose various management possibilities. In the absence of clinical trial data on bowel management in MS, these should be considered as a consensus on clinical practice from a team specialized in bowel dysfunction.
Keywords
Constipation/*etiology/*physiopathology/therapy Fecal Incontinence/*etiology/*physiopathology/therapy Humans Multiple Sclerosis/*complications
Pubmed
Web of science
Create date
25/01/2008 16:12
Last modification date
20/08/2019 15:43
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