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. 2013:2013:319201.
doi: 10.1155/2013/319201. Epub 2013 Sep 17.

Adding to the burden: gastrointestinal symptoms and syndromes in multiple sclerosis

David J Levinthal  1 , Ambreen Rahman, Salman Nusrat, Margie O'Leary, Rock Heyman, Klaus Bielefeldt
Affiliations

Adding to the burden: gastrointestinal symptoms and syndromes in multiple sclerosis

David J Levinthal et al. Mult Scler Int. 2013.

Abstract

Background. Multiple sclerosis (MS) patients often suffer from gastrointestinal (GI) symptoms. However, the full extent and prevalence of such symptoms are not clearly established. Thus, we sought to define the prevalence of GI symptoms and syndromes in those with MS. Methods. 218 MS patients completed self-reported demographic and clinical data questionnaires as well as several standardized surveys probing MS severity and GI health. Results. Nearly two thirds (65.6%) of patients endorsed at least one persistent GI symptom. Constipation (36.6%), dysphagia (21.1%), and fecal incontinence (15.1%) were common. Surprisingly, nearly 30% (28.4%) of the patients reported dyspeptic symptoms. Using validated diagnostic algorithms, patients met criteria for functional dysphagia (14.7%), functional dyspepsia (16.5%), functional constipation (31.7%), and IBS (19.3%), among others. Functional dysphagia, functional dyspepsia, and IBS were significantly more common in those with self-identified mood disorders. Conclusions. Constipation, fecal incontinence, and dysphagia are indeed frequent symptoms seen in MS patients. We also noted a ~30% prevalence of dyspepsia in this population. The mechanisms driving this association are not clear and require further study. However, due to this high prevalence, dyspeptic symptoms should be incorporated into the routine assessment of MS patients and, if found, may warrant collaborative referral with a GI specialist.

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Figures

Figure 1
Figure 1
Prevalence of gastrointestinal symptoms (a) or defined syndromes based on Rome III criteria (b) in MS patients (n = 218). Only symptoms and syndromes with a prevalence of at least 3% were included in the graph. CIN: chronic idiopathic nausea; IBS: irritable bowel syndrome.
Figure 2
Figure 2
Association between the physical score of the MSIS-29 and scores on the Fecal Incontinence Severity Index (FISI) (a) (r 2 = 0.28, P < 0.01) or the MD Anderson Dysphagia Inventory (b) (r 2 = −0.36, P < 0.01).
See this image and copyright information in PMC

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