Lehar Khanna1, Burcu Zeydan2, Orhun H Kantarci2, Michael Camilleri1. 1. Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Rochester, MN, USA. 2. Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: Most prevalent gastrointestinal symptoms in multiple sclerosis (MS) relate to lower bowel dysfunction, often in association with bladder manifestations. OBJECTIVE: To assess clinical and objective gastrointestinal motor dysfunctions in patients with MS. METHODS: This was a single-center, retrospective study of 166 patients evaluated between 1996 and 2020. We reviewed characterization of the MS, gastrointestinal and neurological symptoms, measurements of gastrointestinal and colonic transit, and anorectal manometry. KEY RESULTS: At the time of the gastrointestinal evaluations of the 166 patients with MS (138 women; 83%), 111 were in the relapsing-remitting phase and 52 were in the progressive phase. In 3 patients, disease phase was not assigned due to insufficient data. Constipation was identified in 82% (136/166) of patients. Most [103/116 (88%)] patients with bladder symptoms also had constipation or fecal incontinence. Delayed gastric emptying at 4 h and colonic transit at 24 h was identified in 16% and 7% of the cohort, respectively; 22% had accelerated gastric emptying. On anorectal manometry, resting anal sphincter pressure >90 mm Hg and rectoanal pressure differential below -50mm Hg suggested evacuation disorder in patients with constipation. CONCLUSIONS AND INFERENCES: In addition to slow colonic transit and anorectal dysfunction leading to constipation in MS, 22% of patients had accelerated gastric emptying.
BACKGROUND: Most prevalent gastrointestinal symptoms in multiple sclerosis (MS) relate to lower bowel dysfunction, often in association with bladder manifestations. OBJECTIVE: To assess clinical and objective gastrointestinal motor dysfunctions in patients with MS. METHODS: This was a single-center, retrospective study of 166 patients evaluated between 1996 and 2020. We reviewed characterization of the MS, gastrointestinal and neurological symptoms, measurements of gastrointestinal and colonic transit, and anorectal manometry. KEY RESULTS: At the time of the gastrointestinal evaluations of the 166 patients with MS (138 women; 83%), 111 were in the relapsing-remitting phase and 52 were in the progressive phase. In 3 patients, disease phase was not assigned due to insufficient data. Constipation was identified in 82% (136/166) of patients. Most [103/116 (88%)] patients with bladder symptoms also had constipation or fecal incontinence. Delayed gastric emptying at 4 h and colonic transit at 24 h was identified in 16% and 7% of the cohort, respectively; 22% had accelerated gastric emptying. On anorectal manometry, resting anal sphincter pressure >90 mm Hg and rectoanal pressure differential below -50mm Hg suggested evacuation disorder in patients with constipation. CONCLUSIONS AND INFERENCES: In addition to slow colonic transit and anorectal dysfunction leading to constipation in MS, 22% of patients had accelerated gastric emptying.
Authors: H Kusunoki; K Haruma; N Manabe; H Imamura; T Kamada; A Shiotani; J Hata; H Sugioka; Y Saito; H Kato; J Tack Journal: Neurogastroenterol Motil Date: 2012-03-04 Impact factor: 3.598
Authors: C E Bernard; S J Gibbons; P J Gomez-Pinilla; M S Lurken; P F Schmalz; J L Roeder; D Linden; R R Cima; E J Dozois; D W Larson; M Camilleri; A R Zinsmeister; M J Pozo; G A Hicks; G Farrugia Journal: Neurogastroenterol Motil Date: 2009-02-08 Impact factor: 3.598
Authors: Burcu Zeydan; Xinyi Gu; Elizabeth J Atkinson; B Mark Keegan; Brian G Weinshenker; Jan-Mendelt Tillema; Daniel Pelletier; Christina J Azevedo; Christine Lebrun-Frenay; Aksel Siva; Darin T Okuda; Kejal Kantarci; Orhun H Kantarci Journal: Neurol Neuroimmunol Neuroinflamm Date: 2018-01-22
Authors: Silvia Marola; Alessia Ferrarese; Enrico Gibin; Marco Capobianco; Antonio Bertolotto; Stefano Enrico; Mario Solej; Valter Martino; Ines Destefano; Mario Nano Journal: Open Med (Wars) Date: 2016-11-25