Management of bowel dysfunction in people with multiple sclerosis

Area of Science:

• Neurology
• Gastroenterology
• Rehabilitation Science

Background:

• Bowel dysfunction is a prevalent and impactful issue for individuals with multiple sclerosis (MS).
• It significantly affects physical functioning and psychosocial wellbeing in the MS population.
• Current understanding of best practices for managing MS-related bowel dysfunction is based on limited evidence.

Purpose of the Study:

• To review the existing evidence for best practices in managing bowel dysfunction in people with multiple sclerosis (MS).
• To identify effective interventions and highlight areas where evidence is limited.

Main Methods:

• A comprehensive review of the limited available scientific literature.
• Analysis of evidence related to bowel assessment, fluid and fiber intake, pelvic floor exercises, biofeedback, aerobic exercise, anal plugs, and pharmacological interventions.

Main Results:

• Thorough bowel assessment is crucial for effective management.
• Adequate fluid and fiber intake, alongside pelvic floor exercises, demonstrates clear benefits.
• Biofeedback therapy, aerobic exercise, and anal plugs offer potential benefits for select individuals.
• Pharmacological interventions require careful consideration due to potential risks and limited evidence.

Conclusions:

• A multi-faceted approach combining assessment, lifestyle modifications, and targeted therapies is recommended for MS-related bowel dysfunction.
• Further research is needed to strengthen the evidence base for various interventions.
• Individualized treatment plans are essential, considering the diverse impact of MS on bowel function.