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Related Experiment Video

Updated: Mar 5, 2026

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Anal sphincter dysfunction in multiple sclerosis: an observation manometric study.

Silvia Marola1, Alessia Ferrarese2, Enrico Gibin1

  • 1University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.

Open Medicine (Warsaw, Poland)
|March 30, 2017
PubMed
Summary

Multiple sclerosis patients show impaired pelvic floor coordination, with sphincter hypotonia and post-contraction spasticity. These anorectal manometry findings are crucial for targeted treatment and rehabilitation in multiple sclerosis patients.

Keywords:
Anorectal manometryEDSSFecal incontinenceObstructed defecation

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Area of Science:

  • Neurology
  • Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Constipation, obstructed defecation, and fecal incontinence are common in multiple sclerosis (MS).
  • Pathophysiological mechanisms underlying these bowel disorders in MS are not well understood.
  • Anorectal manometry is a key diagnostic tool for evaluating anorectal function.

Purpose of the Study:

  • To compare anorectal function in patients with and without multiple sclerosis.
  • To investigate the manometric alterations associated with constipation and fecal incontinence in MS patients.
  • To identify potential targets for treatment and rehabilitation.

Main Methods:

  • A comparative study involving 136 patients (MS and non-MS) with constipation or fecal incontinence.
  • Anorectal manometry was used to assess resting anal pressure, maximum squeeze pressure, rectoanal inhibitory reflex, filling pressure, and urge pressure.
  • Patients were divided into four groups based on MS status and bowel symptoms.

Main Results:

  • Multiple sclerosis patients with constipation (Group A) exhibited greater sphincter hypotonia at rest and during contraction compared to controls (Group C).
  • Multiple sclerosis patients with fecal incontinence (Group B) had a lower rectal sensitivity threshold than controls (Group D).
  • No voluntary post-contraction sphincter relaxation was observed in MS patients (Groups A and B).

Conclusions:

  • A reduced difference in resting anal pressure post-contraction suggests post-contraction sphincter spasticity in MS patients.
  • Impaired pelvic floor coordination is indicated by these manometric findings in multiple sclerosis.
  • Understanding these manometric alterations is vital for selecting appropriate treatments and planning rehabilitation therapies for MS patients.