Gastrointestinal Dysfunction in Multiple Sclerosis and Related Conditions.

Area of Science:

• Neurogastroenterology
• Neurology
• Gastroenterology

Background:

• Nervous system disorders frequently present with gastrointestinal (GI) dysfunction.
• Brain and spinal cord lesions can lead to various GI issues, including altered peristalsis, abdominal strain, appetite changes, and emesis.
• Specific neurological conditions like multiple sclerosis, neuromyelitis optica spectrum disorder, and myelin oligodendrocyte glycoprotein-associated disorder are associated with neurogenic GI dysfunction.

Approach:

• This review synthesizes current knowledge on GI dysfunction in the context of neurological disorders.
• It examines the mechanisms linking nervous system lesions to specific GI symptoms.
• The review highlights the importance of interdisciplinary collaboration for patient care.

Key Points:

• Lesions in areas such as the basal ganglia, pontine defecation center, parabrachial nucleus, area postrema, and hypothalamus can manifest as specific GI problems.
• Spinal cord lesions affecting long tracts or the intermediolateral nucleus can also impair GI motility.
• GI dysfunction may occur before, concurrently with, or after the diagnosis of a primary neurological condition.

Conclusions:

• Neurogenic GI dysfunction is a significant clinical challenge requiring a multidisciplinary approach.
• Prompt recognition and management by both gastroenterologists and neurologists are essential for improving patient outcomes.
• Understanding the neuroanatomical basis of GI symptoms aids in diagnosis and treatment strategies.