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Neurogenic Bowel Dysfunction in Multiple Sclerosis: Clinical Determinants and its Association With Bladder
Yeşim Akkoç1, Necmettin Yıldız2, Hilal Adanur3
1Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, İzmir, Türkiye.
Objective:
To determine the prevalence and severity of neurogenic bowel dysfunction (NBD) in multiple sclerosis (MS) and to identify clinical factors associated with moderate-to-severe bowel dysfunction.
Design:
Multicenter, prospective, cross-sectional study.
Setting:
Twelve tertiary MS centers.
Participants:
A total of 975 patients with MS.
Interventions:
Not applicable.
Main Outcome Measures:
Bowel dysfunction was assessed using the NBD score, and bladder symptoms were evaluated using the Neurogenic Bladder Symptom Score (NBSS). Moderate-to-severe NBD was defined as an NBD score ≥10. Associations between NBD and clinical variables were examined using univariate analyses and multivariable logistic regression.
Results:
The mean age was 39.7±11.4 years, and 72.5% were women. Moderate-to-severe NBD was identified in 6.8% of patients. Higher NBD severity was associated with older age, longer disease duration, and greater disability (all P<.01). In multivariable analysis, Expanded Disability Status Scale (odds ratio [OR], 1.35; 95% CI, 1.13-1.60; P=.001) and NBSS total score (OR, 1.08; 95% CI, 1.06-1.10; P<.001) were independently associated with moderate-to-severe NBD, whereas age, sex, disease duration, and MS subtype were not.
Conclusion:
Moderate-to-severe NBD affects a notable proportion of patients with MS and is independently associated with disability level and bladder dysfunction. These findings highlight the importance of integrated assessment of bowel and bladder symptoms and support routine screening, particularly in patients with higher disability.
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