Neurogenic bowel dysfunction in multiple sclerosis: clinical determinants and its association with bladder...

Area of Science:

• Neurology
• Gastroenterology
• Urology

Background:

• Multiple sclerosis (MS) is a chronic neurological disease impacting the central nervous system.
• Neurogenic bowel dysfunction (NBD) is a common and often debilitating complication in MS patients.
• Understanding the prevalence and associated factors of NBD is crucial for patient management.

Purpose of the Study:

• To determine the prevalence and severity of NBD in patients with MS.
• To identify clinical factors associated with moderate-to-severe bowel dysfunction in this population.

Main Methods:

• A multicenter, prospective, cross-sectional study involving 975 patients with MS across twelve tertiary MS centers.
• Bowel dysfunction was assessed using the Neurogenic Bowel Dysfunction (NBD) score.
• Bladder symptoms were evaluated using the Neurogenic Bladder Symptom Score (NBSS).
• Statistical analyses included univariate and multivariable logistic regression to identify associations.

Main Results:

• Moderate-to-severe NBD was present in 6.8% of the studied MS patients.
• Higher NBD severity correlated with older age, longer disease duration, and greater disability.
• Multivariable analysis revealed that Expanded Disability Status Scale (EDSS) and NBSS total score were independently associated with moderate-to-severe NBD.

Conclusions:

• A significant proportion of MS patients experience moderate-to-severe NBD.
• Disability level and bladder dysfunction are key independent predictors of NBD severity in MS.
• Integrated assessment and routine screening of bowel and bladder symptoms are recommended for MS patients, especially those with higher disability.