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Disturbances of ano-rectal function in multiple sclerosis
A M Nordenbo1, J R Andersen, J T Andersen
1Department of Neurology, Holbaek County Hospital, Denmark.
Journal of Neurology
|June 1, 1996
Summary
Multiple sclerosis (MS) patients often experience bowel dysfunction. Reduced anal sphincter pressure and rectal sensation contribute to fecal incontinence, while altered reflexes may cause constipation in MS.
Area of Science:
- Neuroscience
- Gastroenterology
- Clinical Medicine
Background:
- Bowel dysfunction is a common and distressing symptom in multiple sclerosis (MS).
- Understanding the underlying pathophysiology is crucial for effective management of fecal incontinence and constipation in MS patients.
Purpose of the Study:
- To investigate the anorectal function in patients with multiple sclerosis (MS).
- To identify potential mechanisms contributing to bowel symptoms, including fecal incontinence and constipation, in MS.
Main Methods:
- Anorectal manometry was performed on 30 patients with MS and compared with healthy controls.
- Patients were interviewed regarding their bowel symptoms, including constipation, fecal urgency, and fecal incontinence.
Main Results:
- MS patients exhibited significantly reduced resting anal sphincter pressure and external sphincter contraction force compared to controls.
- Rectal sensation and compliance were diminished in MS patients, with an increased threshold for the defecation reflex.
- Fecal incontinence strongly correlated with reduced rectal sensation, while altered sphincter reflexes may contribute to constipation.
Conclusions:
- Low anal sphincter pressure and impaired rectal sensation are key factors contributing to fecal incontinence in MS.
- Abnormalities in the defecation reflex and early external sphincter excitation may play a significant role in the pathophysiology of constipation in MS patients.