Multiple sclerosis and bowel symptoms: Frequency and barriers to their management

Bertrand Bourre; Charlotte Desprez; Guillaume Gourcerol; Marie-Pierre Tavolacci; Thomas Duflot; Anne-Marie Leroi

doi:10.1016/j.msard.2023.104919

Multiple sclerosis and bowel symptoms: Frequency and barriers to their management

Mult Scler Relat Disord. 2023 Oct:78:104919. doi: 10.1016/j.msard.2023.104919. Epub 2023 Aug 5.

Authors

Bertrand Bourre¹, Charlotte Desprez², Guillaume Gourcerol², Marie-Pierre Tavolacci³, Thomas Duflot⁴, Anne-Marie Leroi⁵

Affiliations

¹ Department of Neurology, CHU Rouen, CIC-CRB 1404, Rouen F-76000, France.
² Department of Digestive Physiology, CHU Rouen, CIC-CRB 1404, Rouen University Normandie, INSERM, ADEN UMR 1073, F-76000, Rouen, France.
³ Department of Epidemiology, CHU Rouen, CIC-CRB 1404, Rouen University Normandie, INSERM, ADEN UMR 1073, F-76000, Rouen, France.
⁴ Department of Pharmacology, Endothelium, Valvulopathy, and Heart Failure, CHU Rouen, CIC-CRB 1404, University Rouen Normandie, INSERM, EnVI UMR1096, F-76000, Rouen, France.
⁵ Department of Digestive Physiology, CHU Rouen, CIC-CRB 1404, Rouen University Normandie, INSERM, ADEN UMR 1073, F-76000, Rouen, France. Electronic address: anne-marie.leroi@chu-rouen.fr.

PMID: 37579644
DOI: 10.1016/j.msard.2023.104919

Abstract

Background: The frequency of bowel symptoms (BSs) is still a matter for debate in multiple sclerosis (MS) patients. However, BSs have been shown to cause significant distress. Our study aimed to (i) investigate the frequency of BSs, particularly those that are not managed, (ii) identify potential predictors for help-seeking care for patients with BSs, and (iii) evaluate the ability of the Neurogenic Bowel Dysfunction (NBD) score to screen for BSs.

Method: Three hundred sixty-nine MS patients completed a cross-sectional demographic and clinical survey of MS and BSs and their management.

Results: BSs were reported by 47.7% of MS patients. Eighty-eight percent of MS patients had a very minor-minor Neurogenic Bowel Disorder (NBD) score and 12% had a moderate-severe NBD score. Forty-one percent of patients did not report their BS to a healthcare provider, mainly because they preferred not to talk about the problem. BS duration was the only significant predictor of help-seeking for BS management. Female sex, visual impairment, a digestive history, and longer MS duration were good predictors of BSs. Patients with BSs (86%) were correctly identified with an NBD score >2.

Conclusion: BSs are under-detected in MS populations. This is partially related to non-declaration by patients. Targeting BSs using the NBD score is a good way to increase reporting.

Keywords: Bowel symptoms; Constipation; Fecal incontinence; Management; Multiple sclerosis; Neurogenic bowel dysfunction.