Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Rochester, MN, USA.
Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA.
Neurogastroenterol Motil. 2022 Aug;34(8):e14326. doi: 10.1111/nmo.14326. Epub 2022 Feb 3.
Most prevalent gastrointestinal symptoms in multiple sclerosis (MS) relate to lower bowel dysfunction, often in association with bladder manifestations.
To assess clinical and objective gastrointestinal motor dysfunctions in patients with MS.
This was a single-center, retrospective study of 166 patients evaluated between 1996 and 2020. We reviewed characterization of the MS, gastrointestinal and neurological symptoms, measurements of gastrointestinal and colonic transit, and anorectal manometry.
At the time of the gastrointestinal evaluations of the 166 patients with MS (138 women; 83%), 111 were in the relapsing-remitting phase and 52 were in the progressive phase. In 3 patients, disease phase was not assigned due to insufficient data. Constipation was identified in 82% (136/166) of patients. Most [103/116 (88%)] patients with bladder symptoms also had constipation or fecal incontinence. Delayed gastric emptying at 4 h and colonic transit at 24 h was identified in 16% and 7% of the cohort, respectively; 22% had accelerated gastric emptying. On anorectal manometry, resting anal sphincter pressure >90 mm Hg and rectoanal pressure differential below -50mm Hg suggested evacuation disorder in patients with constipation.
In addition to slow colonic transit and anorectal dysfunction leading to constipation in MS, 22% of patients had accelerated gastric emptying.
多发性硬化症（MS）中最常见的胃肠道症状与下消化道功能障碍有关，常伴有膀胱表现。
评估 MS 患者的临床和客观胃肠道运动功能障碍。
这是一项单中心、回顾性研究，纳入了 1996 年至 2020 年间评估的 166 例患者。我们回顾了 MS 的特征、胃肠道和神经系统症状、胃肠道和结肠转运测量以及肛门直肠测压的情况。
在对 166 例 MS 患者（138 例女性，83%）进行胃肠道评估时，111 例处于复发缓解期，52 例处于进展期。由于数据不足，有 3 例患者未分配疾病阶段。82%（136/166）的患者存在便秘。有膀胱症状的大多数[103/116（88%）]患者也有便秘或大便失禁。该队列中分别有 16%和 7%的患者存在 4 小时时胃排空延迟和 24 小时时结肠转运延迟；22%的患者胃排空加速。在肛门直肠测压中，静息肛门括约肌压力>90mmHg 和直肠肛门压力差<-50mmHg 提示便秘患者排空障碍。
除了结肠转运缓慢和肛门直肠功能障碍导致 MS 患者便秘外，还有 22%的患者胃排空加速。
