Saleem Fajer, Shadia Sajjal, Govindasamy Vaisnavy, Fatima Rehab, Khan Ramla M, Suresh Keziah Nithiya, John Steve Paulson, Khalid Sana, Mubarak Tamer Azzam Fuad, Abdelsadig Mohamed Khalafalla Adlan, Bano Sher
General Medicine, Ayub Medical College Abbottabad, Abbottabad, PAK.
General Medicine, Shifa College of Medicine, Islamabad, PAK.
Cureus. 2025 May 3;17(5):e83386. doi: 10.7759/cureus.83386. eCollection 2025 May.
Introduction Multiple sclerosis (MS) is a chronic autoimmune neurodegenerative disease that typically leads to neurological signs along with physical and cognitive issues while affecting the gastrointestinal (GI) system. GI dysfunctions like constipation and indigestion frequently affect MS patients, although their relationship with MS disease progression is not well documented. Methods The research team conducted a cross-sectional quantitative study that enrolled 300 adult MS patients between 18 and 65 years of age through purposive sampling. Data collection occurred from January through March 2025 using standardized tools for self-report assessments, clinical evaluations (Gastrointestinal Symptom Rating Scale (GSRS) and Expanded Disability Status Scale (EDSS)), and demographic information. Statistics in this study used Pearson correlation and linear regression methods to establish the relationship between GI symptoms and MS severity determinants. The analysis employed one-way ANOVA for group means assessment according to age categories alongside treatment facilities, followed by chi-square (χ²) for examining age-oriented treatment center relations. Results The research data revealed significant positive links between MS disease severity levels and gastrointestinal symptoms (GI) severity (r = 0.132, p <0.05). In contrast, GI symptoms emerged as an essential predictor of disease severity (β = 0.148, p <0.01). The age groups did not affect GI symptoms significantly (F (2,297) = 0.326, p > 0.05). Government centers had higher levels of disability and GI symptoms (F (3,296) = 14.92, p <0.01). The type of treatment center showed no correlation with the age distributions of patients (χ² = 3.525, p = 0.474). The study participants most commonly fell into the age range of 22-24 years old (198 participants (66%)), while 73% (218 participants) were male. Government-controlled treatment centers indicated more gastrointestinal symptoms as well as disability levels when analyzed against both private facilities and semi-government centers. Conclusion The research confirms that gastrointestinal symptoms are both relevant and very weakly associated with disease progression in MS. Systematically observing gastrointestinal symptoms in MS management will generate better patient treatment outcomes. Long-term investigations about treatment strategies must be conducted to measure cause-and-effect relationships while perfecting symptom management strategies for MS patients.
引言
多发性硬化症（MS）是一种慢性自身免疫性神经退行性疾病，通常会导致神经症状以及身体和认知问题，同时还会影响胃肠道（GI）系统。便秘和消化不良等胃肠道功能障碍经常影响MS患者，尽管它们与MS疾病进展的关系尚未得到充分记录。
方法
研究团队进行了一项横断面定量研究，通过目的抽样招募了300名年龄在18至65岁之间的成年MS患者。数据收集于2025年1月至3月进行，使用标准化工具进行自我报告评估、临床评估（胃肠道症状评分量表（GSRS）和扩展残疾状态量表（EDSS））以及人口统计学信息。本研究使用Pearson相关性和线性回归方法来建立胃肠道症状与MS严重程度决定因素之间的关系。分析采用单向方差分析按年龄类别以及治疗机构评估组均值，随后采用卡方检验（χ²）来检查以年龄为导向的治疗中心关系。
结果
研究数据显示，MS疾病严重程度水平与胃肠道症状（GI）严重程度之间存在显著的正相关（r = 0.132，p <0.05）。相比之下，胃肠道症状是疾病严重程度的重要预测指标（β = 0.148，p <0.01）。年龄组对胃肠道症状没有显著影响（F（2,297）= 0.326，p > 0.05）。政府中心的残疾水平和胃肠道症状水平更高（F（3,296）= 14.92，p <0.01）。治疗中心类型与患者年龄分布无相关性（χ² = 3.525，p = 0.474）。研究参与者最常见的年龄范围是22 - 24岁（198名参与者（66%）），而73%（218名参与者）为男性。与私立机构和半政府中心相比，政府控制的治疗中心显示出更多的胃肠道症状和残疾水平。
结论
该研究证实，胃肠道症状在MS疾病进展中既相关又关联较弱。在MS管理中系统地观察胃肠道症状将产生更好的患者治疗效果。必须对治疗策略进行长期调查，以衡量因果关系，同时完善MS患者的症状管理策略。
