Constipation prevalence in multiple sclerosis about a cohort of 81 patients.

OBJECTIVE: Transit disorders are frequent in multiple sclerosis with an impact on the health related quality of life. However, just a few studies have been published on this subject. Moreover, these studies often concern patients with high EDSS. To get a more accurate view, we conducted an epidemiological study including all patients seen in PRM consultation over a given period.

MATERIALS/PATIENTS AND METHODS: All MS patients having been seen in PRM consultation over a 4-month period were questioned about the existence of constipation, its consequences and its management.

RESULTS: 81 patients, 48 women, 33 men, and mean age 49.5+-12 years were seen in consultation. The average EDSS was 4.3+-2, (median 4). Disease duration was 14.5+-9 years (median 12). MS was relapsing in 56.7%, primitive progressive in 16% and secondary progressive in 27, 3%. 46 patients, 56.8% of the study population complained of constipation. In four cases, the constipation was associated with a fecal incontinence. NBD average score was 5+-4 (median 4), 8 patients had a score higher than 10. On a Likert scale, discomfort is considered moderate or severe to 41.3% and constraint related to constipation moderate or severe for 40%. 61% of patients report complications: abdominal bloating for 16 patients, pain for 13 and hemorrhoid problems for 9. No statistical link was found between the existence of constipation and age, sex, MS duration, MS type or EDSS. Constipation is a common symptom in MS with a major impact in everyday for patients with MS.

DISCUSSION/CONCLUSION: We found a prevalent consistent with literature data. In our sample, constipation is more common than urinary problems. It does not seem to be associated with the developing profile of the disease. This implies an early screening for appropriate care to minimize the clinical consequences of bowel disorders.