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Anorectal dysfunction in multiple sclerosis

Servei de Neurología, Hospital del Mar, Barcelona, Spain, 91774{at}imas.imim.es

M Andreu

Servei de Digestiu, Hospital del Mar, Barcelona, Spain

M J Téllez

Secció de Neurofisiología, Hospital del Mar, Barcelona, Spain

D Mon

Servei de Neurología, Hospital del Mar, Barcelona, Spain

A Ois

Servei de Neurología, Hospital del Mar, Barcelona, Spain

J Roquer

Servei de Neurología, Hospital del Mar, Barcelona, Spain

Objective To ascertain the prevalence of anorectal dysfunction (ARD) in patients with multiple sclerosis (MS) and its relationship with MS clinical characteristics.

Methods Prospective transversal study in 193 patients with MS. All patients fulfilled a protocol that included: demographic variables, clinical characteristics of MS and the presence of ARD and urinary dysfunction (UD).

Results One hundred and ninety-three patients: 66.8% women, an average age of 42.8 (12.1) years; 67.8% of patients had relapsing-remitting MS, 21.2% a secondary progressive and 10.9% a primary progressive form. The average duration of MS was 10.7 (9.4) years and the EDSS 2.8 (2.3). ARD was present in 93 patients (48.2%), and UD in 50.2%. ARD associated to UD was present in 35.7% of cases. The univariate study revealed that patients with ARD were older (p<0.001), had greater disability (p<0.0001), longer disease duration (p<0.001) and a greater association with UD (p<0.0001). ARD was more frequent in progressive forms (p<0.0001). The logistic regression analysis showed that female sex (P=0.015), EDSS (P=0.002) and UD (P=0.003) were independent factors related to ARD.

Conclusion ARD is a highly prevalent disorder in MS. Female sex, EDSS and UD are independent predictors of ARD development.

Key Words: anorectal dysfunction • bowel • bladder • manometric • multiple sclerosis • paradoxical contraction

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