Prevelance of neurogenic bowel dysfunction in multiple sclerosis and its association with quality of life

Gastrointestinal abnormalities are common in MS patients. This study aims to determine the prevalence of both neurogenic bowel dysfunction and individual bowel complaints—namely constipation, fecal incontinence, diarrhea, and bloating—in people with MS; to examine the relationships of these complaints with sociodemographic characteristics, disease-related features, dietary habits, and imaging findings; and to evaluate the impact of NBD severity on quality of life and fatigue. One hundred and two MS patients who were followed up in neurology outpatient clinic were included. Sociodemographic characteristics, disease duration, MS subtypes, EDSS scores, ongoing treatments and imaging findings of the patiens were assessed. Dietary habits were evaluated using a self-reported structured assessment form. The presence and severity of fecal incontinence were determined with WFIS and the presence and severity of NBD were assessed using NBDS. Quality of life and fatigue were evaluated with MSQoL-54, FIS and FSS. Among participants, 49% had chronic constipation, 22.5% chronic diarrhea, 43.1% bloating, 27.45% fecal incontinence and 86.3% neurogenic bowel dysfunction. Constipation risk was higher in individuals with lower educational attainment and higher EDSS scores, while DMF usage appeared protective against constipation. Individuals with lower EDSS scores had a higher risk of diarrhea. Marital status significantly influenced the development of bloating. Having two or more thoracic cord lesions was a significant predictor of both WFIS and NBDS scores. The likelihood of NBD was higher in patients with elevated EDSS scores and in women. Increase in bowel dysfunction was associated with reduced quality of life and increased fatigue. In conclusion, a substantial proportion of individuals with MS experience bowel complaints, which in turn impair quality of life. This study highlights the high prevalence of bowel dysfunction in MS. Early recognition of bowel complaints and timely treatment planning may improve patients' quality of life.