PREVALENCE OF BOWEL DYSFUNCTION IN PATIENTS WITH MULTIPLE-SCLEROSIS AND BLADDER DYSFUNCTION

Urinary dysfunction is common in cases of multiple sclerosis (MS). The close proximity of those neural pathways which control the bladder to those which control anorectal function might be expected to lead to a high coexistence of bladder and bowel symptoms. Seventy-seven consecu tive patients with clinically definite MS attending a uro-neurology cl inic were interviewed about their bowel function. All patients had cli nical evidence of spinal cord disease with varying degrees of impaired mobility and sufficiently severe disturbance of bladder control to se ek medical advice. Thirty-six per cent of these patients had constipat ion. Twenty per cent had ''current incontinence'', although another 30 % had had at least one episode of faecal incontinence more than 3 mont hs previously. Some patients had both constipation and faecal incontin ence. A total of 52% currently had at least one bowel symptom. The pat tern of bowel symptoms did not correlate with the pattern of urinary d isturbance, or the duration of MS, or the degree of disability. Bowel symptoms are common in patients with MS, but even in those with urinar y dysfunction are not universal. Whereas bladder dysfunction in MS is clearly related to spinal cord disease, the neurological basis for the bowel dysfunction is less clear.