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首页> 外文期刊>Degenerative Neurological and Neuromuscular Disease >Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies
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Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies

机译：多发性硬化症患者的神经源性肠功能障碍：患病率，影响和治疗策略

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Bowel dysfunction in patients with multiple sclerosis (MS) is highly prevalent. Constipation and fecal incontinence can coexist and alternate, impacting on the patient’s quality of life and social interactions, as well as burdening the caregivers. The cost for the health care providers is also significant, with increased number of hospital admissions, treatment-related costs, and hospital appointments. The origin is multifactorial, and includes alteration of neurological pathways, polypharmacy, behavioral elements, and ability to access the toilet. Every patient with MS should be sensitively questioned about bowel function, and red flag symptoms should prompt adequate investigations. Manipulation of life style factors and establishment of a bowel regime should be attempted in the first place, and if this fails, other measures such as biofeedback and transanal irrigation should be included. A stoma can improve quality of life, and is not necessarily a last-ditch option. Antegrade colonic enemas can also be an effective option,?whilst neuromodulation has not proved its role yet. Effective treatment of bowel dysfunction improves quality of life, reduces incidence of urinary tract infection, and reduces health care costs.
机译：多发性硬化症（MS）患者的肠功能障碍非常普遍。便秘和大便失禁可以共存和交替出现，影响患者的生活质量和社交互动，并给护理人员增加负担。卫生保健提供者的费用也很可观，医院住院的人数，与治疗有关的费用和医院预约的次数都在增加。起源是多因素的，包括神经系统途径的改变，多元药房，行为因素以及上厕所的能力。应该对每个MS患者的肠功能进行敏感询问，并且红旗症状应促使进行充分检查。首先应尝试操纵生活方式因素并建立排便制度，如果失败，应包括其他措施，例如生物反馈和经肛门冲洗。气孔可以改善生活质量，不一定是最后的选择。整合性结肠灌肠也可以是一种有效的选择，尽管神经调节尚未证明其作用。有效治疗肠功能障碍可改善生活质量，减少尿路感染的发生率，并降低医疗保健成本。

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