Review Article
Anorectal Dysfunction in Multiple Sclerosis: A Systematic Review
Table 1
Mechanisms of anorectal dysfunction.
| Assessment tool | Symptom | Sample size | MS severity | Results | Reference |
| Anorectal manometry | Con | 21 | EDDS: 5.3 | Decreased rectoanal inhibitory reflex | [23] | Con or FI | 39 | EDSS: 5 | No difference based on symptom patterns | [22] | | | DSS : 5 | | | Con | 13 | DSS : 8 |
Weak external sphincter: 62; impaired straining: 82 |
[11] | Con | 30 | EDSS: 6 | Lower squeeze pressure, impaired valsalva pressures | [12] | Con and FI | 11 | | Lower sphincter pressures in women | [35] | Con and FI | 23 | Wheelchair: 9 | Abnormal squeeze pressure in a subset | [36] | Con and FI | 16 | | Impaired amplitude and duration of squeeze pressure | [19] | Con and FI | 52 | EDSS: 4.13 | Decreased squeeze pressures | [16] | FI | 6 | | Markedly reduced squeeze pressure | [32] | FI | 12 | | Lower squeeze pressure in women only after childbirth | [27] | Con | 9 | EDSS: 9.6 | Decreased squeeze pressure | [13] |
| Recto-anal sensitivity | Con and FI | 39 | EDSS: 5 | No differences in rectal or anal sensory thresholds | [22] | Con and FI | 11 | | Normal rectal sensory thresholds | [35] | FI | 5 | | Abnormal sensory threshold to distension in 3/5 patients | [19] | Con | 9 | EDSS: 9.6 | Normal rectal and anal sensory thresholds | [13] | FI | 6 | | Normal rectal sensory thresholds | [32] | Con and FI | 52 | EDSS: 4.13 | Normal rectal sensory thresholds | [16] | Con and FI | 30 | EDSS: 6 | Abnormal sensory threshold to distension in 15 patients | [12] |
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Con: constipation; FI: fecal incontinence; EDSS: expanded disability status scale.
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