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Multiple Sclerosis International
Volume 2013, Article ID 319201, 9 pages
Research Article

Adding to the Burden: Gastrointestinal Symptoms and Syndromes in Multiple Sclerosis

1Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, S848 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, USA
2Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA
3Division of Gastroenterology, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
4Neuroimmunology/Multiple Sclerosis Division, Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA

Received 12 June 2013; Accepted 14 August 2013

Academic Editor: Mark S. Freedman

Copyright © 2013 David J. Levinthal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Multiple sclerosis (MS) patients often suffer from gastrointestinal (GI) symptoms. However, the full extent and prevalence of such symptoms are not clearly established. Thus, we sought to define the prevalence of GI symptoms and syndromes in those with MS. Methods. 218 MS patients completed self-reported demographic and clinical data questionnaires as well as several standardized surveys probing MS severity and GI health. Results. Nearly two thirds (65.6%) of patients endorsed at least one persistent GI symptom. Constipation (36.6%), dysphagia (21.1%), and fecal incontinence (15.1%) were common. Surprisingly, nearly 30% (28.4%) of the patients reported dyspeptic symptoms. Using validated diagnostic algorithms, patients met criteria for functional dysphagia (14.7%), functional dyspepsia (16.5%), functional constipation (31.7%), and IBS (19.3%), among others. Functional dysphagia, functional dyspepsia, and IBS were significantly more common in those with self-identified mood disorders. Conclusions. Constipation, fecal incontinence, and dysphagia are indeed frequent symptoms seen in MS patients. We also noted a ~30% prevalence of dyspepsia in this population. The mechanisms driving this association are not clear and require further study. However, due to this high prevalence, dyspeptic symptoms should be incorporated into the routine assessment of MS patients and, if found, may warrant collaborative referral with a GI specialist.