Unfortunately, bowel dysfunction is stigmatized by society and is not much talked about, even with health care practitioners (HCPs). Even though it is known that 50% of people with multiple sclerosis (MS) have some kind of bowel dysfunction, a recent study showed that it is not always addressed by HCPs. Furthermore, bowel symptoms such as constipation and fecal incontinence create great distress for both people with MS and their carers.
Transanal irrigation (TAI) is one bowel management therapy that is successful for some people with bowel dysfunction. Although a new publication show a high drop-out rate after 12 months of follow-up after TAI, the persons who continue with the treatment show an increase in quality of life and a reduction in bowel symptom scores.
https://www.ncbi.nlm.nih.gov/pubmed/28550483
Dibley L, Coggrave M, McClurg D, Woodward S, Norton C. UK
A qualitative study including patients with multiple sclerosis (MS) and their carers, investigating what it is like to live with bowel problems. The aim is to understand the impact that bowel problems have on their lives.
Participants of the study want bowel issues to be discussed more openly, with clinicians instigating a discussion early after MS diagnosis and repeating enquiries regularly. Patients’ experience with care services is often unsatisfactory.
Qualitative study of healthcare support of bowel dysfunction in MS.
This publication is described further in the highlight section.
https://www.ncbi.nlm.nih.gov/pubmed/28550422
Juul T, Christensen P. Denmark
A one year prospective study of 507 patients with bowel problems who have been introduced to transanal irrigation (TAI).
Adherence after 12 months was 43%. The main reason for discontinuation was unsatisfactory effectiveness. In those patients who continued, quality of life was increased and bowel function scores decreased.
Prospective study of patients introduced to TAI.
http://journals.sagepub.com/doi/10.1177/2050640616663439
Krogh K, Chiarioni G, Whitehead W. Denmark
A review covering chronic constipation (CC), including prevalence, pathophysiology and treatment suggestions. Treatments range from lifestyle modifications to surgery.
Chronic constipation is a common condition and most patients should be treated in primary care. However, in some evacuation disorders, rectal irrigation should be attempted. Surgery is restricted to patients with very severe symptoms.
Review of chronic constipation from prevalence, pathophysiology to treatment schedule.
This blog post is an extract of the Science Alert from June 2017 (76040-USX-1706)