Constipation as a primer symptom in patients with Multiple Sclerosis
Constipation as a primer symptom in patients with Multiple SclerosisA group of 1256 multiple sclerosis (MS) patients, 361 males and 895 females, aged 47+/-9.3, with a duration of disease 9.5+/-4.2 years, were studied prospectively for a period of 10 years, in an attempt to evaluate the significance of constipation in their clinical course. Constipation and fatigue were priming symptoms in the greatest proportion of the patients, with a prevalence of 88.6% and 67.5%, respectively. A strong positive correlation of these symptoms was observed with the patients’ Kurtzke EDSS stage(p>0,01). Exacerbation of constipation was especially following disease crises triggered by infectious episodes. Generally, constipation was significantly worsening the patients’ quality of life, while the manipulation of the symptom with the conventional therapies was extremely difficult. A subgroup of 240 of the above patients (55 males and 185 females) submitted to mitoxantrone therapy (100mg) for their disease. Following-up these patients for one year period, we observed an up to 45% amelioration of their clinical symptoms. It is worth mentioning that constipation was ameliorated up to 11%, while in young patients the amelioration reached 15%. Only 2 of the MS patients treated with mitoxantrone appeared deteriorated. It is concluded that constipation consists a difficulty managed priming symptom of MS (65%) as well as that mitoxantrone appears especially effective in its treatment.
Abstract published in abstract book of the 8th world congress of the International Gastro-Surgical Club, 1998
paper presented at the 8th World Congress of the International Gastro-Surgical Club, Strasbourg, France April 15-18, 1998