Long-term efficacy and safety of transanal irrigation in multiple sclerosis.

Autor: Passananti V; GI Physiology Unit, University College London Hospital and National Hospital for Neurology & Neurosurgery, London, UK., Wilton A; Department of Physiology, University of Bristol, Bristol, UK., Preziosi G; GI Physiology Unit, University College London Hospital and National Hospital for Neurology & Neurosurgery, London, UK., Storrie JB; GI Physiology Unit, University College London Hospital and National Hospital for Neurology & Neurosurgery, London, UK., Emmanuel A; GI Physiology Unit, University College London Hospital and National Hospital for Neurology & Neurosurgery, London, UK.
Jazyk: angličtina
Zdroj: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society [Neurogastroenterol Motil] 2016 Sep; Vol. 28 (9), pp. 1349-55. Date of Electronic Publication: 2016 Apr 26.
DOI: 10.1111/nmo.12833
Abstrakt: Background: Multiple sclerosis (MS) is the commonest disabling neurological disease in young adults. A majority of patients experience bowel dysfunction, reporting a wide spectrum of bowel symptoms that significantly negatively impact social activities and emotional state. Transanal irrigation (TAI) is a method of managing such bowel symptoms. We aimed to investigate long-term efficacy of TAI, to measure health status-related quality of life and identify factors predictive of TAI outcome.
Methods: Forty-nine consecutive MS patients (37 female; mean age 51, range 26-80) were studied. We investigated predominant symptoms, reason for beginning TAI and medical comorbidity. All patients underwent anorectal physiology testing. They completed Neurogenic Bowel Dysfunction and EQ-5D questionnaires at baseline and annual follow-up.
Key Results: Mean follow-up was 40 months, at which there was 55% rate of continuation of TAI. Severe bowel dysfunction was present in 47% at baseline, falling to 18%. The EQ-5D scores at latest follow-up were not statistically significant, but 42% had improved visual analog scores. The only predictive factor for successful therapy was impaired anal electrosensitivity (p = 0.008).
Conclusions & Inferences: Long-term continuation of TAI, with improved bowel symptomatology, is seen in the majority of patients. The EQ-5D is insufficiently sensitive to show change in MS patients that using TAI.
(© 2016 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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