Bladder and bowel dysfunction in multiple sclerosis: A review of treatment effectiveness
E Jean C Hay-Smith, Richard J. Siegert, Mark Weatherall, David A. Abernethy
In the present review we located and examined 22 articles reporting trials of treatments for bladder and bowel problems among people diagnosed with multiple sclerosis (MS). Of those studies, 16 included only people with MS. The wide range of measures and methods used precluded any quantitative analysis and hence a narrative review was adopted. There is limited research evidence to guide the treatment of bladder and bowel problems among people with MS. We consider that there is reasonable evidence that oral anticholinergic agents and intranasal desmopressin offer some short-term relief for overactive bladder and nocturia respectively For those patients with persistent or refractory symptoms there is limited evidence from single trials which suggest that intravesical administration of antimuscarinics or vanilloids, or injection of detrusor muscle with botulinum-A toxin, might be considered. Future research priorities should include: studies that focus on managing bladder and bowel symptoms with samples consisting exclusively of people with MS; research on conservative strategies for the management of bladder symptoms; intervention studies of all types with longer follow-up periods. Finally, there is an urgent need for further research on the management of bowel problems in MS.