CoChat
Sign Up
Cited by 24Gastrointestinal motility and disordersMultiple Sclerosis Research StudiesPelvic floor disorders treatments

Gastrointestinal motility disorders in patients with multiple sclerosis: a single-center study

Open access
Khanna, Lehar, Zeydan, Burcu, Kantarci, Orhun H., Camilleri, Michael·2022·Neurogastroenterology & Motility
DOI 10.1111/nmo.14326PMC PMC9338921
Open this paper in CoChat — free account

Abstract

Background: Most prevalent gastrointestinal symptoms in multiple sclerosis (MS) relate to lower bowel dysfunction, often in association with bladder manifestations. Objective: To assess clinical and objective gastrointestinal motor dysfunctions in patients with MS. Methods: This was a single‐center, retrospective study of 166 patients evaluated between 1996 and 2020. We reviewed characterization of the MS, gastrointestinal and neurological symptoms, measurements of gastrointestinal and colonic transit, and anorectal manometry. Key Results: At the time of the gastrointestinal evaluations of the 166 patients with MS (138 women; 83%), 111 were in the relapsing‐remitting phase and 52 were in the progressive phase. In 3 patients, disease phase was not assigned due to insufficient data. Constipation was identified in 82% (136/166) of patients. Most [103/116 (88%)] patients with bladder symptoms also had constipation or fecal incontinence. Delayed gastric emptying at 4 h and colonic transit at 24 h was identified in 16% and 7% of the cohort, respectively; 22% had accelerated gastric emptying. On anorectal manometry, resting anal sphincter pressure >90 mm Hg and rectoanal pressure differential below −50mm Hg suggested evacuation disorder in patients with constipation. Conclusions and Inferences: In addition to slow colonic transit and anorectal dysfunction leading to constipation in MS, 22% of patients had accelerated gastric emptying.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/nmo.14326

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Gastric emptying abnormalities in multiple sclerosis show phenotypic heterogeneity influenced by comorbidities and medications.

    “highlighting phenotypic heterogeneity and the influence of comorbidities and medications (Khanna et al., 2022).”

    From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Khanna et al., 2022

    The Results (Gastrointestinal Transit Study; page unavailable) document both accelerated and delayed gastric emptying in patients with MS, supporting phenotypic heterogeneity. They say medications could conceivably alter gastrointestinal motility, but do not establish that medications influenced the observed gastric-emptying abnormalities; the cited passages also do not establish an influence of comorbidities. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Gastrointestinal symptoms affect more than 80% of individuals with relapsing-remitting multiple sclerosis.

    “Gastrointestinal (GI) symptoms affect more than 80% of individuals with relapsing-remitting multiple sclerosis (RRMS).”

    From The effects of ginger supplementation on common gastrointestinal symptoms in patients with relapsing-remitting multiple sclerosis: a double-blind randomized placebo-controlled trial (2023) · cites this paper as [4]

    The Results (Demographics and Clinical Characteristics; GI Symptoms and Relationship to Gastrointestinal Transit Results) report constipation in 86 of 111 patients in the relapsing-remitting phase and fecal incontinence without constipation in another five—91 of 111, or about 82%. However, this was a selected group undergoing gastrointestinal evaluation, and the 111 included 11 patients with isolated syndromes rather than confirmed RRMS. The paper does not establish a prevalence above 80% among individuals with RRMS generally. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Anorectal dysfunction and slow colonic transit leading to constipation are the most prevalent gastrointestinal problems in individuals with multiple sclerosis.

    “In particular, anorectal dysfunction and slow colonic transit leading to constipation appear to be the most prevalent GI problems in individuals with MS [4].”

    From The effects of ginger supplementation on common gastrointestinal symptoms in patients with relapsing-remitting multiple sclerosis: a double-blind randomized placebo-controlled trial (2023) · cites this paper as [4]

    The Results (Gastrointestinal Transit Study; page not provided) identify constipation as the most common symptom, and the Conclusions link slow colonic transit and anorectal dysfunction to constipation. But the Discussion reports that delayed colonic transit and defecatory dysfunction occurred in a relatively small proportion of this selected cohort; it does not support calling those dysfunctions the most prevalent GI problems in individuals with MS. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In a single-center retrospective cohort of 166 multiple sclerosis patients evaluated for GI motility symptoms over a 25-year interval, delayed gastric emptying was reported in 16%.

    “In a single-center retrospective cohort of 166 MS patients evaluated for GI motility symptoms over a 25-year interval, delayed gastric emptying (16%) and accelerated emptying (22%) were both reported, highlighting phenotypic heterogeneity and the influence of comorbidities and medications (Khanna et al., 2022).”

    From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Khanna et al., 2022

  • In a single-center retrospective cohort of 166 multiple sclerosis patients evaluated for GI motility symptoms over a 25-year interval, accelerated gastric emptying was reported in 22%.

    “In a single-center retrospective cohort of 166 MS patients evaluated for GI motility symptoms over a 25-year interval, delayed gastric emptying (16%) and accelerated emptying (22%) were both reported, highlighting phenotypic heterogeneity and the influence of comorbidities and medications (Khanna et al., 2022).”

    From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Khanna et al., 2022

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 35

  1. [2]Kantarci O, Siva A, Eraksoy M, Survival and predictors of disability in Turkish MS patients. Turkish Multiple Sclerosis Study Group (TUMSSG). Neurology 1998; 51: 765– 772. 9748024
  2. [3]Sletten DM, Suarez GA, Low PA, Mandrekar J, Singer W. COMPASS 31: a refined and abbreviated composite autonomic symptom score. Mayo Clin Proc 2012; 87: 1196– 1201. 23218087 PMC3541923
  3. [4]Foschi M, Giannini G, Merli E, Frequency and characteristics of dysautonomic symptoms in multiple sclerosis: a cross-sectional double-center study with the validated Italian version of the Composite Autonomic Symptom Score-31. Neurol Sci 2021; 42: 1395– 1403. 32776288 PMC7955976
  4. [5]Levinthal DJ, Rahman A, Nusrat S, O’Leary M, Heyman R, Bielefeldt K. Adding to the burden: gastrointestinal symptoms and syndromes in multiple sclerosis. Mult Scler Int 2013; 2013: 319201. 24163768 PMC3791579
  5. [6]Hinds JP, Eidelman BH, Wald A. Prevalence of bowel dysfunction in multiple sclerosis. A population survey. Gastroenterology 1990; 98: 1538– 1542. 2338192
  6. [7]Read SJ, Leggett BA, Pender MP. Gastroparesis with multiple sclerosis. Lancet 1995; 346: 1228. 7475681
  7. [9], Caruana BJ, Wald A, Hinds JP, Eidelman BH. Anorectal sensory and motor function in neurogenic fecal incontinence. Comparison between multiple sclerosis and diabetes mellitus. Gastroenterology 1991; 100: 465– 470. 1985043
  8. [10]Kantarci OH. Phases and phenotypes of multiple sclerosis. Continuum (Minneap Minn) 2019; 25: 636– 654. 31162309
  9. [11]Tack J, Drossman DA. What’s new in Rome IV? Neurogastroenterol Motil 2017 Sep; 29(9). doi: 10.1111/nmo.13053. Epub 2017 Mar 17. 28303651 · DOI
  10. [12]Camilleri M, Iturrino J, Bharucha AE, Performance characteristics of scintigraphic measurement of gastric emptying of solids in healthy participants. Neurogastroenterol Motil 2012; 24: 1076– e562. 22747676 PMC3465511
  11. [13]Burton DD, Camilleri M, Mullan BP, Forstrom LA, Hung JC. Colonic transit scintigraphy labeled activated charcoal compared with ion exchange pellets. J Nucl Med 1997; 38: 1807– 1810. 9374360
  12. [14]Camilleri M, Zinsmeister AR, Greydanus MP, Brown ML, Proano M. Towards a less costly but accurate test of gastric emptying and small bowel transit. Dig Dis Sci 1991; 36: 609– 615. 2022162
  13. [15]Kolar GJ, Camilleri M, Burton D, Nadeau A, Zinsmeister AR. Prevalence of colonic motor or evacuation disorders in patients presenting with chronic nausea and vomiting evaluated by a single gastroenterologist in a tertiary referral practice. Neurogastroenterol Motil 2014; 26: 131– 138. 24118658 PMC3865078
  14. [16]Khoshbin K, Busciglio I, Burton D, Breen-Lyles MK, Camilleri M. Expanding criteria for slow colonic transit in patients being evaluated for chronic constipation by scintigraphy. Neurogastroenterol Motil 2020; 32: e13878. 32394592 PMC7483962
  15. [17]Lee TH, Bharucha AE. How to perform and interpret a high-resolution anorectal manometry test. J Neurogastroenterol Motil 2016; 22: 46– 59. 26717931 PMC4699721
  16. [18]Minguez M, Herreros B, Sanchiz V, Predictive value of the balloon expulsion test for excluding the diagnosis of pelvic floor dyssynergia in constipation. Gastroenterology 2004; 126: 57– 62. 14699488
  17. [19]Grossi U, Carrington EV, Bharucha AE, Horrocks EJ, Scott SM, Knowles CH. Diagnostic accuracy study of anorectal manometry for diagnosis of dyssynergic defecation. Gut 2016; 65: 447– 455. 25765461 PMC4686376
  18. [20]Zeydan B, Gu X, Atkinson EJ, Cervical spinal cord atrophy: An early marker of progressive MS onset. Neurol Neuroimmunol Neuroinflamm 2018; 5: e435. 29435472 PMC5795903
  19. [21]Weber J, Grise P, Roquebert M, Radiopaque markers transit and anorectal manometry in 16 patients with multiple sclerosis and urinary bladder dysfunction. Dis Colon Rectum 1987; 30: 95– 100. 3803128
  20. [22]Marola S, Ferrarese A, Gibin E, Anal sphincter dysfunction in multiple sclerosis: an observation manometric study. Open Med (Wars) 2016; 11: 509– 517. 28352843 PMC5329875
  21. [23]Goyal RK, Guo Y, Mashimo H. Advances in the physiology of gastric emptying. Neurogastroenterol Motil 2019; 31: e13546. 30740834 PMC6850045
  22. [24]Anema JR, Heijenbrok MW, Faes TJ, Heimans JJ, Lanting P, Polman CH. Cardiovascular autonomic function in multiple sclerosis. J Neurol Sci 1991; 104: 129– 134. 1940968
  23. [25]Wang XJ, Burton DD, Breen-Lyles M, Camilleri M. Gastric accommodation influences proximal gastric and total gastric emptying in concurrent measurements conducted in healthy volunteers. Am J Physiol Gastrointest Liver Physiol 2021; 320: G759– G767. 33719546 PMC8202200
  24. [26]Wunsch M, Jabari S, Voussen B, The enteric nervous system is a potential autoimmune target in multiple sclerosis. Acta Neuropathol 2017; 134: 281– 295. 28620692
  25. [27]Kuerten S, Lichtenegger FS, Faas S, Angelov DN, Tary-Lehmann M, Lehmann PV. MBP-PLP fusion protein-induced EAE in C57BL/6 mice. J Neuroimmunol 2006; 177: 99– 111. 16781782
  26. [28]Chen J, Chia N, Kalari KR, Multiple sclerosis patients have a distinct gut microbiota compared to healthy controls. Sci Rep 2016; 6: 28484. 27346372 PMC4921909
  27. [29]Takewaki D, Suda W, Sato W, Alterations of the gut ecological and functional microenvironment in different stages of multiple sclerosis. Proc Natl Acad Sci U S A 2020; 117: 22402– 22412. 32839304 PMC7486801
  28. [30]Breen M, Camilleri M, Burton D, Zinsmeister. Performance characteristics of the measurement of gastric volume using single photon emission computed tomography. Neurogastroenterol Motil 2011; 23: 308– 315. 21210894 PMC3105214
  29. [31]Kusunoki H, Haruma K, Manabe N, Therapeutic efficacy of acotiamide in patients with functional dyspepsia based on enhanced postprandial gastric accommodation and emptying: randomized controlled study evaluation by real-time ultrasonography. Neurogastroenterol Motil 2012; 24: 540– 545.e250–1. 22385472
  30. [32]Tack J, Janssen P, Masaoka T, Farre R, Van Oudenhove L. Efficacy of buspirone, a fundus-relaxing drug, in patients with functional dyspepsia. Clin Gastroenterol Hepatol 2012; 10: 1239– 1245. 22813445
  31. [33]Chial HJ, Camilleri M, Burton D, Thomforde G, Olden KW, Stephens D. Selective effects of serotonergic psychoactive agents on gastrointestinal functions in health. Am J Physiol Gastrointest Liver Physiol 2003; 284: G130– G137. 12488239
  32. [34]Jacob D, Busciglio I, Burton D, Effects of NK1 receptors on gastric motor functions and satiation in healthy humans: results from a controlled trial with the NK1 antagonist aprepitant. Am J Physiol Gastrointest Liver Physiol 2017; 313: G505– G510. 28814387 PMC5792217
  33. [35]Camilleri M, Cowen T, Koch TR. Review: Enteric neurodegeneration in ageing. Neurogastroenterol Motil 2008; 20: 417– 429. 18371012
  34. [36]Bernard CE, Gibbons SJ, Gomez-Pinilla PJ, Effect of age on the enteric nervous system of the human colon. Neurogastroenterol Motil 2009; 21: 746– e46. 19220755 PMC2776702
  35. [37]Oblizajek NR, Gandhi S, Sharma M, Chakraborty S, Muthyala A, Prichard D, Feuerhak K, Bharucha AE. Anorectal pressures measured with high-resolution manometry in healthy people -normal values and asymptomatic pelvic floor dysfunction. Neurogastroenterol Motil 2019; 31: e13597. 30957382 PMC6559859

Cited by

Sorted by citations

Authors
Khanna, L., Zeydan, B., Kantarci, O. H., & Camilleri, M.
Affiliations
  • Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Division of Gastroenterology and Hepatology Rochester MN USA
  • Mayo Clinic (US)
Corresponding author
Camilleri, Michael
ORCID
Venue
Neurogastroenterology & Motility
Publisher
Wiley
Published
2022-02-03
Volume
34
Issue
8
Pages
e14326-e14326
ISSN
  • 1350-1925 (ISSN-L)
  • 1365-2982
DOI
10.1111/nmo.14326
PMC
PMC9338921
OpenAlex
W4210344545
Cited by
24
References
2
Citations by year
2026: 8 · 2025: 6 · 2024: 3 · 2023: 7
FWCI
0.82
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Neurogastroenterology & Motility (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (R01‐DK122280)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
Keywords
multiple sclerosis, gastrointestinal motility disorders, constipation, fecal incontinence, colonic transit, gastric emptying, anorectal manometry, anal sphincter pressure, defecation disorders, bladder dysfunction
MeSH terms
Anal Canal, Constipation, Female, Gastrointestinal Motility, Gastrointestinal Transit, Humans, Manometry, Multiple Sclerosis, Retrospective Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review