Gastric motility dysfunction in patients with multiple sclerosis assessed by gastric emptying scintigraphy

Abstract

Background: Gastrointestinal tract symptoms are common in patients with multiple sclerosis (MS), especially constipation and/or fecal incontinence. Aims: To assess gastric emptying in patients with MS to detect the severity of autonomic disturbances in the gastrointestinal tract, and to find the relationship between lower bowel disturbances and the rate of gastric emptying. Methods: Forty-nine patients with definite MS and 20 control subjects were included in the study. All patients underwent full neurological examination and magnetic resonance imaging of the brain and spinal cord. The labelled meal for gastric emptying scintigraphy consisted of cooked eggs mixed with 3 mCi of technetium-99m colloid, and was followed by serial images at 15 min intervals for 2 h. Results: Five studies were excluded due to technical artifacts. Twenty-one patients (47.7 %) demonstrated slow emptying, 15 (34.1%) demonstrated normal and eight (18.2%) demonstrated fast clearance curves. The mean half-time of gastric emptying in MS patients was 96.6±22.4 min and the controls showed a mean half-time of 41.3±18.7 min (P<0.05). The half-time was longer in patients with constipation; nevertheless, it showed no significant difference compared with patients without constipation (P=0.197). Moreover, although half-time was shorter in patients with fecal incontinence, there was not a significant difference compared with those without fecal incontinence (P=0.654). Conclusions: The gastric emptying rate is slow in MS patients. As for lower bowel disturbances, the gastric emptying rate was obviously affected in patients complaining of constipation and fecal incontinence, although statistical significance was not reached. © 2005 Pulsus Group Inc. All rights reserved.