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Increased prevalence of bladder and intestinal dysfunction in amyotrophic lateral sclerosis.

Abstract
Amyotrophic lateral sclerosis (ALS) is predominantly characterized by a progressive loss of motor function. While autonomic dysfunction has been described in ALS, little is known about the prevalence of lower urinary tract symptoms (LUTS) and intestinal dysfunction. We investigated disease severity, LUTS and intestinal dysfunction in 43 patients with ALS attending our outpatient department applying the ALS functional rating scale, the International Consultation on Incontinence Modular Questionnaire, the Urinary Distress Inventory and the Cleveland Clinic Incontinence Score. Results were compared to the German population of a cross-sectional study assessing LUTS in the healthy population, the EPIC study. Results showed that urinary incontinence was increased in patients with ALS aged ≥ 60 years compared to the EPIC cohort (female: 50%/19% (ALS/EPIC), p = 0.026; male: 36%/11% (ALS/EPIC), p = 0.002). No difference was seen at 40-59 years of age. Urge incontinence was the predominant presentation (73% of symptoms). A high symptom burden was stated (ICIQ-SF quality of life subscore 5.5/10). Intake of muscle relaxants and anticholinergics was associated with both urinary incontinence and severity of symptoms. Furthermore, a high prevalence of constipation (46%), but not stool incontinence (9%), was noted. In conclusion, the increased prevalence of urge incontinence and high symptom burden imply that in patients with ALS, LUTS should be increasingly investigated for.
AuthorsGeorg S Nübling, Eva Mie, Ricarda M Bauer, Mira Hensler, Stefan Lorenzl, Alexander Hapfelmeier, Debra E Irwin, Gian Domenico Borasio, Andrea S Winkler
JournalAmyotrophic lateral sclerosis & frontotemporal degeneration (Amyotroph Lateral Scler Frontotemporal Degener) Vol. 15 Issue 3-4 Pg. 174-9 (Jun 2014) ISSN: 2167-9223 [Electronic] England
PMID24479577 (Publication Type: Journal Article)
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Amyotrophic Lateral Sclerosis (complications, epidemiology)
  • Female
  • Germany
  • Humans
  • Intestinal Diseases (classification, epidemiology, etiology)
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Urination Disorders (epidemiology, etiology)

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