AuD is a common cause of disability in MS patients, ranging from sphincter (bladder and bowel) dysfunction, to fatigue and cardiovascular autonomic dysfunction (CAD), among others. Both the sympathetic (SNS) and parasympathetic (PNS) nervous systems are frequently, albeit not always simultaneously, compromised. Bladder dysfunction is reported by approximately 75% of people with MS. Filling symptoms (ie failure to store), such as increased frequency, urinary urgency and nocturia, and emptying symptoms, such as intermittency, weak stream and straining at the beginning of urination are the most common manifestations. Lack of ability to inhibit the detrusor muscles controlling urination, leading to neurogenic detrusor over activity has a high incidence in MS. Bowel disorders are also common in MS, They are present in more than 70% of MS patients and are markedly associated with low quality of life scores. Bowel incontinence, diarrhea and constipation are the commonest manifestations most frequent underlying disorders are poor anal sphincter control, gut motility and ano-rectal sensation/coordination .
Last date updated on January, 2021