好色先生

好色先生

Explore the latest content from across our publications

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Burden of Constipation in Patients with Amyotrophic Lateral Sclerosis and Possible Relationship to Dysautonomia
Neuromuscular and Clinical Neurophysiology (EMG)
Autonomic Disorders Posters (7:00 AM-5:00 PM)
007

Amyotrophic lateral sclerosis (ALS), considered a pure motor disease, can affect the autonomic nervous system, with sudomotor, cardiovagal, adrenergic, bladder and gastrointestinal (GI) dysfunction. Patients with ALS (PALS) report high rates of GI dysfunction; constipation, but its extent, severity, and relationship to autonomic dysfunction is not well understood.

To ascertain the burden of constipation in PALS and its possible relationship to dysautonomia. We hypothesize constipation in ALS is due to autonomic dysfunction and/or decreased mobility, fluid intake, and medications.

Autonomic dysfunction, constipation’s impact on quality of life, and constipation symptoms in 44 PALS were assessed with Scales for Outcomes in Parkinson’s Disease-Autonomic (SCOPA-AUT), Patient Assessment of Constipation- Quality of Life (PAC-QOL), and Patient Assessment of Constipation- Symptoms (PAC-SYM) respectively. Scores were compared to previously reported disease-free subjects’(DFS) scores. 

PALS had higher rates of constipation on PAC-SYM; higher means for abdominal (3.44 vs. 1.59), rectal (2.6 vs. 1.06) and stool (5.47 vs. 2.07) symptoms

SCOPA-AUT results; 86% with GI dysfunction, vs 17% DFS. Other autonomic symptoms were urinary (81% vs. 46%), thermoregulatory (59% vs. 37%), and cardiac (31% vs. 9%).

PALS had greater negative effects on PAC-QOL; higher medians for physical discomfort (4.31 vs. 2.09), psychosocial discomfort (6.4 vs. .93), worries/concerns (9.26 vs. 1.69), and satisfaction (12.05 vs. 3.49).

Negative correlation exists between ALS-FRS, SCOPA-AUT, PAC-QOL and PAC-SYM scores. No significant correlation noted between disease duration or site of onset.

PALS on tricyclic antidepressants, narcotics, anticholinergics, antihistamines, antipsychotics, or Edaravone, had higher median SCOPA-AUT (13 vs. 6) and PAC-SYM scores (8 vs. 2).

We report higher rates of GI dysfunction in PALS and propose possible relationship to dysautonomia.  This study is ongoing, to ascertain extent/association of autonomic dysfunction, fluid intake, and medications.  This can pave way for individualizing treatment for GI dysfunction in PALS.

 

Authors/Disclosures
Anika Mazumder (Saint Louis University School of Medicine)
PRESENTER
Anika Mazumder has nothing to disclose.
No disclosure on file
UTTARA KOUL, MBBS (Hartford Healthcare) Dr. KOUL has nothing to disclose.
Jafar Kafaie, MD, PhD (Saint Louis University) Dr. Kafaie has nothing to disclose.
Roula Al-Dahhak, MD Dr. Al-Dahhak has nothing to disclose.
Ghazala Hayat, MBBS, FAAN (Saint Louis University) Dr. Hayat has received personal compensation in the range of $500-$4,999 for serving as a Consultant for kabafusion. Dr. Hayat has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for csl. Dr. Hayat has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for alexion. Dr. Hayat has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for MTPA. Dr. Hayat has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for alexion. Dr. Hayat has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for kabafusion.