About all

MS Stomach Symptoms: Understanding and Managing Bowel Problems in Multiple Sclerosis

How does Multiple Sclerosis affect bowel function. What are the common stomach symptoms associated with MS. How can individuals with MS manage constipation and diarrhea. What lifestyle changes can help alleviate MS-related bowel problems. Why is it important to address bowel issues in MS management.

Содержание

The Connection Between Multiple Sclerosis and Bowel Dysfunction

Multiple Sclerosis (MS) is a complex neurological condition that can affect various bodily functions, including the digestive system. Many individuals with MS experience bowel problems at some point during their illness. These issues arise due to damage in the communication pathways between the brain and the digestive system, impacting the control of colon muscles.

The primary bowel dysfunctions associated with MS are:

  • Constipation
  • Incontinence
  • Diarrhea (less common)

These symptoms occur because MS can affect the proper functioning of anal sphincter muscles, leading to difficulties in relaxation or contraction when needed. Additionally, other MS symptoms like fatigue and spasticity can exacerbate bowel problems by reducing physical activity and altering fluid intake patterns.

Constipation in MS: Causes, Symptoms, and Impact

Constipation is the most prevalent bowel dysfunction in individuals with MS. It typically results from a combination of factors, including:

  • Reduced physical activity due to MS-related fatigue
  • Poor diet lacking in fiber
  • Inadequate fluid intake
  • Neurological damage affecting colon muscle control

Common symptoms of constipation in MS patients include:

  • Infrequent bowel movements
  • Hard, dry stools
  • Straining during defecation
  • Abdominal discomfort or bloating
  • Feeling of incomplete evacuation

Constipation can significantly impact quality of life for MS patients, leading to discomfort, embarrassment, and potential complications if left unaddressed.

Diarrhea and Bowel Incontinence in MS: Understanding the Causes

While less common than constipation, diarrhea and bowel incontinence can also affect individuals with MS. These symptoms may arise from various factors:

  • Stomach infections or bugs
  • Food poisoning
  • Side effects of medications or antibiotics
  • Overflow incontinence due to severe constipation

It’s important to note that what appears to be diarrhea in MS patients may actually be leakage around impacted stools caused by severe constipation. This phenomenon, known as overflow incontinence, can be mistaken for true diarrhea and requires proper diagnosis for effective management.

The Mind-Body Connection: Emotional Wellbeing and Bowel Function in MS

The relationship between emotional wellbeing and bowel function is crucial in MS management. Stress, anxiety, and depression can exacerbate bowel problems, creating a vicious cycle of physical and emotional distress. Conversely, bowel issues can lead to embarrassment, social isolation, and reduced quality of life, further impacting mental health.

Addressing the emotional aspects of MS-related bowel dysfunction is essential for comprehensive treatment. Strategies to promote emotional wellbeing include:

  • Seeking support from healthcare professionals
  • Joining support groups or online communities
  • Practicing stress-reduction techniques like meditation or mindfulness
  • Engaging in regular physical activity to boost mood and reduce anxiety

By prioritizing emotional wellbeing, individuals with MS can better manage their bowel symptoms and improve their overall quality of life.

Lifestyle Modifications for Managing MS-Related Bowel Problems

Effectively managing bowel problems in MS often involves implementing lifestyle changes. These modifications can significantly improve symptoms and reduce the impact of bowel dysfunction on daily life.

Dietary Adjustments for Improved Bowel Function

A balanced diet rich in fiber is crucial for maintaining regular bowel movements. Foods that can help alleviate mild constipation include:

  • Fruits: dried fruit, figs, pears, prunes, apples, and rhubarb
  • Vegetables: spinach, artichoke, and sweet potato
  • Seeds and nuts: linseeds, chia seeds, and flaxseed
  • Whole grains: oat bran and whole-grain rye bread

However, it’s important to note that for severe constipation, high-fiber foods like unprocessed bran may cause uncomfortable bloating. In such cases, consulting a healthcare professional is advisable.

Hydration: The Key to Regularity

Adequate fluid intake is essential for maintaining healthy bowel function. When increasing fiber intake, it’s crucial to simultaneously increase fluid consumption. While some individuals find that coffee stimulates bowel movements, it’s important to remember that caffeine can irritate the bladder and act as a diuretic. Therefore, relying on coffee for fluid intake is not recommended.

The Role of Exercise in Bowel Health

Regular physical activity is vital for managing MS-related bowel problems. Exercise stimulates abdominal muscles, which in turn promotes movement in the colon. Even for individuals with limited mobility, there are various exercise options available:

  • Yoga or tai chi for gentle movement and improved circulation
  • Swimming or water aerobics for low-impact full-body workouts
  • Adapted sports like bowling or sailing
  • Seated exercises or stretching routines

The key is to find activities that are enjoyable and sustainable, as consistent exercise can improve multiple MS symptoms, including bowel function.

Medical Interventions for MS-Related Bowel Dysfunction

While lifestyle modifications are often the first line of treatment for MS-related bowel problems, medical interventions may be necessary in some cases. These can include:

  • Laxatives or stool softeners for constipation
  • Anti-diarrheal medications for loose stools
  • Pelvic floor physical therapy to improve muscle control
  • Biofeedback training for better bowel function awareness
  • In severe cases, surgical interventions may be considered

It’s crucial to work closely with healthcare providers to determine the most appropriate treatment plan based on individual symptoms and needs.

The Importance of Open Communication with Healthcare Providers

Discussing bowel problems can be uncomfortable, but open communication with healthcare providers is essential for effective management. Neurologists, primary care physicians, and continence advisors can offer valuable insights and treatment options.

When discussing bowel issues with healthcare providers, consider the following:

  • Keep a symptom diary to track bowel habits and associated factors
  • Be honest about the impact of symptoms on daily life
  • Ask about potential interactions between MS medications and bowel function
  • Inquire about new treatment options or clinical trials

Remember that healthcare professionals are accustomed to discussing these issues and can provide support and guidance without judgment.

Innovative Approaches to MS Bowel Management

As research in MS continues to advance, new approaches to managing bowel dysfunction are emerging. Some innovative strategies include:

Neuromodulation Techniques

Neuromodulation involves using electrical stimulation to influence nerve activity. In the context of MS-related bowel problems, techniques such as sacral nerve stimulation or tibial nerve stimulation may help improve bowel control and reduce symptoms of incontinence.

Gut Microbiome Interventions

Growing evidence suggests that the gut microbiome plays a role in MS progression and symptoms. Probiotics, prebiotics, and fecal microbiota transplantation are being explored as potential interventions to improve bowel function and overall MS management.

Smart Technology for Symptom Tracking

Wearable devices and smartphone apps are being developed to help individuals with MS track their bowel symptoms, diet, and medication use. These tools can provide valuable data to healthcare providers and empower patients to take a more active role in managing their condition.

Personalized Nutrition Plans

Tailored dietary approaches based on individual nutritional needs, gut microbiome composition, and MS symptoms are being developed. These personalized plans aim to optimize bowel function and overall health in MS patients.

While these innovative approaches show promise, it’s important to discuss any new treatments or management strategies with healthcare providers before implementation.

Addressing the Psychological Impact of MS-Related Bowel Problems

The psychological toll of living with MS-related bowel dysfunction can be significant. Many individuals experience feelings of embarrassment, anxiety, and social isolation due to their symptoms. Addressing these psychological aspects is crucial for comprehensive MS management.

Cognitive Behavioral Therapy (CBT)

CBT can be an effective tool for managing the emotional impact of bowel problems. This therapeutic approach helps individuals identify and change negative thought patterns and behaviors associated with their symptoms. CBT can improve coping strategies and reduce anxiety related to bowel dysfunction.

Support Groups and Peer Connections

Connecting with others who share similar experiences can provide invaluable emotional support. Support groups, whether in-person or online, offer a safe space to share concerns, exchange coping strategies, and build a sense of community. These connections can help reduce feelings of isolation and provide practical advice for managing daily challenges.

Mindfulness and Relaxation Techniques

Practicing mindfulness and relaxation techniques can help reduce stress and anxiety associated with bowel problems. These may include:

  • Deep breathing exercises
  • Progressive muscle relaxation
  • Guided imagery
  • Meditation

Regular practice of these techniques can improve overall emotional wellbeing and may even have positive effects on bowel function by reducing stress-related symptoms.

Counseling and Psychotherapy

Individual counseling or psychotherapy can provide personalized support for those struggling with the emotional impact of MS-related bowel problems. A mental health professional can help develop coping strategies, work through feelings of shame or embarrassment, and address any underlying mental health concerns that may be exacerbating symptoms.

By addressing both the physical and psychological aspects of MS-related bowel dysfunction, individuals can achieve a more comprehensive and effective management strategy, leading to improved quality of life and overall wellbeing.

Navigating Social and Professional Situations with MS Bowel Symptoms

Managing MS-related bowel problems in social and professional settings can be challenging. However, with proper planning and strategies, individuals can maintain an active and fulfilling life despite these symptoms.

Workplace Accommodations

Open communication with employers about MS symptoms, including bowel problems, can lead to helpful accommodations. These may include:

  • Flexible work hours to accommodate symptom management
  • Access to private restroom facilities
  • Option for remote work when symptoms are severe
  • Ergonomic adjustments to workspaces to support proper posture and comfort

Understanding workplace rights and available accommodations can help individuals maintain productivity and job satisfaction while managing their symptoms.

Travel and Social Event Planning

Preparation is key when navigating social situations or travel with MS bowel symptoms. Strategies may include:

  • Researching restroom locations in advance
  • Carrying an emergency kit with spare clothing and hygiene supplies
  • Planning meals and hydration to support regular bowel function
  • Communicating needs to trusted friends or event organizers

By anticipating potential challenges and planning accordingly, individuals can participate in social activities with greater confidence and comfort.

Educating Others

While not everyone needs to know about personal health challenges, educating close friends, family members, and colleagues about MS and its potential impact on bowel function can foster understanding and support. This education can help reduce stigma and create a more accommodating environment.

Utilizing Adaptive Products

Various products are available to help manage bowel symptoms discreetly in social settings. These may include:

  • Absorbent undergarments
  • Odor-neutralizing sprays or supplements
  • Portable bidets or cleansing wipes
  • Specialized clothing with built-in protection

Exploring these options can provide added security and confidence in various social situations.

By developing strategies to navigate social and professional settings, individuals with MS can maintain an active lifestyle while effectively managing their bowel symptoms. This proactive approach can significantly improve quality of life and reduce the social isolation often associated with chronic health conditions.

MS & Bowel Problems & Symptoms | MS Stomach Pain

Overview

If you have MS, you may experience bowel problems at some point. Many people find bowel problems hard to talk about, but with the right information and support, you can successfully manage the symptoms and live well with little impact on your daily life (if at all).

Bowel problems as a result of MS are due to damage in communication between the digestive system and the brain, affecting the control of the colon muscles. This can lead to incontinence or constipation. Anal sphincter muscles may not relax properly or squeeze tightly enough when you need them to and straining can lead to leakage with weakened anal muscles.

Other MS symptoms can make these bowel problems worse.  MS fatigue can lead to you being less active, therefore slowing down waste to your colon. Spasticity can affect muscle control and bladder problems, which can lead to lower fluid intake making constipation worse. On top of this, MS bowel problems can make other MS symptoms such as bladder spasms worse.

Constipation is usually due to lack of exercise or poor diet and can be quickly and easily fixed with a diet and exercise plan.

The most common bowel dysfunction in MS is constipation. It is usually due to a poor diet and lack of physical activity. Incontinence can also be helped by making some positive lifestyle changes. 

MS and constipation

If you find that you get constipated due to MS, it can result in a variety of different symptoms:

It is unlikely that you would experience all of these symptoms with constipation, but some people might experience a combination of them.

MS and diarrhea

Diarrhea can be caused by having a stomach bug, through infection, from medications, antibiotics or food poisoning just like those who do not have MS.

However, bowel incontinence is often a result of constipation where stools become so impacted that there is leakage around them. So you might need to wear a hidden pad or plug due to leakage, rather than diarrhea.

Managing bowel problems with MS

It is important that you prioritise your emotional wellbeing when you have MS, as losing motivation or feeling low can cause constipation. If you feel upset, embarrassed or stressed by MS bowel problems this can also exacerbate the problem. The mind-body connection is powerful.

Managing bowel problems with MS is key in taking back control over your body and not letting it stop you from enjoying life to the fullest.

It’s not easy to approach a professional about bowel issues, but your doctor, neurologist or continence advisor will be able to help. If you combine this advice with positive lifestyle changes with the OMS 7-Step Recovery Program you will be improving other MS symptoms as well.

Managing constipation with MS

Fortunately, there are some lifestyle changes you can make to manage constipation when you have MS, along with consulting your doctor. These include making sure that you have:

✔ A balanced diet

If you eat a balanced diet with lots of fiber it will help your bowel movements regularly. There are certain foods which can help relieve mild constipation, including:

  • Fruit (eg dried fruit, figs, pears, prunes, apples, rhubarb) 

  • Vegetables (eg spinach, artichoke, sweet potato)

  • Seeds and nuts (including linseeds, chia seeds and flaxseed)

  • Cereals (oat bran, whole-grain rye bread)

If you have severe constipation, the fiber in some foods such as unprocessed bran could lead to uncomfortable bloating, so it is important to consult your doctor.

✔ Plenty of water

It is important to remember that your daily fluid requirements will increase when you increase your fiber. 

If you have MS bladder problems you may consciously or subconsciously reduce your fluid intake. Some people find that coffee helps to activate the bowel, but caffeine can irritate your bladder and is a diuretic so don’t rely on coffee for your fluid intake. 

✔ Regular exercise

If you have MS spasticity or MS fatigue you may have become less active, and that cause constipation. But it is vital that you incorporate exercise into your daily routine as this improves many MS symptoms, including constipation. Exercise will stimulate your abdominal muscles that in turn stimulate movement in the colon. 

Some people with MS climb mountains, win medals at the Paralympics or run marathons which is fantastic and inspirational – if you are not that way inclined, regular exercise might simply mean doing an activity that you find fun. Whether it is joining a yoga or tai chi class to encourage bowel movement, or sailing, bowling, horse riding or swimming for a full body workout, take a look at our exercise options for inspiration.

The great thing is that there are exercises to do at all levels which will help with a number of MS symptoms. The key is for the activities and exercises to be enjoyable and regular so that you will see the positive results to help you to stay motivated.

✔ A medication review with your doctor

Some medication can cause constipation, including:

Managing bowel incontinence with MS

There are also changes you can make and successful treatments which will allow you to manage bowel incontinence and regain control. 

You can:

✔ Improve your stool consistency 

✔ Train your muscles to provide better control

✔ Eliminate controllable lifestyle choices that make bowel incontinence worse

This includes:

✔ Experimenting with your diet

Try to include foods that make stools firmer in your diet:

  • Ripe bananas

  • High fiber foods

  • Arrowroot

  • White marshmallows

  • Mashed potato

There will also be some foods which make you produce a looser stool and this will also take some experimentation to find out which foods irritate and you can avoid. Common examples include:

  • Caffeine

  • Dairy products

  • Chocolate

  • Spicy food

  • Alcohol

  • Artificial sweeteners

✔ Regular exercise

Keeping to a healthy weight will alleviate the pressure on your pelvic floor and reduce bowel incontinence.

You can also do regular pelvic floor exercises along with a technique called biofeedback,which can help strengthen the muscles used to control the opening and closing of your bowels.

✔ Meditation

Strategies to reduce anxiety and stress are vital for your health and wellbeing and stress can worsen bowel incontinence. In fact, meditation is so important that it is one of the central elements of the Overcoming Multiple Sclerosis Recovery Program.

Relieving stomach pain

Making lifestyle changes to help with bowel problems will also help to alleviate any stomach pain felt from constipation or diarrhea.

The OMS Recovery Program incorporates MS diet recommendations that are scientifically researched and will not only help any bowel problems, but other symptoms of MS too.

Making sure that you eat plenty of fiber, engage in regular physical activity and drink more water will see improvements with bowel problems. This will relieve any stomach pain or discomfort, making you feel happier and more relaxed.

Some people with MS experience bowel problems, while others never do, but it is comforting to know there are ways to manage it if you do experience these symptoms so that it doesn’t impact your life. 

What are the next steps?

If it seems like there is too much information and you don’t know where to start, read through our next steps – we can help you.

 

Further reading 

Katy’s story 

What Common Digestive Problems Are There In Multiple Sclerosis

Multiple Sclerosis is a neurological autoimmune condition that affects the brain and spinal cord; the immune system attacks the protective coating around the nerves called the myelin sheath. This results in the body’s communication system deteriorating. Once diagnosed, MS stays with you for life, however, there are treatments that can help you manage your symptoms.

In the UK, over 100,000 people are diagnosed or have MS, and symptoms usually start in people in their early 20’s and 30’s and progress more in their 40’s and 50’s. The symptoms of MS do not develop until damage to the myelin sheath has occurred; this means that when the neurological symptoms are present, some damage is irreparable.

Symptoms of MS include fatigue, difficulty mobilising, vision problems, incontinence, irregular bowel habits, numbness or tingling in different parts of the body, muscle stiffness and spasms, problems with balance and coordination, and problems with thinking, learning and planning.

MS starts in 1 of 2 general ways; relapses or gradual progression. Someone with relapsing-remitting MS will have episodes of new or worsening symptoms, known as relapses, and symptoms gradually worsen over time. In primary progressive MS, symptoms gradually worsen and accumulate over several years, and there are no periods of remission, though people often have periods where their condition appears to stabilise.

Your digestive system is home to different types of bacteria, fungi, and viruses. The main role is to help the immune system by absorbing nutrients and removing toxins. Factors including lifestyle, diet, antibiotics, and stress can disrupt the balance. Research suggests that two strains of gut bacteria ( Acinetobacter and Akkermansia) is four times higher in people with MS – these are known to increase inflammation. Also, the gut bacteria Parabacteroides was lower in people with MS and this strain reduces inflammation.

Below are some of the common digestive issues that those with Multiple Sclerosis suffer with:

  • Acid reflux
  • Bowel dysfunction – caused by muscle spasms that impacts signals between the central nervous system and the digestive system.
  • Persistent hiccups – due to spasms in the diaphragm due to damage to the vagus nerve
  • Adverse effects of medication that cause heartburn, bloating, nausea, diarrhoea and constipation

Gastroparesis is a disorder that slows or stops the movement of food from the stomach to the small intestine. Healthy stomach muscles that are controlled by the vagus nerve contract and break up food to move it along the gastrointestinal tract. When the vagus nerve is damaged, the stomach walls stop working normally resulting in ni food moving slowly from the stomach to the small intestine, and in some cases, it stops moving altogether. Individuals can experience weight loss or even weight gain and crave food due to the poor absorption of nutrients. Individuals with Multiple Sclerosis have a damaged vagus nerve which partially paralyses the stomach. Scientific studies looked at the relationship between vitamin D deficiency and the digestive system as a way to better understand how MS develops; findings showed deficiencies in vitamin D can impact the ability of the intestines to absorb calcium. This could potentially result in the development of gastroparesis; as the digestive system needs adequate amounts of calcium in order for the smooth muscles of the intestine to contract properly.

Although there is no treatment for Multiple Sclerosis, there are things you can do to manage the symptoms and prevent them from flaring frequently.

  • Fibre – the indigestible part of plant foods that acts as a brush inside the intestines to sweep waste matter through. A lack of fibre can lead to food moving more slowly through the digestive tract. Also, when stools are not bulked by fibre they do not likely to stimulate the digestive systems evacuation mechanism in the digestive system.
  • Fluid – water is an important component of a well-formed stool. Lack of fluid intake can causes stools to become dry and more difficult to pass.
  • Balance gut flora – roughly 30% of stool is bacteria and the gut dysbiosis can have a significant effect on the consistency and frequency of bowel movements. An overgrowth of bad bacteria or yeast in the gut or infection by parasites could lead to constipation.
  • Increase digestive function –healthy digestion requires each stage working effectively before food passes on to the next. A lack of stomach acid, low levels of digestive enzymes, or lack of bile can result in improperly digested food in the intestines. This can slow transit time and contribute to constipation.
  • Physical activity – 30 minutes of moderate physical activity maintains muscle mass and retains energy levels
  • Vitamin D – 15 minutes of sunlight should be sufficient to meet your daily vitamin D requirements, otherwise supplement!
  • Manage stress – stress increases MS symptoms, figure out what makes you relaxed by trial and error.

In addition to the above, a nutrient-rich, diverse diet is key to ensure your microbiome is full of all the beneficial bacteria, as well as essential vitamins necessary. Speak to one of our Nutritionists or Functional Medicine Practitioner to get more information on how to get your vitamins and nutrients from food, or taking supplements can help you meet your needs and improve your health.

If this resonates with you then…

Take advantage of our 15-minute sessions either with a Nutritionist or Functional Medicine Practitioner, designed to give you the support you need with your concerns and to get you started on your road to recovery. Find very quick and effective results!

At Perfect Balance Clinic, our Nutritionists or Functional Medicine Practitioners will provide you with an important assessment of your condition and discuss many routes to explore for optimum health. Our assessment covers important aspects that most practitioners seem to miss in normal sessions with their clients. This allows us to accelerate your recovery! Simply use the contact form below to provide us with your details to get booked in.

Acute abdominal pain as the only symptom of a thoracic demyelinating lesion in multiple sclerosis

Case Reports

doi: 10.1016/j. braindev.2015.03.006.

Epub 2015 Apr 11.

Affiliations

Expand

Affiliations

  • 1 Department of Pediatrics, Osaka Medical College, Takatsuki, Osaka, Japan. Electronic address: [email protected].
  • 2 Department of Pediatrics, Osaka Medical College, Takatsuki, Osaka, Japan.
  • 3 Department of Pediatric Neurology, Hirakata Municipal Hospital, Hirakata, Osaka, Japan.
  • 4 Department of Pediatric Neurology, Tanabe Children’s Clinic, Hirakata, Osaka, Japan.

Item in Clipboard

Case Reports

Shohei Nomura et al.

Brain Dev.

2015 Nov.

Show details

Display options

Display options

Format

AbstractPubMedPMID

doi: 10.1016/j.braindev.2015.03.006.

Epub 2015 Apr 11.

Affiliations

  • 1 Department of Pediatrics, Osaka Medical College, Takatsuki, Osaka, Japan. Electronic address: [email protected].
  • 2 Department of Pediatrics, Osaka Medical College, Takatsuki, Osaka, Japan.
  • 3 Department of Pediatric Neurology, Hirakata Municipal Hospital, Hirakata, Osaka, Japan.
  • 4 Department of Pediatric Neurology, Tanabe Children’s Clinic, Hirakata, Osaka, Japan.

Item in Clipboard

Full text links
CiteDisplay options

Display options

Format
AbstractPubMedPMID

Abstract

Multiple sclerosis (MS) is a syndrome characterized by complex neurological symptoms resulting from demyelinating lesions in the central nervous system. We report a child with a relapse of MS whose only presenting symptom was severe abdominal pain. Dysfunctional intestinal mobility was assessed by abdominal computed tomography. Findings resembled paralytic ileus resulting from peritonitis. However, the patient demonstrated no other symptoms of peritonitis. A T2-weighted magnetic resonance image revealed a new demyelinating lesion localized to thoracic segments T4-T12. The lesion presumably affected autonomic efferents involved in intestinal mobility. Treatment with a pulse of methylprednisolone reduced both abdominal pain and lesion size. To our knowledge, this is the first reported case of a pediatric MS patient with a demyelinating lesion associated with an autonomic symptom of altered intestinal mobility in the absence of neurological symptoms. This atypical presentation of MS highlights the need for physicians’ vigilance when treating this patient population.


Keywords:

Abdominal pain; Multiple sclerosis; Paralytic ileus; Thoracic spinal lesion.

Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Similar articles

  • [Acute posterior cord lesions in multiple sclerosis. An MRI study of the clinical course in 20 cases].

    Pou Serradell A, Roquer González J, Perich Alsina X.
    Pou Serradell A, et al.
    Rev Neurol (Paris). 2000 Dec;156(12):1126-35.
    Rev Neurol (Paris). 2000.

    PMID: 11139729

    French.

  • Multiple sclerosis and coexisting intradural extramedullary spinal cord tumour: a case report.

    Etus V, Akansel G, Ilbay K, Koç K, Ceylan S.
    Etus V, et al.
    Neurol Sci. 2002 Sep;23(3):119-22. doi: 10.1007/s100720200037.
    Neurol Sci. 2002.

    PMID: 12391496

  • [Magnetic resonance study of lesions of the cervical spinal cord in multiple sclerosis].

    Dal Pozzo G, Taverni N, Mascalchi M, Siracusa GF, Tanfani G, Bartolozzi C.
    Dal Pozzo G, et al.
    Radiol Med. 1989 Jul-Aug;78(1-2):23-9.
    Radiol Med. 1989.

    PMID: 2781060

    Italian.

  • [Recommendations for using and interpreting magnetic resonance imaging in multiple sclerosis].

    Rovira A, Tintoré M, Alvarez-Cermeño JC, Izquierdo G, Prieto JM.
    Rovira A, et al.
    Neurologia. 2010 May;25(4):248-65.
    Neurologia. 2010.

    PMID: 20609303

    Spanish.

  • [Diagnostic criteria of multiple sclerosis in neuroimaging].

    Dupel-Pottier C.
    Dupel-Pottier C.
    Rev Neurol (Paris). 2001 Sep;157(8-9 Pt 2):949-62.
    Rev Neurol (Paris). 2001.

    PMID: 11787360

    Review.
    French.

Cited by

1
article

  • The “Treatise on the spleen and stomach” (Pí Wèi Lùn) as the first record of multiple sclerosis in the medical literature A hypothesis based on the analysis of clinical presentation and herbal medicine.

    Fuzimoto AD, Brigo F.
    Fuzimoto AD, et al.
    J Tradit Complement Med. 2020 Mar 2;10(3):288-300. doi: 10.1016/j.jtcme.2020.02.009. eCollection 2020 May.
    J Tradit Complement Med. 2020.

    PMID: 32670824
    Free PMC article.

    Review.

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / etiology
  • Abdominal Pain / pathology
  • Magnetic Resonance Imaging / methods
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / pathology
  • Multiple Sclerosis / physiopathology
  • Tomography Scanners, X-Ray Computed

[x]

Cite

Copy

Format:

AMA

APA

MLA

NLM

9 Surprising Symptoms of Multiple Sclerosis

3. Difficulty Swallowing

You may experience difficulty swallowing (dysphagia) if you have MS, particularly in the later stages of the disease, notes the NMSS. This can happen when the nerves that control the muscles in the mouth and throat become damaged. It can also be a result of numbness of the mouth and throat, or mouth dryness due to medication.

Difficulty swallowing can be a serious problem, and it’s important to seek diagnosis and treatment as soon as possible. A speech or language pathologist can teach you strategies and exercises for safer eating and swallowing, and help you make any necessary dietary changes.

RELATED: 10 Lifestyle Tips to Help You Manage MS Symptoms

4. Itching

Some people who have MS experience dysesthesias, or painful sensations in the legs, feet, arms, and hands. They typically feel like burning, prickling, stabbing, ice cold, or electrical sensations, according to the NMSS.

Pruritis (itching) is a form of dysesthesias. When you have MS, the nerves in the central nervous system that convey sensory information can be damaged. This damage can cause you to feel itchy even though you don’t see any irritation. Because the cause is neurological and not physical like a bug bite or rash, topical skin creams won’t help.

Treatment for this type pain or itching may include anti-seizure medications, anti-depressants, as well as acupuncture, mindfulness, meditation, and cognitive behavioral therapy (CBT).

RELATED: What You Should Know About MS Complications

5. Hearing Problems

About 6 percent of people who have MS report having impaired hearing, per the NMSS. Rarely, hearing loss can occur as the first symptom of the disease. Hearing loss in MS can be linked to damaged nerve pathways in the brain and the brainstem. However, it’s important to note that hearing loss in MS is very uncommon, and most acute episodes get better over time. Be sure to talk to your healthcare provider to determine what is causing your impaired hearing.

6. Tremors

Tremors, or uncontrollable or involuntary shaking, can occur in various body parts as a result of MS-related damage to the nerve pathways that coordinate movements, notes the NMSS.

The most common type of tremor (and most disabling) that occurs in MS is known as an intention tremor. It’s usually most pronounced during physical movement, and gets worse as you try to grasp or reach for something, or move your hand or foot to a specific spot.

Tremor can make it challenging to perform daily activities like eating, drinking, and getting dressed, and can cause some people to feel embarrassed and to avoid social situations.

Your healthcare provider may try different medications to treat tremor, but finding an effective treatment can be difficult. A few small studies have suggested that cannabis may be helpful, but further research is needed. Occupational and physical therapists can also help you find ways to manage tremor, including the use of assistive devices.

RELATED: Depression, Anxiety, and MS: What’s the Connection?

7. Headache and Migraine

While headache isn’t considered a hallmark symptom of MS, a meta-analysis published in December 2020 in Brain and Behavior reviewed 16 studies covering 3,560 patients and found the pooled prevalence of headache was 56 percent. The review also found that the overall prevalence of migraine and tension headache among people with MS was 27 percent and 10 percent, respectively. Previous studies have found that up to half of people with MS who experience headache have either cortical or brainstem lesions, the review notes.

RELATED: How to Get Rid of a Headache or Migraine Attack Fast

8. Breathing Problems

Breathing problems can occur as a result of MS-related damage to the nerves that control the chest muscles, according to the NMSS. This issue can get worse over time, and be especially exhausting for those who already experience MS fatigue.

Breathing exercises can be helpful, but it’s important to see a healthcare provider who specializes in breathing issues to ensure proper diagnosis and treatment.

9. Loss of or Change of Taste and Smell

Research has shown that many people who have MS experience changes in how food tastes and smells. One study, published in April 2016 in Journal of Neurology, found that a significant number of people with MS have a decreased ability to sense all four basic areas of taste: sweet, sour, salty, and bitter, and that these taste deficits that are linked to MS-related lesions throughout the brain.

It’s not common, but other people with MS have reported hyperosmia, or an abnormally heightened sense of smell or abnormal sensitivity to odors.

RELATED: 8 Things to Try When MS Affects Your Ability to Taste and Smell

Before you assume that MS is the cause of impaired or decreased taste, get your symptoms checked out by your doctor, as new loss of taste and smell can also be a symptom of COVID-19, among other conditions.

The MS Hug: Understanding Girdle-Band Pain

Perhaps one of the oddest pain-related symptoms is the “MS hug” (a.k.a. girdle-band sensation, girdling, or banding)—the feeling like there’s a tight band around the chest and ribs. This can come and go over the course of several weeks and range from an annoying pressure to abject pain. Though it’s common in MS, this type of pain tends to be one of the most annoying and uncomfortable symptoms that MS patients experience.

Verywell / JR Bee

Symptoms

Like many MS symptoms, the MS hug feels different for each individual. It can also feel different in the same people on different days or at different times of the day.

The pain of an MS hug has been described in many unique ways, including:

  • Sharp
  • Dull
  • Burning
  • Tickling
  • Tingling
  • Crushing or constricting
  • Pressure

This pain usually occurs somewhere in between your neck and your waist.

You might only feel it on one side or in one small area; at other times, it can wrap around your entire torso. The pain can occur in waves that last seconds, minutes, or hours, or it can be steady for longer periods of time.

Like other symptoms of MS, this type of pain can intensify or be triggered by fatigue or stress. It can also sometimes be accompanied by a sensation of difficulty breathing, which is why it may be perceived as a heart attack or panic attack.

Chest pain needs to be taken seriously. Be sure to seek immediate medical attention if you experience severe chest pain and/or you’re also having difficulty breathing or other signs of a heart attack. Even if you think it’s simply MS-related, see a doctor to be on the safe side.

Causes

The MS hug is caused by a lesion or an area of active inflammation within the spinal cord. This means that the myelin sheath, the coating that insulates nerve fibers, has been damaged. The type of pain caused by the MS hug is technically classified as a neuropathic type of pain, also called dysesthesia, which refers to any abnormal sensation.

The sensation itself is the result of tiny muscles between each rib called intercostal muscles going into spasm. These muscles have the job of holding your ribs together, as well as keeping them flexible and aiding in movement, such as forced expiration.

However, like everything related to MS, the root cause of the MS hug has to do with damage to the myelin sheath.

In cases where you’ve already been diagnosed with MS and the MS hug starts up suddenly along with other symptoms, it’s possible that you’re having a relapse.

Diagnosis

Years ago, people thought MS was a painless disease, even doctors. Now scientists know that this isn’t true. In fact, research shows that likely more than half of people with MS experience pain at some point in their disease course. Besides the MS hug, other types of pain include trigeminal neuralgia, abnormal sensations in your legs and feet, and Lhermitte’s sign among the most common. However, other types of pain can include muscle aches, neck pain, and headaches.

While you should not be shy about sharing details of your discomfort with your doctor—it’s information that can help lead to a diagnosis—your doctor will still need to do a thorough workup if your symptoms are similar to those of MS hug because a number of other health conditions can mimic it.

Differential Diagnosis

In addition to a heart attack and a panic attack, the following need to be ruled out to confirm the diagnosis of MS hug:

  • Gallbladder disease
  • Stomach or intestinal infection
  • Lung disease
  • Inflammation of the cartilage between the ribs (called costochondritis)

If these other causes have been ruled out and you have already been diagnosed with MS, your neurologist may want to order a magnetic resonance imaging (MRI) scan to see if you’re having an MS relapse, as you may need steroids if your symptoms are severe or debilitating.​

Treatment

If your doctor determines that your hug pain is indeed MS-related, there are some ways it can be treated, depending on the severity of your pain and whether or not you’re having a relapse. In many cases, you won’t need treatment and the pain will pass on its own.

Medications

For severe cases of MS hug in which you’re experiencing a lot of pain or it’s lasting a long time, your doctor may prescribe medication (or a combination of medications) to help, such as:

  • A muscle relaxant like Lioresal (baclofen) or Zanaflex (tizanidine)
  • An antispastic drug such as Valium (diazepam) or Ativan (lorazepam)
  • An anticonvulsant like Lyrica (pregabalin) or Neurontin (gabapentin)
  • An antidepressant such as Cymbalta (duloxetine) or Elavil (amitriptyline)

Some doctors have used Botox (botulinum toxin) injections to selectively reduce muscle spasticity. Botox blocks a chemical neurotransmitter called acetylcholine, allowing your muscles to relax. Treatment is typically indicated for those with severe pain and can last for up to six months with relatively few side effects (mainly injection site pain or redness). Botox is also commonly used to treat severe MS-associated bladder dysfunction.

If your doctor thinks that your symptoms indicate a true MS relapse, they may prescribe a course of a high-dose corticosteroid known as Solu-Medrol.

Home Treatments

While it would be nice to be able to erase the pain of MS with a simple pill, that’s usually not the case. Instead, many people manage their MS pain by embracing tried-and-true home remedies used by others who experience similar discomfort.

Some of these methods, which can be used to manage other MS pain as well, include:

  • Applying direct pressure to the pain with the flat of your hand
  • Wrapping the affected area tightly with an elastic bandage or wearing tight clothing (some people feel this helps their brains deal with the constricting feeling better)
  • Practicing deep breathing to expand your chest and minimize spasms
  • Wearing lightweight, loose clothing
  • Applying an ice pack wrapped in a thin towel directly to the pain (unless the pain was triggered by cold)
  • Taking a warm bath or applying an electrical or microwaveable heating pad (unless the pain was triggered by humidity or heat)
  • Using topical analgesics such as IcyHot or lidocaine creams
  • Taking a pain reliever like Tylenol (acetaminophen) or a nonsteroidal anti-inflammatory drug (NSAID) such as Advil or Motrin (ibuprofen)
  • Moving around, whether it’s shifting your position, occasionally getting up and walking, or engaging in regular exercise
  • Getting a massage

Trial and Error

Because of the individual nature of pain, you may need to try a variety of methods before you find what works for you. It may also take a number of strategies used together to combat your MS pain.

A Word From Verywell

Even though MS hug pain is a common occurrence, this doesn’t make it any less difficult to deal with, especially if you haven’t experienced it before. If your pain isn’t going away or you’re unable to relieve it using home treatments, be sure to talk to your doctor about prescription medication options that can help. And as with any chronic condition, work to make your lifestyle as healthy as possible to help minimize your MS pain by eating a healthy diet, getting adequate sleep, staying hydrated, learning relaxation techniques to combat stress, keeping appointments with your doctor, and staying active as much as you’re able.

Pediatric Multiple Sclerosis: Causes, Symptoms & Treatments

Overview

What is pediatric multiple sclerosis (MS)?

Multiple sclerosis (MS) is a central nervous system disorder. This means it affects the brain and spinal cord. It is an autoimmune disease as it is inflammatory—meaning that white blood cells, which protect against infection, enter the nervous system and cause damage. The harm is done because the myelin sheath, the protective coating for nerves, is stripped off by the antibodies produced by the immune system. (This is called demyelination.) MS is a long-term disease that can happen to anyone.

Pediatric MS is multiple sclerosis that begins in children or teens. About 98% have relapsing-remitting MS, versus 84% of adults with MS. This means that symptoms come and go (relapse and remit). When symptoms are gone, the disease is still able to progress. This condition may also be called pediatric-onset multiple sclerosis (POMS), early-onset MS, or juvenile MS. Relapses seem to happen more often in children and teens. This group appears to recover from the neurologic disability more quickly but are at increased risk of cognitive difficulties that can affect school work.

Who is affected by pediatric multiple sclerosis (MS)?

There are about 730,000 people in the U. S. with multiple sclerosis. Onset during childhood accounts for about 5% of the total.

Before puberty, the ratio of females to males who develop pediatric MS is about equal. After puberty, the ratio is about 2-3 to 1. This might indicate that sex hormones have a role in developing the condition.

Symptoms and Causes

What causes pediatric multiple sclerosis (MS)?

In short, we do not know what causes multiple sclerosis. However, research does point to an increase in risk due to the following:

  • Being exposed to toxins, like secondhand smoke and pesticides.
  • Having low levels of vitamin D in your blood.
  • Being overweight.
  • Genetic issues, especially in terms of the immune system.
  • Being infected with the Epstein-Barr virus (having mononucleosis).

Is pediatric multiple sclerosis (MS) contagious?

No. Your child cannot give MS to someone else and cannot catch it from someone who has it.

What are the signs and symptoms of pediatric multiple sclerosis (MS)?

The symptoms of MS vary from person to person and may even be different from one day to the next. This is true for children and adults. The symptoms may be physically sensory (involving changes in feeling) or motor (changes in movement) or may involve other factors, such as vision, emotions, thinking, or walking. Most people have only a few of these common symptoms, not all of them.

Common symptoms include:

  • Numbness, tingling, the “pins and needles” feeling, or pain.
  • Dizziness, difficulty walking or keeping your balance.
  • Fatigue, weakness, tremor (shaking).
  • Problems with concentration or memory, depression.
  • Problems with vision, including blurry vision, trouble seeing, or double vision.
  • Sensitivity to heat.

Diagnosis and Tests

How is pediatric multiple sclerosis (MS) diagnosed?

Pediatric MS is diagnosed using widely agreed-upon guidelines. Tests include an MRI, a neurological examination and possibly other tests at times will be used for diagnosis. at times other tests will allow diagnosis. There are other diseases that may be similar to MS and other types of conditions that cause demyelination. These include acute infections, neuromyelitis optica spectrum disorder (NMOSD), autoimmune encephalitis and vasculitis of the central nervous system.

Some early signs of pediatric MS could include optic neuritis (ON), meaning painful vision loss in one or both eyes, and/or transverse myelitis (TM), which refers to weakness and or numbness due to an inflammatory spinal cord lesion. There are various diagnostic criteria that must be present for all of these conditions. MS can be diagnosed when the diagnostic criteria are met.

A neurologist will conduct a neurological examination, take a medical history, and will ask about symptoms you may have experienced. Many neurologic diagnoses have symptoms that are common across more than one disease. Diagnosing MS involves testing which may include:

  • Blood and urine tests.
  • Magnetic resonance imaging tests (MRIs).
  • Cerebrospinal fluid (CSF) test (with the fluid obtained from a spinal tap (lumbar puncture).
  • Evoked potential (EP) tests.
  • Other imaging tests, including optical coherence tomography.

Management and Treatment

How is pediatric multiple sclerosis (MS) treated?

For many years, the FDA had not approved any specific therapy for MS in children. It was the practice to use disease-modifying therapies (DMTs) that had been approved for adults. However, in 2018, the FDA approved an oral form of fingolimod (Gilenya®) to treat relapsing multiple sclerosis in children aged 10 years old and older. Fingolimod had been approved earlier for treating adults with MS. Other DMTs are currently in trials for pediatric use.

The goals of DMT usage are to decrease the number of relapses (also called attacks or flare-ups) and to control the number of lesions (abnormal spots) that appear on MRI scans. Overall, the goal is to slow down the disease activity and prevent long term disability.

Your healthcare provider will treat some related symptoms specifically. These include pain, fatigue, anxiety and/or depression. Your provider might recommend visiting a psychologist or a psychiatrist who works with children and teens.

It is true for children and teens with MS, and for people who do not have MS, that getting enough good sleep, eating healthy and regular exercise is important.

Clinical trials involving treatment for MS, including pediatric MS, may be available. Ask your healthcare provider if you are interested in participating. Also, there is an organization called US Networks of Pediatric MS Centers that organized treatment and research for the Pediatric MS patient and NARCOMS Registry for Multiple Sclerosis (https://www.narcoms.org/) that collects information from people with MS and shares it with researchers.

What are the side effects of fingolimod for pediatric multiple sclerosis (MS)?

Some of the side effects seen most often include:

  • Headache.
  • Higher levels of liver enzymes.
  • Diarrhea, stomach pain.
  • Cough, flu, sinusitis.
  • Back pain.
  • Pain in the hands and feet.

These are not the only side effects. There are some that are much more unlikely but also more serious. Your healthcare provider will discuss these with you.

Corticosteroid side effects are somewhat well-known. They include mood changes, insomnia, high blood pressure (hypertension) and high blood sugar (hyperglycemia).

What kind of a diet is recommended for someone with pediatric multiple sclerosis (MS)?

There is no special diet, but research has indicated that eating an unhealthy diet is linked to a higher rate of relapse in children with MS. It is recommended that people with MS make sure to consume adequate amounts of fruits and vegetables. Research suggests that a healthy lifestyle, healthy eating combined with exercising, may help lessen disease progression. And a healthy lifestyle is always a good thing for many reasons.

Outlook / Prognosis

What is the prognosis (outlook) for someone with pediatric multiple sclerosis (MS)?

First of all, due to the newer treatments of MS and the national centers to focus on the care of pediatric onset MS patients, the outlook can be positive. The patient and their caregivers need to meet regularly to manage the MS.

It is true that pediatric MS seems to affect cognitive function (thinking and learning) in the years following the start of the disease. It is a good idea for children or teens with MS to have neuropsychological testing so there is a baseline to keep in mind. This helps the healthcare team work with schools to improve education approaches.

Some people who have relapsing-remitting MS go on to develop secondary progressive MS. This form has few instances of relapses but slowly gets worse. People who have had pediatric MS tend to physically progress more slowly than people who develop MS as adults.

Living With

When should you call the doctor about pediatric multiple sclerosis (MS)?

If your child tells you about any neurological symptoms, it is very important to tell your healthcare provider. Finding MS early is key. Healthcare providers can evaluate the child or teen and determine the best path to a diagnosis, it is best to start with a Pediatrician then a referral to a Neurologist as needed.

Also, you and/or your child should make sure to contact the healthcare team if any new symptoms come up, or if flare-ups happen. Contact your provider if your child or teen develops changes in mood. This could mean that they are more irritable, sad, tearful or have changes in sleep habits.

Resources

Are there resources for children with pediatric multiple sclerosis and their families?

You might find the following organizations to be helpful to you.

Pediatric Multiple Sclerosis | Children’s Hospital of Philadelphia

Multiple sclerosis (MS) is thought to be an autoimmune disease that attacks the central nervous system (CNS), causing episodes of neurologic symptoms. These neurologic symptoms may include weakness, numbness, tingling, difficulty balancing, bowel or bladder problems, or changes to vision.

The central nervous system consists of the brain, spinal cord and optic nerves. MS primarily attacks the coating around nerve cells called myelin. The attacks leave spots (called plaques or lesions) that interfere with nerve conduction and produces the symptoms of MS. Symptoms of multiple sclerosis vary depending on the location of lesions.

Multiple sclerosis affects about 1 in 1,000 people. About 450,000 people in the United States and Canada are living with multiple sclerosis. Although the peak age of diagnosis is between 20 to 50 years old, approximately 2.7% to 5% of people are diagnosed before the age of 16, with the majority of these cases diagnosed after the age of 10.

Multiple sclerosis is more common in women than in men. It is more common in Caucasians than in Hispanics or African Americans, and more common in temperate areas of the world away from the Equator. It is rare in Asians and other groups.

The cause of multiple sclerosis is still unknown. Researchers believe there is a genetic predisposition that is triggered by some environmental factor, such as a viral infection. That means that MS is not genetically passed down from one generation to the next, like hair color or eye color, but a combination of genes can make one person more susceptible to the disease than another person. Subsequently, the average risk of developing multiple sclerosis is 1 in 750, but the risk of a child whose parent has MS is 1 in 40.

Signs and symptoms of multiple sclerosis include:

  • Fatigue
  • Changes in vision
  • Weakness
  • Numbness
  • Tingling
  • Pain
  • Imbalance
  • Stiffness
  • Problems with bowel/bladder
  • Emotional changes (including depression and anxiety)
  • Speech difficulties
  • Problems with thinking and memory

Children who are diagnosed with MS have a type called relapsing-remitting MS. This form of MS is characterized by recurring attacks causing new or worsening neurologic symptoms, followed by periods without new symptoms, called remissions.

At the time of a first attack, it is not always clear whether the diagnosis of MS is appropriate since relapsing disease has not yet occurred. New relapses or attacks will confirm your child’s diagnosis and provide insight to help their doctors better manage their care.

There is no single diagnostic test for MS. In most cases, MS is diagnosed with a combination of methods. Your child’s healthcare provider will take a careful medical history and will order tests that may include:

  • A neurological exam
  • An MRI to check for lesions in the brain, spinal cord or optic nerves
  • A lumbar puncture to check the cerebral spinal fluid for antibodies and proteins associated with MS

In some patients, the first MRI scan shows multiple lesions that are so consistent with MS that an MS diagnosis may be given after only one clinical attack has happened. While not as common, early diagnosis can offer an important opportunity for early treatment.

There is no cure for multiple sclerosis. Treatment is focused on managing symptoms during attacks, as well as slowing the disease progression to prevent relapses and limit formation of new lesions in the brain or spine.

Your child’s care team will determine the best treatment based on your child’s symptoms and condition.

Treatment of MS relapses

Steroids

Steroids (corticosteroids, prednisone, or methylprednisolone), most commonly IV methylprednisolone, are used for the acute treatment of MS symptoms. IV methylprednisolone is given only for a few days. If needed, oral prednisone may be prescribed for a further one to two weeks.

Serious side effects are possible, but they are not common when treatment is short. Less serious side effects are common, however, and these include irritability and difficulty sleeping. Giving the steroids in the morning reduces the impact on sleep. Upset stomach is common and medications that reduce stomach acid are typically given to prevent this. High blood sugar levels may also be a side effect that resolves when the steroids are stopped.

Intravenous immunoglobulin

Intravenous immunoglobulin (IVIG) is an IV medication that is made up of antibodies from healthy blood donors. These help decrease the unwanted immune response that occurs in MS. The most common side effect is headache, but other side effects include muscle or joint pain and low-grade fever. IVIG is not usually the first treatment used for an MS relapse, but may be used in certain situations.

Plasma exchange

Plasma exchange, also called plasmapheresis or PLEX, is used when neurologic symptoms are difficult to treat. It is a process where the blood is removed from the body and washed to remove disease-causing substances, such as antibodies from the plasma (the liquid component of blood). The blood cells are then returned to the body. Multiple treatments are required, given over a couple of weeks. Plasma exchange requires the surgical placement of a special line for IV access. Risks include changes in blood pressure and fluid balance as well as infection of the access site.

Medicines to prevent relapses and progression of MS

Treatments to prevent relapses and progression of MS may include the following categories of disease-modifying agents. Decisions about the best disease-modifying therapy can be complicated and are always made while considering other health conditions and what is best for each individual patient.

Injectable medications
  • Interferons (Avonex®, Rebif®, Betaseron®, Plegridy®): These medications mimic the effects of some proteins that your body can make to change how your immune system works. They are used to decrease the number of relapses and new lesions on MRI. Common side effects include flu-like symptoms shortly after the injection and injection site pain. Regular blood tests are required to monitor the medication. The type and frequency of injection is different with each of these medications.
  • Glatiramer acetate (Copaxone®): This medicine is given by subcutaneous injection (just under the skin). This medication looks like one of the proteins that makes up myelin in the brain and spinal cord. The injection is given daily or three days a week. Common side effects include injection site reactions and, rarely, a reaction with chest pain. Regular blood tests are not required. 
Oral medications

While there are several oral medications used in the treatment of MS, only fingolimod (Gilenya®) is currently under widespread use in the treatment of children with MS.

This medicine is taken daily and decreases relapses by trapping certain white blood cell in the lymph nodes to decrease immune system reactions. Blood testing is required before starting fingolimod and during treatment because it is associated with an increased risk of infection. Fingolimod also requires close monitoring with an eye doctor as it may cause an eye problem called macular edema.

The first dose of fingolimod is administered in a hospital or medical office setting because it can lower your heart rate. If you stop and then restart fingolimod, you will have to be monitored again when you restart it.

Infused medications

Infused medications such as Rituximab®, Tysabri® or Ocrevus® are given by IV infusion in a hospital setting. They are associated with increased risks of infection and require blood tests before starting as well as close monitoring and blood testing during treatment. These medications are most often used when injectable or oral medications have not been effective, but may be used in other settings as well.

Other treatments for MS

In addition to medication, certain lifestyle factors can help decrease relapses and manage MS symptoms.

  • Taking vitamin D if needed. Having enough vitamin D decreases MS disease activity. We will check vitamin D levels and may recommend taking vitamin D3. Vitamin D may also decrease the risk of disease in other family members.
  • Avoiding cigarette smoking. We know that exposure to cigarette smoke increases the risk of MS. Please don’t smoke, and avoid exposure to second-hand smoke. Family members who smoke should smoke outside and change clothes when they come inside. 
  • Eating a healthy diet and exercising. It is extra important for people with MS to be sure that they are making healthy choices. A healthy diet, regular exercise, and plenty of sleep are all essential. Maintaining a healthy weight is important.

Close follow-up for children with MS is vital to the long-term outcome, and this is provided in the Pediatric MS and Neuroinflammatory Disorders Clinic at CHOP. We follow children closely for evidence of relapse, and to monitor the efficacy of medications. Follow-up MRI studies will also be needed on a regular basis, and we will review those images in person during clinic visits.

MS is a chronic condition that needs to be managed throughout life. The course of the disease is difficult to predict and varies from person to person. Some have long periods of remission while others have more frequent attacks.

The Pediatric Multiple Sclerosis Clinic at Children’s Hospital of Philadelphia provides a multidisciplinary approach to caring for children with MS. Your child will see a team of experts who specialize in demyelinating diseases like MS, and who are involved in cutting-edge research in MS and other neuro-inflammatory disorders. Your child’s care team will include a neurologist, nurse practitioner, nurse, occupational therapist, physical therapist and social worker. The clinic also partners with other specialties at CHOP such as ophthalmology, urology, pain management and neuropsychiatry to coordinate your child’s care as necessary.

Our team is actively involved in research studies to learn more about childhood demyelination and how it affects children and teenagers.

Metabolic syndrome: description of the disease, causes, symptoms, cost of treatment in Moscow

Hormonal and metabolic pathologies together are metabolic syndrome. These pathologies include the presence of obesity, impaired carbohydrate and lipid metabolism, arterial hypertension, and respiratory failure during sleep. Such diseases are closely related to each other, and when combined, the patient is diagnosed with metabolic syndrome. These pathologies pose a danger to human life, and they call them the deadly quartet.

Metabolic syndrome, in most cases, occurs in adults. According to statistics, it affects people whose age ranges from 22 to 50 years (about 30 percent). In men, the disease appears more often than in women. When the age exceeds 50 years, the number of cases is equalized.

In the presence of such a syndrome, cardiovascular diseases begin to progress, which are directly related to atherosclerosis. In addition, due to metabolic syndrome, coronary complications develop, as a result of which the patient dies.If obesity is a complement to the pathology, arterial hypertension develops half times more often.

Why does

syndrome appear?

The main cause of metabolic syndrome is a genetic predisposition to insulin resistance, as well as if a person consumes excessive fats and does not adhere to an active lifestyle.

The syndrome develops mainly due to insulin resistance. Thanks to insulin, many important functions take place in the body.However, it is designed to bind to receptors that are sensitive to it. They are present in cells, or rather, in membranes. If the connection is adequate, glucose is transported into the cells. The immediate task of insulin is to open such a “gateway” for glucose. But, if the receptors lose sensitivity to this hormone, the cells are not saturated with glucose, and it begins to accumulate in the bloodstream. In addition, insulin accumulates in the blood.

It is necessary to consider each of the reasons in more detail

The presence of a genetic predisposition to insulin resistance.Some people have this from birth. With a gene mutation, the following problems develop:

  • The cells lose a sufficient number of insulin-sensitive receptors.

  • Sufficient receptors may be present, but they are not sensitive to insulin, so glucose and food are deposited in adipose tissue.

  • The immune system produces antibodies that block insulin-sensitive receptors.

  • The pancreas produces bad insulin.

Eating foods that are high in fat. If saturated fatty acids are consumed in excess, their processing and oxidation slows down. As a result, obesity develops and progresses.

With an excessive amount of such fatty acids, the structure of phospholipids, which are contained in the cell membrane, changes.This factor contributes to the fact that there is no normal penetration of glucose into cells. In addition, fats are higher in calories than carbohydrates and proteins. For example, one gram of fat contains 9 kilocalories, and one gram of carbohydrates and proteins contains four kilocalories. Therefore, with excessive intake of fats in the body, the excess calories are deposited into the fat reserve.

Failure to comply with an active lifestyle. This is another cause of metabolic syndrome.In the absence of physical activity, the processes of fat breakdown slow down. Also, adipose and muscle tissue is saturated with triglycerides, and there is not enough glucose in the muscles. As a result, the metabolic syndrome develops rapidly.

Medications. If a person takes a certain drug, weight may increase. This refers to the reception:

  • Antipsychotics.

  • Tricyclic antidepressants.

  • Drugs, due to which the level of glucose in the blood decreases.

  • Glucocorticoids.

  • Anticonvulsants.

  • Adrenoblockers.

  • Antihistamines.

  • Hormonal contraceptives.

The presence of these four causes lead to the formation of metabolic syndrome.

In addition, the presence of certain risk factors can influence the occurrence of such a disease. This happens when:

1. Obesity.

2. Belonging to the male sex.

3. Postmenopausal period.

4. Alcohol abuse.

5. Senile age.

6. Long-term psychological stress.

7. Arterial hypertension.

8. Certain diseases.

How does the disease manifest

If the disease is at an early stage, the symptoms are difficult to determine. The development of such a pathology occurs almost imperceptibly, there are no painful sensations. However, the disease does not become less dangerous.

A distinctive feature of the metabolic syndrome is the severe course of cerebrovascular disease and ischemia of the heart, even at a young age. Among the main symptoms of the syndrome are:

  • Bad mood that occurs with attacks. Especially often with hunger. Unmotivated aggression and irritability appear. This happens because glucose is not supplied to the brain in sufficient quantities.

  • Decreased performance.Even with a high amount of sugar in the blood, cells do not receive glucose, so they lose their energy source.

  • Sleep apnea. Snoring appears, in the daytime there is an increase in drowsiness. If a person snores at night, the risk of coronary artery disease and stroke increases. Also, you can get a professional injury and provoke a car accident.

  • Blood pressure increases, arterial hypertension develops even in young patients.The increased pressure may not produce the characteristic sensations. The pressure rises at night. The fundus changes, which can be determined by an ophthalmologist. The increase in blood pressure in metabolic syndrome is difficult to control.

  • Nephritis develops, which is characterized by high blood pressure and changes in the quality of urine. Such a symptom can only be determined by laboratory analysis (hypoisostenuria). The patient is struck by gouty arthritis, which is caused by an increased content of uric acid.

  • Fat mass is deposited on the abdomen and shoulders. This is dangerous because fat coats the vital organs. They are pinched, stop functioning normally.

  • The appearance of red spots, the localization of which is the chest, neck. This symptom indicates that blood pressure is increasing and blood vessels are spasmodic.

  • Regular and prolonged headache appears.

  • Heart aches.

  • The patient is constantly thirsty, the mouth is dry. Drowsiness increases after eating. I often want to eat something sweet.

Diagnostic measures

The beginning of the diagnosis is to examine the patient. Then he is interviewed about concomitant diseases, the waist circumference is measured. The main criteria for clarifying the diagnosis:

one.High blood pressure. The indicator exceeds 140 by 90 millimeters of mercury.

2. Decreased high density lipoproteins (less than 1.2 mmol).

3. Triglycerides increase.

4. There is a violation of glucose tolerance.

5. The indicator of glucose on an empty stomach is above 6 mmol.

To make an accurate diagnosis, you do not need to have all five of the above indicators.The fact that the patient is obese is enough, plus 2 items from the list.

In addition, the clinic’s specialist can prescribe the patient to undergo an electrocardiogram, daily blood pressure monitoring, ultrasound, computed tomography (it assesses how much the internal organs are surrounded by visceral fatty tissue).

Peculiarities of gastric ultrasound and preparation for it

Ultrasound examination of the stomach is currently considered one of the most accessible and informative diagnostic methods.In most cases, it is part of a comprehensive abdominal ultrasound scan. If you are interested in the price of ultrasound in Simferopol, you can find out from us.

Features of gastric ultrasound

In most cases, patients are prescribed this procedure in the presence of symptoms such as:

  • Heartburn.
  • Belching.
  • Nausea and vomiting.
  • Feeling of bitterness in the mouth.
  • Increased formation of gases.
  • Pain in the stomach.

In addition, ultrasound of the stomach is performed if there is suspicion of oncological and other diseases. During the procedure, the patient is in a supine position. A gel is applied to his body in the region of the stomach. The specialist moves the sensor of the ultrasound machine and evaluates the picture on the monitor.

With the help of this study, it is possible to identify pathologies such as:

  • Increase in the thickness of the walls of the stomach. Normally, they should have the same thickness anywhere.
  • Hernias, cysts and polyps.
  • Presence of a foreign body in the stomach.
  • Inflammation of the mucous membrane.
  • Tumors of a benign nature.
  • Cancer diseases.
  • Pyloric stenosis.
  • Stomach ulcer, if it has acquired a significant size.

Ultrasound examination of the stomach is performed strictly on an empty stomach, preferably in the morning. It is very important to abstain from food for 6-12 hours before the examination. Adults are not allowed to drink liquid for two hours before the test, children – for an hour.

Before the procedure, it is not allowed to smoke, suck lollipops and chew chewing gum. Patients who have a tendency to constipation should take a laxative the day before the study or do an enema in the morning before it.

A couple of days before the ultrasound of the stomach, it is advisable to delete from the menu products that contribute to the increased formation of gases: legumes, dark flour bread, cabbage, as well as alcohol, coffee and strong tea. Well, if you want to have an ultrasound scan in Simferopol, please contact our company.

Esophagus, its functions and diseases

Every day, people leave all their business to eat and recharge. Like a car that needs to be refueled regularly, a person needs to eat at certain times of the day

Also, food provides material for the so-called plastic processes, that is, it ensures the growth of body tissues, the restoration and replacement of constantly decaying cells.
This responsible function, thanks to which food begins to turn into substances that give the human body energy and material for plastic processes, is performed by the gastrointestinal tract.
No wonder it was called a tract. This is a really intelligently arranged path, about eight meters long. There are various adjusting devices with the help of which the eaten food slowly, with the necessary stops, makes its short journey.
The digestive tract begins, of course, from the oral cavity, where solid food is ground with teeth and moistened with saliva. Food chewed and moistened with saliva passes into the esophagus. We will talk about him further.

The esophagus is a narrow, approximately 25 centimeters long, 2-2.5 centimeters in diameter, vertically located tube that connects the pharynx to the stomach.Although the esophagus is not actively involved in food processing, it plays a large role.
The main task of this organ is to deliver food to the stomach, otherwise this function is called transport or motor. Another task of the esophagus is to lubricate food passing through it. The material for lubrication is produced by the secretory glands of the mucous membrane lining the cavity of the organ. The esophagus is designed to protect against the penetration of food from the stomach back, that is, it promotes the movement of food in only one direction.
And unfortunately, this organ is susceptible to a wide range of different diseases.
About 40% of the adult population experience heartburn from time to time.
It is the most common symptom of gastroesophageal reflux disease.
Gastroesophageal reflux disease (GERD) is a condition that occurs when stomach contents back up into the esophagus cause troublesome symptoms and / or complications.
In addition to heartburn, pain in the throat, chest may be troubling; nausea, sleep disturbance, difficulty swallowing, cough, hoarseness.

Gastroesophageal reflux disease is dangerous for its complications:

  1. erosive esophagitis – destruction of the surface layer of the stratified squamous epithelium of the esophagus,
  2. esophageal ulcer – destruction of cells of the entire thickness of the mucous membrane,
  3. esophageal strictures – the formation of scar tissue at the site of ulcer healing,
  4. metaplasia – replacement of stratified squamous epithelium with a single-layer cylindrical epithelium (Barrett’s esophagus),
  5. dysplasia – cancer localized in the mucous membrane of the esophagus,
  6. adenocarcinoma – cancer that invades other layers of the esophagus.

Thus, heartburn is far from a harmless condition. Lack of adequate treatment of the esophagus not only leads to pain, but can also disrupt the entire work of the digestive system. And improper treatment of gastroesophageal reflux disease (for example, taking baking soda) increases the risk of complications.
Only a gastroenterologist can prescribe an adequate treatment for the esophagus after a full examination. 90,000 Treatment of stomach neurosis in the medical center “KORSAKOV”

Neurosis of the stomach is one of the diseases of somatoform symptoms.This pathology is completely reversible. Patients who feel even minor pain sensations should consult a gastroenterologist. The doctor prescribes a diagnosis of the gastrointestinal tract. In the absence of problems with the digestive tract, he refers to a psychotherapist. This type of disease occurs in people of different age groups.

This disorder of the mental system can lead to regular insomnia. Patients experience pain in the stomach, accompanied by vomiting, morning and night heaviness.Their blood pressure often rises, their head is spinning. Such somatic reactions are due to the psychopathic mechanism of pathology.

Sign up for a consultation with a doctor for the treatment of stomach neurosis
+7 (499) 288-19-74
Thank you for your trust!

  • Evidence-based psychotherapy
  • Specialized individual psychological assistance
  • Relaxation therapy, hypnosis
Service: Cost
Psychotherapist appointment

4 950 rub

Family psychotherapy

7 150 rub

Hypnotherapy

4 950 rub

Clinical psychologist consultation

4 950 rub

Psychiatric consultation

3 850 rub

* The administration of the KORSAKOV medical center takes all measures to timely update the price list posted on the website, however, in order to avoid possible misunderstandings, we advise you to clarify the cost of services in the contact center by phone +7 (499) 288-19-74

Treatment of stomach neurosis in the clinic “Korsakov”

In the multidisciplinary clinic “Korsakov” , treatment of stomach neurosis is carried out by experienced psychotherapists and nutritionists.They use progressive psychotherapy methods. Organize a comprehensive examination of patients. Individual courses of therapy are compiled depending on the symptoms of the disease, the severity of the pathology and the characteristics of the patient’s body. The dietitian develops the correct diet or corrects a previously prescribed diet. This allows you to ensure the achievement of effective results even in the most difficult to diagnose cases. The disease at any stage of development is cured without side complications.

Medical Center “KORSAKOV”

+7 (499) 288-19-74

There are contraindications.Consultation of a specialist is required.

Request a call

Plan of diagnostic procedures for inpatient or outpatient treatment of gastric neurosis in the KORSAKOV clinic:

  1. Laboratory diagnostics for the diagnosis of gastric neurosis:
  • Complete blood count
  • General urinalysis
  • Blood glucose
  • Blood bilirubin
  • Blood creatinine
  • Blood urea
  1. Instrumental diagnostics for the diagnosis of gastric neurosis:
  • ECG
  • EEG
  • Psychodiagnostics
  • Ultrasound of the abdominal cavity
  • FGDS
  1. Consultation of specialists for the diagnosis of gastric neurosis:
  • Psychotherapist
  • Psychiatrist
  • Medical Psychologist
  1. Consultations of specialists that are necessary only for individual indications:
  • Gastroenterologist
  • Endocrinologist
  • Nutritionist
  • Neurologist
  • Physiotherapist
  • Psychologist
  • Therapist
  • Sex therapist

Treatment plan for inpatient or outpatient treatment of gastric neurosis in the KORSAKOV clinic

  1. Drug treatment for the diagnosis of gastric neurosis (according to indications):
  • Antidepressants
  • Antipsychotics
  • Tranquilizers
  • Vitamins
  • Nootropics
  • Proton pump preparations
  • Antispasmodics
  • Gastrocytoprotectors
  • Prostaglandins
  1. Physical and active methods of treatment for the diagnosis of gastric neurosis (according to indications):
  • Individual psychotherapy
  • Physiotherapy
  • Xenon therapy
  • Reflexology
  • LFC
  • Art therapy
  • Massage
  • Electrosleep

Our specialists provide specialized psychological assistance.They use hypnotic sessions to enhance the healing effect. Relaxation therapy is used, anti-anxiety drugs are prescribed on a herbal, natural basis. The clinic’s psychotherapists organize individual consultations and conduct family therapy with the assistance of an experienced psychiatrist. They offer a system of rehabilitation measures for the successful social adaptation of the patient.

TREATMENT OF GASTRIC NEUROSIS CONDUCT

  • Polina Sergeevna

    NOSOVA


    Head of the psychiatric department.Senior Researcher. Psychiatrist

  • Anton Evgenievich

    NIKOLISHIN


    Psychiatrist, doctor expert

  • Sergey Vladimirovich

    KURENKOV


    Clinical psychologist.Psychotherapist. Hypnotherapist

  • Yuri Borisovich

    MOZHGINSKY


    Doctor of Medical Sciences. Psychiatrist-psychotherapist

  • Asiyat Mustafaevna

    NIYAZOV


    Analytical psychotherapist, clinical psychologist

  • Alexandra Mikhailovna

    MAKAROVA


    Psychiatrist-psychotherapist

  • Teona Otarievna

    KACHARAVA


    Doctor-adolescent psychiatrist, doctor-sexologist

What are the causes of this disease?

For an effective treatment of gastric neurosis , the true causes of its occurrence should be established.Among the main causative factors that cause this disease, the following pain symptoms can be distinguished:

  • Intermittent, inadequate sleep. A person needs at least 8 aces for the normal functioning of internal organs;
  • Excessive workload. They cause a constant stressful state, strong emotional experiences;
  • Mental disorders;
  • High level of mental stress. It is especially manifested during exams, work;
  • Irregular, unhealthy diet.The human body needs a whole range of vitamins, minerals and nutrients;
  • Introduction to the diet of products harmful to the body: frozen food, fast food, carbonated drinks;
  • Postponed viral diseases;
  • Pathology of organs entering the gastrointestinal tract and other systems.

If you do not pay attention to the problems associated with the work of the stomach in time, you can suffer from painful sensations for many years.The disease at an early stage will quickly develop into a more complex form. Therefore, if even insignificant symptoms of stomach and intestinal neurosis are found, you should immediately seek help from a qualified psychotherapist.

Characteristic symptoms of gastric neurosis

This disease most often affects women under 35 years of age. The disease can manifest itself in the intestines and abdomen. To determine an effective treatment system, the patient is prescribed a preliminary diagnosis.The doctor organizes a thorough examination, examines the results of the examination and develops an individual course of therapeutic procedures.

When a neurosis of the stomach occurs, the symptoms of appear in:

  • Constant hunger;
  • Strong aversion to food and smells from food;
  • Signs of heartburn and colic in the abdomen;
  • Frequent vomiting, nausea;
  • Abdominal bloating, flatulence;
  • Stool disorders;
  • Constant headaches, migraines, dizziness;
  • Frequent changes in blood pressure;
  • Rapid heart rate;
  • Shortness of breath, rapid breathing.

Most often, patients with this disease complain of vomiting. The painful sensations are so strong that they cause a lot of unpleasant sensations both day and night. Therefore, when symptoms of gastric neurosis manifest, treatment should be organized as soon as possible. Otherwise, the disease will proceed in a chronic form, which will significantly complicate the healing process.

What methods are used to treat stomach neurosis?

When symptoms of gastric neurosis are detected, treatment in adults for patients is based on the following methods:

  • Use of effective medicinal products;
  • Provision of psychological assistance;
  • Appointment of an individual diet;
  • Physiotherapy procedures;
  • Massage procedures;
  • Hydrotherapy based on sea salt and medicinal herbs;
  • System of preventive measures to improve the physical and mental health of patients.

Drug treatment consists in the appointment of a complex of drugs that normalize the work of the gastrointestinal tract and endocrine system together with vitamins. Doctors use only reliable, safe drugs that do not cause side effects. For each patient, an individual diet is drawn up in parallel with the intake of gentle sedatives.

Physiotherapy procedures allow to normalize bowel function and stabilize the patient’s mental state.Massage, hydrotherapy can be used as additional therapeutic techniques to enhance the therapeutic effect. To eliminate the risks of recurrence of the disease, the patient is prescribed walks in the fresh air, sports, physical education. He is recommended a balanced diet with the obligatory inclusion of vitamin complexes. In order to consolidate the results achieved, patients are advised to relax in sanatoriums, to restore their mental health, without thinking about daily problems at work and in personal life.

Such a systematic approach can guarantee a positive result even in the treatment of neurosis of the stomach and intestines at a severe stage of development .

How do the doctors of our clinic organize the treatment of stomach neurosis?

In their work, the doctors of the Korsakov clinic use modern diagnostic equipment and the latest medical technologies. This allows you to organize a comprehensive diagnosis, make the correct diagnosis and develop the correct therapy regimen.The use of reliable medications enhances the therapeutic effect, excludes relapses in subsequent years.

Particular attention is paid to the provision of qualified psychological assistance. Our psychotherapists define a system of individual and group consultations, thanks to which patients quickly socialize and go through the rehabilitation stage without complications. All patients are on an outpatient basis, which allows you to create the most comfortable, relaxed environment.They can seek help from our specialists at any time of the day.

Submit applications in a convenient way. Call +7 (499) 288-19-74 at any time or make an appointment with a psychotherapist for the treatment of stomach neurosis on the official website of the clinic. Our address: Moscow, 3rd Cherkizovskaya Street, 14. For vehicles, secured, free parking is provided. She works around the clock. Entrance to the territory through an automatic gate.

The full price list can be found at the medical center or ask a question by calling the hotline: +7 (499) 288-19-74

* The administration of the KORSAKOV medical center takes all measures to timely update the price list posted on the website, however, in order to avoid possible misunderstandings, we advise you to clarify the cost of services in the contact center by phone +7 (499) 288-19-74

The posted price list is not an offer.Medical services are provided on the basis of a contract.
There are contraindications. Consultation of a specialist is required.

Checked by a psychiatrist, a narcologist: Orlov Andrey Mikhailovich.
Medical information is correct, reliable, current.
Latest Check Date:

90,000 Chemotherapy for stomach cancer. Treatment of gastric oncology with chemotherapy

Surgical method is the leading method of treating gastric cancer in the early stages.Chemotherapy for gastric neoplasms is used in the following cases:

  • Neoadjuvant chemotherapy for stomach cancer is a treatment that is carried out before surgery in order to reduce the size of the tumor or to completely disappear it, in order to create conditions for performing radical surgery .
  • Adjuvant chemotherapy for stomach cancer – is a treatment that is carried out after surgery, aimed at suppressing the remaining malignant cells in the body that are not visible to the surgeon’s eyes or by radiological research methods (ultrasound, MRI, CT), as well as to prevent the development of relapses and metastasis …
  • Chemotherapy as an independent method of treatment for stomach cancer – performed in case of impossibility of performing a surgical method of treatment (inoperable process) or contraindications to surgery.
  • Palliative chemotherapy for stomach cancer – used in patients with terminal stages of the tumor process, to eliminate symptoms that disturb the quality of life (pain syndrome, etc.)

INTERDISCIPLINARY APPROACH IS IMPORTANT

Treatment is planned at an interdisciplinary oncological council with the involvement of highly qualified MC ONCOLIFE specialists, the commission includes:

  • clinical oncologist “chemotherapist”
  • Oncosurgeon
  • Oncologist-Radiologist

To make an appointment with oncologist – chemotherapist , call:

Or fill out Form


AT OUR CENTER WE USE INTERNATIONAL RECOMMENDATIONS AND TREATMENT PROTOCOLS

CHEMOTHERAPY FOR STOMACH CANCER IN ZAPORIZHIA

As chemotherapy for stomach cancer, Oncolife MC specialists use drugs such as:

  • 5-Fluorouracil
  • Oxaliplatin
  • Docetaxel
  • Paclitaxel
  • Cisplatin
  • Carboplatin
  • Capecitabine
  • Epirubicin

All chemotherapy drugs can be used as first and / or second line.