Multiple sclerosis and related disorders · 2025
Non-pharmacological interventions for fecal incontinence in people with multiple sclerosis: A scoping review.
СтатьяScoping ReviewНазвание и аннотация: Перевод в очереди
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Özkan İlknur, Polat Dünya Cansu, Taylan Seçil
Аннотация
BACKGROUND: Fecal incontinence (FI) is a common but often underrecognized symptom in people with multiple sclerosis (MS), markedly impairing quality of life. Non-pharmacological strategies are recommended as first-line management; however, existing evidence remains limited and fragmented. This review aimed to map current evidence on such interventions and identify key gaps to inform future research.
METHODS: A scoping review was conducted following the Joanna Briggs Institute's six-stage framework and reported according to PRISMA-ScR guidelines. Comprehensive searches were performed in PubMed, Web of Science, CINAHL, Scopus, and ScienceDirect, finalized in August 2025. Empirical studies investigating non-pharmacological management of FI in adults with confirmed MS were included. Two reviewers independently extracted and synthesized data using thematic analysis.
RESULTS: Fifteen studies met the inclusion criteria. The most frequently evaluated interventions were transanal irrigation (n=6) and biofeedback therapy (n=4), followed by posterior tibial nerve stimulation (n=2), sacral neuromodulation (n=2), pelvic floor physiotherapy (n=1), and behavioral programs (n=1). These interventions showed promise in reducing FI symptoms and improving quality of life. However, most studies were limited by small sample sizes, heterogeneous protocols, and non-MS-specific outcome measures. Thematic analysis identified four key domains: clinical effectiveness; factors influencing treatment response; feasibility and sustainability; and research limitations with future directions.
CONCLUSION: Non-pharmacological management of FI in MS appears safe, feasible, and potentially effective in improving symptoms and quality of life. Future research should adopt standardized protocols, MS-specific assessment tools, and long-term follow-up in larger samples. Integration of digital and home-based strategies may further enhance sustainability and accessibility of interventions.
METHODS: A scoping review was conducted following the Joanna Briggs Institute's six-stage framework and reported according to PRISMA-ScR guidelines. Comprehensive searches were performed in PubMed, Web of Science, CINAHL, Scopus, and ScienceDirect, finalized in August 2025. Empirical studies investigating non-pharmacological management of FI in adults with confirmed MS were included. Two reviewers independently extracted and synthesized data using thematic analysis.
RESULTS: Fifteen studies met the inclusion criteria. The most frequently evaluated interventions were transanal irrigation (n=6) and biofeedback therapy (n=4), followed by posterior tibial nerve stimulation (n=2), sacral neuromodulation (n=2), pelvic floor physiotherapy (n=1), and behavioral programs (n=1). These interventions showed promise in reducing FI symptoms and improving quality of life. However, most studies were limited by small sample sizes, heterogeneous protocols, and non-MS-specific outcome measures. Thematic analysis identified four key domains: clinical effectiveness; factors influencing treatment response; feasibility and sustainability; and research limitations with future directions.
CONCLUSION: Non-pharmacological management of FI in MS appears safe, feasible, and potentially effective in improving symptoms and quality of life. Future research should adopt standardized protocols, MS-specific assessment tools, and long-term follow-up in larger samples. Integration of digital and home-based strategies may further enhance sustainability and accessibility of interventions.