Neurogenic Bowel Problems in Spinal Cord Injury and Multiple Sclerosis: Prevalence, Dietary and Gut Microbiota Interventions

Summary

This dissertation investigates neurogenic bowel dysfunction (NBD) in patients with spinal cord injury (SCI) and multiple sclerosis (MS). Both conditions frequently lead to distressing bowel problems that significantly impair quality of life. Using large patient datasets, our studies reveal that effective bowel management remains difficult to achieve after SCI rehabilitation, particularly in complete or non-traumatic injuries. In MS, bowel problems affect 73% of patients, yet awareness and timely care are often lacking. Diet quality among SCI patients seems poor, with low fiber intake and little recognition of diet’s influence on NBD. A systematic review indicated altered gut microbiota, especially reduced diversity in SCI, though evidence remains inconsistent. A randomized trial testing probiotics in SCI patients showed no significant effect in preventing antibiotic-associated diarrhea. Overall, the thesis emphasizes the need for better education, structured dietary support, personalized management, and further microbiome research to improve outcomes.