SynthesisJournal of neurology2026
Gastrointestinal symptoms and disorders in multiple sclerosis: a systematic review and meta-analysis.
Synthesis in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
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Abstract
backgroundGastrointestinal (GI) symptoms and disorders are frequently reported in multiple sclerosis (MS), but the evidence remains fragmented and highly diverse. We conducted a systematic review and meta-analysis to define the extent and range of GI symptoms and disorders in people with MS (pwMS).
methodsPubMed, Scopus, and Web of Science were searched from inception through October 1, 2025. Eligible studies included observational and interventional designs that reported GI symptoms or diseases in MS. Random-effects meta-analyses were performed for outcomes reported by three or more studies. Prevalence estimates were pooled across all eligible studies, and odds ratios (ORs) were additionally calculated for outcomes reported in case-control studies.
resultsA total of 114 studies involving 1,272,170 pwMS were included. Autonomic GI dysfunction was the predominant phenotype, affecting approximately one-third of pwMS (31.4% [95% CI 26.4-36.5%]), with a high prevalence of dysphagia (43.4% [95% CI 35.9-51.0%]) and bowel dysfunction (37.9% [95% CI 25.0-51.8%]). When analyzed by anatomical domains, lower GI symptoms and disorders were more frequent than upper GI manifestations (28.9% vs 11.5%). In case-control analyses, pwMS had significantly higher odds of autonomic GI dysfunction compared with controls (OR 3.26 [95% CI 1.81-5.86]). Substantial between-study heterogeneity was present across all analyses.
conclusionsAutonomic GI involvement is a common and clinically important aspect of MS. Marked heterogeneity reflects differences in assessment methods and populations, supporting the view of pooled estimates as general indicators and emphasizing the need for standardized outcome definitions and structured clinical screening.
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Registered trials
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