There are 3 main types of MS:

1. relapsing remitting MS
2. primary progressive MS
3. secondary progressive MS

Relapsing remitting MS is the most common type of MS, affecting around 85 per cent of those diagnosed. It means that symptoms appear (a relapse), and then fade away, either partially or completely.

Primary progressive MS affects about 10 to 15 per cent of people diagnosed with MS. Symptoms gradually get worse over time, rather than appearing as sudden attacks (relapses).

Secondary progressive MS is a stage of MS which can come after relapsing remitting MS. It means there is a sustained build up of disability, completely independent of any relapses.

It is not uncommon for a diagnosis to take several months, and frustratingly it can take even longer. A range of other possible causes need to be explored and many different tests need to be carried out.

What should I do if I think I have MS?

Most people who experience unexplained symptoms won't have MS. However, if you're concerned that you may have MS, your GP should be your first port of call.

If your symptoms are not too severe, your GP may not do anything immediately. However, if you have another period of symptoms, your GP should refer you to a neurologist. If the neurologist thinks that you might have MS, they will normally give you a number of tests.

Many people going through this process describe themselves as being in limbo, since doctors are often reluctant to confirm a diagnosis until they are 100% certain. 

MS is an autoimmune disease. The body’s immune system attacks its own tissue thinking it’s a foreign body. In the case of MS, the immune system attacks myelin in the brain and spinal cord therefore sending incorrect messages from your brain. Initially, symptoms commonly occur as separate “attacks” or relapses, each lasting a few weeks and resolving, not always completely spontaneously.

Symptoms vary greatly in terms of severity as everyone is different but those with MS may experience:

• fatigue
• anxiety and depression
• loss of bladder and bowel control
• issues surrounding cognition, concentration and memory
• sensory impairment including heat sensitivity, pain and pins and needles
• motoneurone issues including dropped foot, muscle weakness, tremor, spasms and spasticity
• loss of vision including blurred and double vision
• problems surrounding speech and swallowing
• a lack of balance, dizziness, vertigo, visual problems and poor visuo-spatial perception
• a variety of sexual issues

No one knows the exact cause of MS, but it is likely that it is influenced by a mix of genetic and environmental factors.

Genes and family history

MS is not directly inherited as there is no single gene that causes it. However, it is  likely that a combination of genes make some people more susceptible to developing MS, but not everyone with this specific gene combination will develop the disease.

While MS can occur more than once in a family, it is more likely this will not happen. There's only around a two per cent chance of a child developing MS when a parent is affected.

Environmental factors

MS is more common in areas further away from the equator. It is virtually unheard of in places like Malaysia or Ecuador, but relatively common in Britain, North America, Canada, Scandinavia, Southern Australia and New Zealand.

Viruses

It is not clear why people further away from the equator are more likely to get MS, but it is possible that something in the environment, perhaps bacteria or a virus, plays a role.

No single virus has been identified as definitely contributing to MS, but there is growing evidence that a common childhood virus, such as the Epstein Barr virus (which can cause glandular fever), may be a contributory factor.

Vitamin D

There is also a growing amount of research that suggests that a lack of vitamin D could be a factor in causing MS. During the summer months, we get most of our vitamin D from exposure to sunlight. Low levels of vitamin D have been linked to higher numbers of people developing many different conditions, including MS.

What is Multple Sclerosis?

Multiple sclerosis (MS) is a condition of the central nervous system. It is the most common disabling neurological disease of young adults in the UK. Over 100,000 people in the UK have MS and it effects over 2,000,000 more. It is not considered a terminal illness and it is not contagious. Most people are diagnosed with MS in their 20s and 30s and it affects more women than men.

In MS, the protective coating around nerve fibers (called myelin) is damaged.

In MS, your immune system, which normally helps to fight off infections, mistakes myelin for a foreign body and attacks it. This damages the myelin and strips it off the nerve fibres, either partially or completely, leaving scars known as lesions or plaques.

This damage disrupts messages travelling along nerve fibres – they can slow down, become distorted, or not get through at all.

As well as myelin loss, there can also sometimes be damage to the actual nerve fibres. It is this nerve damage that causes the accumulation of disability that can occur over time.

At North Bristol NHS Trust, we are proud to continue delivering high quality research that directly benefits our patients.

If you are considering a role in research but do not have any experience, do not worry! Most of our colleagues were in the same boat and we have excellent on-the-job training to support your development. We can help you with all that you need to do your role. 

We come from a range of backgrounds, including AHPs, nurses, midwives, clinical research practitioners (CRPs) and administrators. We offer support for CRP registration, making the roles accessible for those with a range of experience.

If you have training requests please contact your line manager in the first instance.

We also promote GCP training organised by the NIHR West of England CRN. If you are interested in a GCP training course, please get in touch with NIHR West of England CRN direct via 0117 342 1375 or email westengland@nihr.ac.uk.

ICH GCP Training

Freedom to Speak Up

Speak up - We will listen

If you have a concern about something at work, this policy will tell you how you can raise a concern, and what support you will receive.

Speaking up about any concern you have at work is really important. In fact, it’s vital because it will help us to keep improving our services for all patients and the working environment for our staff.

For more information download 

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• Diagnostic and Therapeutic Upper GI Endoscopy
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• Investigation and treatment of gastro-oesophageal problems including reflux (GORD), hiatus hernia, Barrett’s oesophagus and ulcer disease
• Investigation and treatment of disorders of the spleen and  Achalasia of the oesophagus
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Procedures performed

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• Inguinal hernia repair – laparoscopic and open
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GMC Number: 2922964

Year of first qualification: 1981, Cambridge

Specialty: Rheumatology

Clinical interest: Osteoporosis

Secretary: Jessica Goodwin

Telephone: 0117 4142849

Professor Jon Tobias is active across all adult general rheumatology services and is the Clinical Director for Rheumatology.

He has a particular interest in osteoporosis and other metabolic bone diseases, as part of which he supervises the North Bristol NHS Trust (NBT) DXA services, and runs a dedicated osteoporosis clinic.

He is also an active researcher through his position as Professor of Rheumatology, School of Clinical Sciences, University of Bristol.

The 105-year-old hospital has had a complete refurbishment and offers modern and fully accessible facilities from which the NHS will deliver a wider range of services, closer to people’s homes. 

The refurbishment of Cossham Memorial Hospital followed detailed consultation with local people and an NHS review to look at the healthcare needs of the population in Kingswood and East Bristol. 

The Cossham development, will be part of a network of community hospitals and healthcare centres being created throughout Bristol, South Gloucestershire and North Somerset. These will provide people with a wider range of healthcare nearer to where they live.

Services include:

• Physiotherapy and Patient Falls Services
• Free-standing, midwife led Birth Centre
• Radiology service including MRI
• A Dialysis Unit

• CATS and SATS

• Outpatients -  Rheumatology, Dermatology, Cardiology, Gastroenterology, Urology, Diabetes & Endocrinology, Respiratory Medicine, Nutrition & Dietetics, General and Vascular Surgery clinics.

• Audiology