Bowel dysfunction in spinal-cord-injury patients.
BACKGROUND
This study aimed to determine the prevalence, nature, and effects--both physical and psychological--of spinal-cord-injury (SCI) on bowel function.


METHODS
115 consecutive hospital outpatients (89 male, median age 38 years) with chronic SCI (median duration 62 months, range 9-491 months, 48% cervical, 47% thoracic, 5% lumbar) completed a questionnaire about pre and post injury bowel function, the Hospital Anxiety and Depression Scale (HADS), and self assessment of the impact of their disabilities and symptoms.


RESULTS
Nausea, diarrhoea, constipation, and fecal incontinence were all much more common (p<0.0001) after SCI. 95% of patients required at least one therapeutic method to initiate defaecation. Half the patients became dependent on others for toileting. 49% took more than 30 min to complete their toilet procedure. Bowel function was a source of distress in 54% of patients and this was significantly (p=0.005) associated with the time required for bowel management and frequency of incontinence (p=0.001). There was a highly significant correlation between the HADS scores and the time taken for bowel management. On a scale of 0 (for no perceived problem) to 10 (maximum perceived problem), patients rated their loss of mobility as a mean of 6.8 (SD 3.3) and their bowel management as 5.1 (SD 3.6).


CONCLUSIONS
Bowel function is a major physical and psychological problem in SCI patients.
Glickman
S
S
Department of Medical Rehabilitation, Charing Cross Hospital, London, UK.
Kamm
M A
MA
D000328:Adult; D000368:Aged; D003672:Defecation; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications*; D011795:Surveys and Questionnaires