Colonoscopic lesions in patients with spinal cord injury.
OBJECTIVE
In spinal cord injury (SCI), loss of central or peripheral neural control causes neurogenic bowel. Patients may not exhibit the typical signs and symptoms of gastrointestinal disease. Few studies have looked at the risk of gastrointestinal disease in this group and the indications for preventive screening. The objective of this study was to study colonoscopic lesions in patients with SCI and determine whether there are any differences in the prevalence of lesions between SCI and control patients.


METHODS
Case control study.


METHODS
Twenty-five patients with SCI were compared with 41 control patients who received colonoscopy at the same time. Mann-Whitney test for continuous variable, and Fisher exact test for frequency variables were used.


METHODS
Demographic information, duration of SCI, and colonoscopy findings were gathered.


RESULTS
Colonic lesions were observed in 52% of patients with SCI and in 41.5% of control patients. Most frequent lesions in SCI group were inflammatory bowel disease (16%) and polyp (16%), followed by proctitis (12%) and hemorrhoid (12%). In the control group, hemorrhoid (17.1%) was most common, followed by polyp (12.2%) and melanosis coli (9.8%). No significant differences were found between the 2 groups. In the SCI group, no significant differences in lesions were found among the patients with cervical, thoracic, and lumbar SCI in the SCI group. Duration of SCI did not affect the pattern of colonoscopic lesions.


CONCLUSIONS
Patients with SCI had the same incidence of colonscopic lesions as control patients. Inflammatory bowel disease, which is a risk factor for cancer, was the most common findings in the SCI group, although there was no significant difference from the control group. In patients with SCI, colonoscopy screening is warranted at the same frequency as for the general population.
Department of Rehabilitation Medicine, Ewha Womans University, School of Medicine, Seoul, Republic of Korea. ocrystal@ewha.ac.kr
Soo Jeong
SJ
Han
Chung Mi
CM
Kim
Jeong Eun
JE
Lee
Tae Hoon
TH
Lee
D000328:Adult; D016022:Case-Control Studies; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000601:surgery; D018709:Statistics, Nonparametric