title: Gastric and small intestinal dysfunction in spinal cord injury patients.
abstract: BACKGROUND
  Many patients with spinal cord injury (SCI) suffer from constipation, abdominal pain, nausea, or bloating, and colonic transit times are prolonged in most. Gastric and small intestinal dysfunction could contribute to symptoms but remain to be described in detail. Also, it is obscure whether the level of SCI affects gastric and small intestinal function.
  
  
  OBJECTIVE
  To study orocecal transit time and gastric emptying (GE) in patients with SCI.
  
  
  METHODS
  Nineteen patients with SCI (7 ♀, median age 54 years) and 15 healthy volunteers (9 ♀, median age 32 years) were included. All were referred because of neurogenic bowel problems. Eleven patients had low SCI (located at conus medullaris or cauda equina) affecting only the parasympathetic nerves to the left colon and eight had high SCI (above Th6) affecting parasympathetic and sympathetic innervation. Subjects ingested a small magnetic pill that subsequently was tracked by the Motility Tracking System - MTS-1 (Motilis, Lausanne, Switzerland).
  
  
  RESULTS
  Orocecal transit time was longer than normal both in individuals with high lesions (P < 0.01) and in individuals with low lesions (P < 0.01). Individuals with high lesions had slower GE than those with conal/cauda equina lesions (P < 0.05). Basic contractile frequencies of the stomach and small intestine were unaffected by SCI.
  
  
  CONCLUSIONS
  Surprisingly, upper gastrointestinal transit is prolonged in subjects with SCI suffering from bowel problems, not only in subjects with cervical or high thoracic lesions but also in subjects with conal/cauda equina lesions. We speculate that this is secondary to colonic dysfunction and constipation.
authors.affiliation: Neurogastroenterology Unit, Department of Hepatology and Gastroenterology V, Aarhus University Hospital, Denmark. lfynne@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Fynne
authors.forename: J
authors.initials: J
authors.lastname: Worsøe
authors.forename: T
authors.initials: T
authors.lastname: Gregersen
authors.forename: V
authors.initials: V
authors.lastname: Schlageter
authors.forename: S
authors.initials: S
authors.lastname: Laurberg
authors.forename: K
authors.initials: K
authors.lastname: Krogh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000503:physiopathology; D003248:Constipation / Q000150:complications / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D007421:Intestine, Small / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D013270:Stomach / Q000503:physiopathology*