title: [Intestinal alterations in patients with a medullary lesion].
abstract: Loss of bowel control is distressing for persons with a medullary lesion and affects their quality of life. The present study aims to provide an updated review of the topic. Impaired neural control of continence and defecation after a medullary lesion provokes bowel dysfunction, with a high prevalence of two main symptoms: fecal incontinence and constipation. The physiopathology of these disorders is correlated with the neurological characteristics of the lesion, and various physiopathologic patterns have been established that correlate with the clinical manifestations. Evaluation of bowel dysfunction in these patients is normally exclusively clinical and complementary examinations are rarely used, although they seem promising. Treatment is based on establishing a program of evacuation. However, despite correct application, the results can be unsatisfactory and consequently other therapeutic alternatives should be developed.
authors.affiliation: Unidad de Rehabilitación Funcional Digestiva, Institut Guttmann, Universidad Autónoma de Barcelona, Barcelona, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Vallès
authors.forename: Fermín
authors.initials: F
authors.lastname: Mearin
mesh_terms: D003248:Constipation / Q000209:etiology* / Q000628:therapy; D005242:Fecal Incontinence / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007422:Intestines / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology