title: Cross-Sectional Study of Bowel Symptoms in Adults With Cerebral Palsy: Prevalence and Impact on Quality of Life.
abstract: OBJECTIVE
  To determine the prevalence and type of bowel symptoms, and their impact on health-related quality of life (HRQOL) in adults with cerebral palsy (CP).
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  Urban, outpatient rehabilitation facility.
  
  
  METHODS
  Adults with CP (N=91; 46 men, 45 women; mean age, 36y; age range, 18-79y).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Participants were interviewed using standardized instruments to assess the frequency and types of bowel dysfunction. The International Consultation of Incontinence Questionnaire-Bowel was used to assess bowel incontinence and impact on quality of life, and constipation presence was determined using the Rome III criteria for constipation. Constipation symptoms were rated by the Patient Assessment of Constipation-Symptom Scale. Participants' mobility status was classified using the Gross Motor Function Classification System (GMFCS). Interactions between mobility measures, anthropometric measures, and bowel symptoms were assessed.
  
  
  RESULTS
  Of the 91 participants enrolled, 62.6% were GMFCS IV or V. Twenty-eight participants (30.8%) reported severe difficulty with control of liquid stool (rating never or rarely); these participants were more likely to have a greater GMFCS level (P=.0004). Twenty-six participants (28.6%) reported that bowel function caused embarrassment some/most/all of the time. Fifty-nine participants (64.8%) met criteria for chronic constipation, which did not differ by GMFCS levels. Overall, 57.1% of participants reported that bowel symptoms interfered with life; 40.7% reported moderate to severe interference.
  
  
  CONCLUSIONS
  Bowel symptoms were frequent, a source of embarrassment, and impacted HRQOL in these adults with CP. Addressing bowel-related symptoms has the potential to improve HRQOL in these adults.
authors: Northwestern University, Feinberg School of Medicine, Chicago, IL; Rehabilitation Institute of Chicago, Chicago, IL. Electronic address: cmarciniak@ric.org.
authors: Christina M
authors: CM
authors: Marciniak
authors: Department of Preventive Medicine, Biostatics Collaboration Center, Northwestern University, Chicago, IL.
authors: Jungwha
authors: J
authors: Lee
authors: University of Chicago Hospitals and Clinics, Chicago, IL.
authors: Michael
authors: M
authors: Jesselson
authors: Northwestern University, Feinberg School of Medicine, Chicago, IL; Rehabilitation Institute of Chicago, Chicago, IL.
authors: Deborah
authors: D
authors: Gaebler-Spira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002547:Cerebral Palsy / Q000188:drug therapy / Q000453:epidemiology*; D003248:Constipation / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Cerebral palsy; Constipation; Fecal incontinence; Rehabilitation