Risk Factors Associated With Neurogenic Bowel Complications and Dysfunction in Spinal Cord Injury.
OBJECTIVE
To (1) assess the factors associated with methods of bowel management and bowel-related complications; and (2) determine the risk factors associated with bowel complications and overall bowel dysfunction, using multivariate modeling.


METHODS
Cross-sectional observational study.


METHODS
A Spinal Cord Injury Model System, with additional participants recruited from other sites.


METHODS
Subjects (N=291) who incurred traumatic spinal cord injury (SCI) with resultant neurogenic bowel who were ≥5 years postinjury at the time of interview.


METHODS
Not applicable.


METHODS
Constipation, bowel incontinence, and neurogenic bowel dysfunction questionnaire scores. These measures were all derived from the Bowel and Bladder Treatment Index. Data analyses included descriptive and bivariate statistics as well as logistic and linear regression modeling.


RESULTS
Risk factors contributing to bowel incontinence included overall bowel dysfunction as measured by the neurogenic bowel dysfunction score, timing of bowel program, being married or having a significant other, urinary incontinence, constipation, and use of diuretics. Constipation was best predicted by age, race/ethnicity, using laxatives/oral medications, incomplete tetraplegia, frequency of bowel movements, abdominal pain, access to clinicians and caregivers, and history of bowel surgeries. Neurogenic bowel dysfunction scores were predicted by neurologic classification; use of laxatives, oral medications, or both; bowel incontinence; and frequency of fiber intake.


CONCLUSIONS
These results suggest a number of factors that should be considered when treating neurogenic bowel complications and dysfunction in persons with SCI.
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI. Electronic address: dgtate@umich.edu.
Denise G
DG
Tate
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI.
Martin
M
Forchheimer
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI.
Gianna
G
Rodriguez
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI.
Anthony
A
Chiodo
Department of Urology, University of Michigan Medical School, Ann Arbor, MI.
Anne Pelletier
AP
Cameron
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI.
Michelle
M
Meade
International Collaboration On Repair Discoveries (ICORD)-University of British Columbia, Department of Medicine, Division of Physical Medicine and Rehabilitation, Vancouver, British Columbia, Canada.
Andrei
A
Krassioukov
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000209:etiology; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055496:Neurogenic Bowel / Q000209:etiology*; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000145:classification* / Q000150:complications*; D015599:Trauma Severity Indices; D014549:Urinary Incontinence / Q000209:etiology; D055815:Young Adult
Constipation; Fecal incontinence; Neurogenic bowel; Rehabilitation; Risk factors; Spinal cord injuries