title: [Assessment of severity of neurogenic bowel dysfunction in chronic patients with a simple 1-item questionnaire (PGI-S)].
abstract: BACKGROUND
  Bowel symptoms (constipation and incontinence) are frequent in patients with a neurologic disease, but rarely assessed in rehabilitation centres.
  
  
  OBJECTIVE
  To study the prevalence of neurogenic bowel dysfunction (NBD) in those patients, and to assess its severity with the Patient Global Impression of Severity (PGI-S).
  
  
  METHODS
  Prospective study by questionnaires, with the Neurogenic Bowel Dysfunction Score (0-47) and the PGI-S, a 1-item questionnaire (absent, mild, moderate, severe) for the severity of the bowel symptoms, and the Bristol Stool Chart for stool consistency. All patients presenting a chronic (>2months) neurological disease were included.
  
  
  RESULTS
  Inclusion of 169 patients, 97 with spinal cord injury, 42 with multiple sclerosis and 30 with hemiplegia. In each population, prevalence of constipation was 67 %, 45 % and 17 %, of pelvic floor dyssynergia 82 %, 45 % and 27 %, and leakages (gas or stools) de 74 %, 48 % and 43 %, respectively. Moderate to severe bowel symptoms were seen in 61 % of spinal cord injury, 43 % of multiple sclerosis and 23 % of hemiplegic patients, with NBD scores of 11.9±6.5, 5.7±4.9 and 3.7±4.2, respectively (P<0.01). There was a significant relation between PGI-S and NBD score (P<0.01). Significant lower NBD scores were associated with normal stool consistency (Bristol type 3 or 4) (P<0.01). In case of severe bowel symptoms, the use of transanal irrigation was hampered by patients' motivation and acceptation, and their autonomy.
  
  
  CONCLUSIONS
  PGI-S and Bristol Stool Chart are reliable tools to assess the presence of bowel symptoms in clinical practice.
authors.affiliation: Centre Calvé, fondation Hopale, 62600 Berck-sur-Mer, France. Electronic address: previnjg@hopale.com.
authors.forename: J G
authors.initials: JG
authors.lastname: Prévinaire
authors.affiliation: Centre Bouffard-Vercelli, 66690 Cerbère, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Soler
authors.affiliation: Centre Calvé, fondation Hopale, 62600 Berck-sur-Mer, France.
authors.forename: H
authors.initials: H
authors.lastname: Bordji
authors.affiliation: Centre Calvé, fondation Hopale, 62600 Berck-sur-Mer, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Fiolet
authors.affiliation: Centre Bouffard-Vercelli, 66690 Cerbère, France.
authors.forename: M A
authors.initials: MA
authors.lastname: Navaux
authors.affiliation: Hôpital Calot, fondation Hopale, 62600 Berck-sur-Mer, France; Service des maladies digestives, CHRU de Lille, 59037 Lille cedex, France.
authors.forename: P E
authors.initials: PE
authors.lastname: Mortier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055496:Neurogenic Bowel / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D057566:Self Report; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Blessés médullaires; Bristol Stool Chart; Constipation; Hemiplegia; Hémiplégies; Incontinence; Multiple sclerosis; PGI-S; Sclérose en plaques; Spinal cord injury; Échelle de Bristol