M Coggrave1, C Norton, J Wilson-Barnett. 1. National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, Bucks, UK. maureen.coggrave@buckshosp.nhs.uk
Abstract
STUDY DESIGN: Postal survey. OBJECTIVES: To describe bowel management in community-dwelling spinal cord-injured (SCI) individuals and to explore associations between age, injury, dependency, problems, interventions and satisfaction. SETTING: Outpatients of a single SCI unit, in the United Kingdom. METHODS: Postal questionnaire to all outpatients with SCI for at least 1 year, of any level or density, aged 18 years or more. RESULTS: Response rate was 48.6% (n=1334). Median age was 52 years, median duration of injury 18 years. The most common intervention was digital evacuation (56%). Up to 30 min was spent on each bowel care episode by 58% of respondents; 31-60 min by 22%; 14% spent over 60 min. Reported problems included constipation (39%), haemorrhoids (36%) and abdominal distension (31%). Reduced satisfaction with bowel function was associated with longer duration of each bowel care episode, faecal incontinence, greater number of interventions used and more problems reported (all P<or=0.001); 130 (9.7%) had undergone any type of surgical bowel intervention. Impact of bowel dysfunction on the respondent's life was rated as significantly greater than other aspects of SCI (P<or=0.001). CONCLUSIONS: Managing SCI bowel function in the community is complex, time consuming and remains conservative. Despite potential for bias from a low response, for this large group of responders, bowel dysfunction impacted most on life compared with other SCI-related impairments. The study findings demand further exploration of bowel management to reduce impact, minimize side effects and increase the choice of management strategies available.
STUDY DESIGN: Postal survey. OBJECTIVES: To describe bowel management in community-dwelling spinal cord-injured (SCI) individuals and to explore associations between age, injury, dependency, problems, interventions and satisfaction. SETTING: Outpatients of a single SCI unit, in the United Kingdom. METHODS: Postal questionnaire to all outpatients with SCI for at least 1 year, of any level or density, aged 18 years or more. RESULTS: Response rate was 48.6% (n=1334). Median age was 52 years, median duration of injury 18 years. The most common intervention was digital evacuation (56%). Up to 30 min was spent on each bowel care episode by 58% of respondents; 31-60 min by 22%; 14% spent over 60 min. Reported problems included constipation (39%), haemorrhoids (36%) and abdominal distension (31%). Reduced satisfaction with bowel function was associated with longer duration of each bowel care episode, faecal incontinence, greater number of interventions used and more problems reported (all P<or=0.001); 130 (9.7%) had undergone any type of surgical bowel intervention. Impact of bowel dysfunction on the respondent's life was rated as significantly greater than other aspects of SCI (P<or=0.001). CONCLUSIONS: Managing SCI bowel function in the community is complex, time consuming and remains conservative. Despite potential for bias from a low response, for this large group of responders, bowel dysfunction impacted most on life compared with other SCI-related impairments. The study findings demand further exploration of bowel management to reduce impact, minimize side effects and increase the choice of management strategies available.
Authors: Michael F La Fountaine; Christopher M Cirnigliaro; Joshua C Hobson; Alexander T Lombard; Adam F Specht; Trevor A Dyson-Hudson; William A Bauman Journal: J Spinal Cord Med Date: 2019-03-14 Impact factor: 1.985
Authors: Gordana Savic; Hans L Frankel; Mohamed Ali Jamous; Bakulesh M Soni; Susan Charlifue Journal: Spinal Cord Date: 2018-02-16 Impact factor: 2.772