Jacinthe J Adriaansen1, Floris W van Asbeck2, Dirk van Kuppevelt3, Govert J Snoek4, Marcel W Post5. 1. Brain Center Rudolf Magnus and Center of Excellence in Rehabilitation Medicine, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, The Netherlands. 2. De Hoogstraat Rehabilitation, Utrecht, The Netherlands. 3. Rehabilitation Centre Sint Maartenskliniek, Nijmegen, The Netherlands. 4. Rehabilitation Centre Het Roessingh, Enschede, The Netherlands. 5. Brain Center Rudolf Magnus and Center of Excellence in Rehabilitation Medicine, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: m.post@dehoogstraat.nl.
Abstract
OBJECTIVE: To describe bowel management and its outcomes in individuals living with a spinal cord injury (SCI) for at least 10 years. DESIGN: Cross-sectional multicenter study. SETTING: Dutch community. PARTICIPANTS: Individuals (N=258; age range, 28-65y) who acquired their SCI between 18 and 35 years of age, who were at least 10 years post-SCI, and who used a wheelchair for their daily mobility. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The International SCI Bowel Function Basic Data Set, the neurogenic bowel dysfunction (NBD) score, and a single item on satisfaction with bowel management. RESULTS: Mean time since injury (TSI) was 24±9 years. Seventy-four percent used ≥1 conservative bowel management method, specifically digital evacuation (35%) and mini enemas (31%). Transanal irrigation (TAI) and surgical interventions were used by 11% and 8%, respectively. Perianal problems were reported by 45% of the participants. Severe NBD was present in 36% of all participants and in 40% of those using a conservative method. However, only 14% were (very) dissatisfied with their current bowel management. Dissatisfaction with bowel management was significantly associated with constipation and severe NBD. With increasing TSI, there was a nonsignificant trend observed toward a decline in dissatisfaction with bowel management and a significant decline in severe NBD. CONCLUSIONS: Although satisfaction rates were high, more than a third of the participants reported severe NBD and perianal problems. Apart from severe NBD, there were no significant associations between bowel problems and TSI. Conservative methods were most often used, but some of these methods were also significantly associated with the presence of severe NBD. Longitudinal research is necessary to provide more knowledge concerning the course of NBD with increasing TSI.
OBJECTIVE: To describe bowel management and its outcomes in individuals living with a spinal cord injury (SCI) for at least 10 years. DESIGN: Cross-sectional multicenter study. SETTING: Dutch community. PARTICIPANTS: Individuals (N=258; age range, 28-65y) who acquired their SCI between 18 and 35 years of age, who were at least 10 years post-SCI, and who used a wheelchair for their daily mobility. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The International SCI Bowel Function Basic Data Set, the neurogenic bowel dysfunction (NBD) score, and a single item on satisfaction with bowel management. RESULTS: Mean time since injury (TSI) was 24±9 years. Seventy-four percent used ≥1 conservative bowel management method, specifically digital evacuation (35%) and mini enemas (31%). Transanal irrigation (TAI) and surgical interventions were used by 11% and 8%, respectively. Perianal problems were reported by 45% of the participants. Severe NBD was present in 36% of all participants and in 40% of those using a conservative method. However, only 14% were (very) dissatisfied with their current bowel management. Dissatisfaction with bowel management was significantly associated with constipation and severe NBD. With increasing TSI, there was a nonsignificant trend observed toward a decline in dissatisfaction with bowel management and a significant decline in severe NBD. CONCLUSIONS: Although satisfaction rates were high, more than a third of the participants reported severe NBD and perianal problems. Apart from severe NBD, there were no significant associations between bowel problems and TSI. Conservative methods were most often used, but some of these methods were also significantly associated with the presence of severe NBD. Longitudinal research is necessary to provide more knowledge concerning the course of NBD with increasing TSI.
Authors: Emanuele Ausili; A Marte; G Brisighelli; P Midrio; G Mosiello; E La Pergola; L Lombardi; B D Iacobelli; E Caponcelli; M Meroni; E Leva; C Rendeli Journal: Childs Nerv Syst Date: 2018-06-12 Impact factor: 1.475
Authors: Gregory O'Connor; Elisabeth Jeffrey; Derik Madorma; Alexander Marcillo; Maria T Abreu; Sapna K Deo; W Dalton Dietrich; Sylvia Daunert Journal: J Neurotrauma Date: 2018-06-07 Impact factor: 5.269
Authors: F H M van Herpen; R B van Dijsseldonk; H Rijken; N L W Keijsers; J W K Louwerens; I J W van Nes Journal: Spinal Cord Ser Cases Date: 2019-12-11