Denise G Tate1, Martin Forchheimer2, Gianna Rodriguez2, Anthony Chiodo2, Anne Pelletier Cameron3, Michelle Meade2, Andrei Krassioukov4. 1. Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI. Electronic address: dgtate@umich.edu. 2. Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI. 3. Department of Urology, University of Michigan Medical School, Ann Arbor, MI. 4. International Collaboration On Repair Discoveries (ICORD)-University of British Columbia, Department of Medicine, Division of Physical Medicine and Rehabilitation, Vancouver, British Columbia, Canada.
Abstract
OBJECTIVES: 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. DESIGN: Cross-sectional observational study. SETTING: A Spinal Cord Injury Model System, with additional participants recruited from other sites. PARTICIPANTS: Subjects (N=291) who incurred traumatic spinal cord injury (SCI) with resultant neurogenic bowel who were ≥5 years postinjury at the time of interview. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: 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.
OBJECTIVES: 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. DESIGN: Cross-sectional observational study. SETTING: A Spinal Cord Injury Model System, with additional participants recruited from other sites. PARTICIPANTS: Subjects (N=291) who incurred traumatic spinal cord injury (SCI) with resultant neurogenic bowel who were ≥5 years postinjury at the time of interview. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: 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.
Authors: Denise G Tate; Tracey Wheeler; Giulia I Lane; Martin Forchheimer; Kim D Anderson; Fin Biering-Sorensen; Anne P Cameron; Bruno Gallo Santacruz; Lyn B Jakeman; Michael J Kennelly; Steve Kirshblum; Andrei Krassioukov; Klaus Krogh; M J Mulcahey; Vanessa K Noonan; Gianna M Rodriguez; Ann M Spungen; David Tulsky; Marcel W Post Journal: J Spinal Cord Med Date: 2020-03 Impact factor: 1.985