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Clin Colon Rectal Surg 2014; 27(03): 113-115
DOI: 10.1055/s-0034-1383904
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bowel Management in Spinal Cord Injury Patients

Matthew Hughes
1   Texas Colon and Rectal Specialists, Carrollton, Texas
› Author Affiliations
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Publication History

Publication Date:
24 September 2014 (online)

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Abstract

Spinal cord injuries are common in the United States, affecting approximately 12,000 people per year. Most of these patients lack normal bowel function. The pattern of dysfunction varies with the spinal level involved. Most patients use a bowel management program, and elements of successful programs are discussed. Surgical treatment, when indicated, could include sacral nerve stimulation, Malone antegrade continence enema, and colostomy.

Keywords

spinal cord injury - neurogenic bowel - bowel management program
 

  • References

  • 1 Spinal cord injury facts and figures at a glance. J Spinal Cord Med 2014; 37 (1) 117-118
    CrossrefPubMedGoogle Scholar
  • 2 Glickman S, Kamm MA. Bowel dysfunction in spinal-cord-injury patients. Lancet 1996; 347 (9016) 1651-1653
    CrossrefPubMedGoogle Scholar
  • 3 Levi R, Hultling C, Nash MS, Seiger A. The Stockholm spinal cord injury study: 1. Medical problems in a regional SCI population. Paraplegia 1995; 33 (6) 308-315
    CrossrefPubMedGoogle Scholar
  • 4 Krogh K, Nielsen J, Djurhuus JC, Mosdal C, Sabroe S, Laurberg S. Colorectal function in patients with spinal cord lesions. Dis Colon Rectum 1997; 40 (10) 1233-1239
    CrossrefPubMedGoogle Scholar
  • 5 Vallès M, Terré R, Guevara D, Portell E, Vidal J, Mearin F. Bowel dysfunction in patients with spinal cord injury: relation with neurological patterns [in Spanish]. Med Clin (Barc) 2007; 129 (5) 171-173
    CrossrefPubMedGoogle Scholar
  • 6 Vallès M, Mearin F. Pathophysiology of bowel dysfunction in patients with motor incomplete spinal cord injury: comparison with patients with motor complete spinal cord injury. Dis Colon Rectum 2009; 52 (9) 1589-1597
    CrossrefPubMedGoogle Scholar
  • 7 Krassioukov A, Eng JJ, Claxton G, Sakakibara BM, Shum S. Neurogenic bowel management after spinal cord injury: a systematic review of the evidence. Spinal Cord 2010; 48 (10) 718-733
    CrossrefPubMedGoogle Scholar
  • 8 Stiens SA, Bergman SB, Goetz LL. Neurogenic bowel dysfunction after spinal cord injury: clinical evaluation and rehabilitative management. Arch Phys Med Rehabil 1997; 78 (3, Suppl): S86-S102
    CrossrefPubMedGoogle Scholar
  • 9 House JG, Stiens SA. Pharmacologically initiated defecation for persons with spinal cord injury: effectiveness of three agents. Arch Phys Med Rehabil 1997; 78 (10) 1062-1065
    CrossrefPubMedGoogle Scholar
  • 10 Frisbie JH. Improved bowel care with a polyethylene glycol based bisacadyl suppository. J Spinal Cord Med 1997; 20 (2) 227-229
    PubMedGoogle Scholar
  • 11 Stiens SA, Luttrel W, Binard JE. Polyethylene glycol versus vegetable oil based bisacodyl suppositories to initiate side-lying bowel care: a clinical trial in persons with spinal cord injury. Spinal Cord 1998; 36 (11) 777-781
    CrossrefPubMedGoogle Scholar
  • 12 Stiens SA. Reduction in bowel program duration with polyethylene glycol based bisacodyl suppositories. Arch Phys Med Rehabil 1995; 76 (7) 674-677
    CrossrefPubMedGoogle Scholar
  • 13 Haas U, Geng V, Evers GC, Knecht H. Bowel management in patients with spinal cord injury — a multicentre study of the German speaking society of paraplegia (DMGP). Spinal Cord 2005; 43 (12) 724-730
    CrossrefPubMedGoogle Scholar
  • 14 Christensen P, Bazzocchi G, Coggrave M , et al. A randomized, controlled trial of transanal irrigation versus conservative bowel management in spinal cord-injured patients. Gastroenterology 2006; 131 (3) 738-747
    CrossrefPubMedGoogle Scholar
  • 15 Kim HR, Lee BS, Lee JE, Shin HI. Application of transanal irrigation for patients with spinal cord injury in South Korea: a 6-month follow-up study. Spinal Cord 2013; 51 (5) 389-394
    CrossrefPubMedGoogle Scholar
  • 16 Korsten MA, Singal AK, Monga A , et al. Anorectal stimulation causes increased colonic motor activity in subjects with spinal cord injury. J Spinal Cord Med 2007; 30 (1) 31-35
    PubMedGoogle Scholar
  • 17 Ayaş S, Leblebici B, Sözay S, Bayramoğlu M, Niron EA. The effect of abdominal massage on bowel function in patients with spinal cord injury. Am J Phys Med Rehabil 2006; 85 (12) 951-955
    CrossrefPubMedGoogle Scholar
  • 18 Korsten MA, Fajardo NR, Rosman AS, Creasey GH, Spungen AM, Bauman WA. Difficulty with evacuation after spinal cord injury: colonic motility during sleep and effects of abdominal wall stimulation. J Rehabil Res Dev 2004; 41 (1) 95-100
    CrossrefPubMedGoogle Scholar
  • 19 Hascakova-Bartova R, Dinant JF, Parent A, Ventura M. Neuromuscular electrical stimulation of completely paralyzed abdominal muscles in spinal cord-injured patients: a pilot study. Spinal Cord 2008; 46 (6) 445-450
    CrossrefPubMedGoogle Scholar
  • 20 Geders JM, Gaing A, Bauman WA, Korsten MA. The effect of cisapride on segmental colonic transit time in patients with spinal cord injury. Am J Gastroenterol 1995; 90 (2) 285-289
    PubMedGoogle Scholar
  • 21 Krogh K, Jensen MB, Gandrup P , et al. Efficacy and tolerability of prucalopride in patients with constipation due to spinal cord injury. Scand J Gastroenterol 2002; 37 (4) 431-436
    CrossrefPubMedGoogle Scholar
  • 22 Korsten MA, Rosman AS, Ng A , et al. Infusion of neostigmine-glycopyrrolate for bowel evacuation in persons with spinal cord injury. Am J Gastroenterol 2005; 100 (7) 1560-1565
    CrossrefPubMedGoogle Scholar
  • 23 Rosman AS, Chaparala G, Monga A, Spungen AM, Bauman WA, Korsten MA. Intramuscular neostigmine and glycopyrrolate safely accelerated bowel evacuation in patients with spinal cord injury and defecatory disorders. Dig Dis Sci 2008; 53 (10) 2710-2713
    CrossrefPubMedGoogle Scholar
  • 24 Vallès M, Rodríguez A, Borau A, Mearin F. Effect of sacral anterior root stimulator on bowel dysfunction in patients with spinal cord injury. Dis Colon Rectum 2009; 52 (5) 986-992
    CrossrefPubMedGoogle Scholar
  • 25 Holzer B, Rosen HR, Novi G, Ausch C, Hölbling N, Schiessel R. Sacral nerve stimulation for neurogenic faecal incontinence. Br J Surg 2007; 94 (6) 749-753
    CrossrefPubMedGoogle Scholar
  • 26 Poirier M, Abcarian H, Nelson R. Malone antegrade continent enema: an alternative to resection in severe defecation disorders. Dis Colon Rectum 2007; 50 (1) 22-28
    CrossrefPubMedGoogle Scholar
  • 27 Teichman JM, Zabihi N, Kraus SR, Harris JM, Barber DB. Long-term results for Malone antegrade continence enema for adults with neurogenic bowel disease. Urology 2003; 61 (3) 502-506
    CrossrefPubMedGoogle Scholar
  • 28 Hocevar B, Gray M. Intestinal diversion (colostomy or ileostomy) in patients with severe bowel dysfunction following spinal cord injury. J Wound Ostomy Continence Nurs 2008; 35 (2) 159-166
    CrossrefPubMedGoogle Scholar