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⩽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⩽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.
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Acknowledgements
This study was funded by an Action Medical Research Training Fellowship award to M Coggrave.
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Coggrave, M., Norton, C. & Wilson-Barnett, J. Management of neurogenic bowel dysfunction in the community after spinal cord injury: a postal survey in the United Kingdom. Spinal Cord 47, 323–333 (2009). https://doi.org/10.1038/sc.2008.137
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DOI: https://doi.org/10.1038/sc.2008.137
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