Bowel management outcomes in individuals with long-term spinal cord injuries

Menter, Robert R.; Weitzenkamp, David; Cooper, Dianne; Bingley, Jenny; Charlifue, Susan; Whiteneck, Gale G.

doi:10.1038/sj.sc.3100461

Cited by 91 publications

(45 citation statements)

References 9 publications

(9 reference statements)

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“…In patients with SCI, approximately half have moderate-to-severe symptoms associated with NBD, 1 with 42% experiencing constipation 2 and 77% faecal incontinence. 3 Approximately 68% of patients with multiple sclerosis develop bowel symptoms 4 and 37% of patients with Parkinson's disease have constipation.…”

Section: Introductionmentioning

confidence: 99%

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Emmanuel

2010

Spinal Cord

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Study design: Neurogenic bowel dysfunction (NBD) is a common occurrence after spinal cord injury (SCI) and in patients with spina bifida or multiple sclerosis. The impact of NBD on well-being is considerable, affecting both physical and psychological aspects of quality of life. Transanal irrigation (TAI) of the colon promotes the evacuation of faeces by introducing water into the colon and rectum through a catheter inserted into the anus. Regular and controlled evacuation in this manner aims at preventing both constipation and faecal soiling. Objectives: The aim of this study was to review current evidence for the efficacy and safety of TAI in patients with NBD. Materials and methods: A literature search was conducted in PubMed. All identified papers were assessed for relevance based on the title and abstract; this yielded 23 studies that were considered to be of direct relevance to the topic of the review. Results: A multicentre, randomized, controlled trial has supported observational reports in demonstrating that TAI offers significant benefits over conservative bowel management in patients with SCI, in terms of managing constipation and faecal incontinence, reducing NBD symptoms and improving quality of life. Among other populations with NBD, TAI shows the greatest promise in children with spina bifida; however, further investigation is required. The overall safety profile of TAI is good, with few, and rare, adverse effects. Conclusions: Building on the positive data reported for patients with SCI, continued evaluation in the clinical trial setting is required to further define the utility of TAI in other populations with NBD.

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Section: Introductionmentioning

confidence: 99%

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Emmanuel

2010

Spinal Cord

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“…[1][2][3][4][5] While urological sequelae and their treatment are well documented, 6,7 neurogenic bowel dysfunctions (NBD) are among the least discussed topics in the literature, perhaps because of the misperception that there is little serious morbidity or mortality associated with NBD. 8 For these reasons, treatment of NBD has been largely empirical and individual solutions have been sought. Management of NBD has often involved diet, mild laxatives combined with sporadic enemas or digital maneuvers.…”

Section: Introductionmentioning

confidence: 99%

Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study

et al. 2008

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Study design: Thirty-six patients with unsatisfactory treatment of neurogenic bowel dysfunctions (NBD) were enrolled from Spinal Units and Rehabilitation Centers in Italy. Treatment was for 3 weeks using a newly developed integrated system with an enema continence catheter for transanal irrigation (Peristeen, Coloplast A/S Kokkedal Denmark). Objectives: To evaluate the effects of Peristeen Anal Irrigation on NBD and patient quality of life (QoL). Setting: Italy. Methods: Lesion level, ambulatory status and hand functionality were determined in all patients. NBD symptoms and QoL were evaluated before and after treatment, using a specific questionnaire. Statistical analysis was performed using McNemar Test and Sign Test. Results: Thirty-six patients were enrolled, and 32 patients completed the study. At the end of the treatment, 28.6% of patients reduced or eliminated their use of pharmaceuticals. Twenty-four patients became less dependent on their caregiver. There was a significant increase in patients' opinion of their intestinal functionality (P ¼ 0.001), QoL score (P ¼ 0.001) and their answers regarding their degree of satisfaction (P ¼ 0.001). A successful outcome was recorded for 68% of patients with fecal incontinence, and for 63% of patients with constipation. Conclusion: Peristeen Anal Irrigation is a simple therapeutic method for managing NBD and improving QoL. It should be considered as the treatment of choice for NBD, playing a role in the neurogenic bowel analogous to that of intermittent clean catheterization in bladder treatment.

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“…SCI is also associated with increased severity and frequency of bowel dysfunction compared with the general population. 6 In a study of individuals who had been injured for at least 20 years, 42% reported constipation, 35% reported gastrointestinal pain and 27% complained of bowel accidents. 6 A range of bowel problems were reported by 50% of outpatients with chronic SCI, and bowel function was reported to be a significant source of distress in 54% of these patients in a study by Glickman and Kamm.…”

Section: Introductionmentioning

confidence: 99%

“…6 In a study of individuals who had been injured for at least 20 years, 42% reported constipation, 35% reported gastrointestinal pain and 27% complained of bowel accidents. 6 A range of bowel problems were reported by 50% of outpatients with chronic SCI, and bowel function was reported to be a significant source of distress in 54% of these patients in a study by Glickman and Kamm. 7 Urinary tract infections (UTIs) have been found to be another major problem.…”

Section: Introductionmentioning

confidence: 99%

Quality of life, social participation, appraisals and coping post spinal cord injury: a review of four community samples

2005

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Study design: Cross-sectional or psychotherapy, questionnaire. Objectives: To examine the community needs of people with spinal cord injury (SCI) across four European countries and to identify areas of unmet needs. It is intended that this information will be of use to rehabilitation professionals in fostering greater social participation among SCI individuals. Setting: United Kingdom, Germany, Austria and Switzerland. Methods: Self-report questionnaires were sent to 1000 people with SCI resident in the community in the UK, Germany, Austria and Switzerland. Questionnaires measured current needs, community integration, mood, appraisals, coping strategies, functional independence and perceived manageability. Results: Occupation, sexual activity and pain relief were areas indicative of highest community needs in all four countries. Most participants were psychologically well adjusted and socially integrated into the community. Well-addressed needs were skin management, wheelchair needs and accommodation. Some differences that occurred in certain areas across the four countries were found. Conclusion: This study has highlighted that the main areas of unmet needs for a European community sample of people with SCI includes levels of occupation, sexual activity and pain relief. The findings will be of interest to those involved in rehabilitation of newly as well as longterm injured people and demonstrate the need to consistently readdress such issues as part of a person's long-term rehabilitation in order to achieve and maximise effective social participation.Spinal Cord (2006) 44, 95-105.

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Bowel management outcomes in individuals with long-term spinal cord injuries

Cited by 91 publications

References 9 publications

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study

Quality of life, social participation, appraisals and coping post spinal cord injury: a review of four community samples

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