Does a colostomy alter quality of life in patients with spinal cord injury? A controlled study

Randell, N; Lynch, A. C.; Anthony, A.; Dobbs, B. R.; Ja, Roake; Frizelle, F. A.

doi:10.1038/sj.sc.3101156

Cited by 51 publications

(49 citation statements)

References 8 publications

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“…Nine studies (aggregate N ¼ 590) examined the effect of colostomy after SCI (Table 11). [60][61][62][63][64][65][66][67][68] Given the ethical nature of this treatment (that is few safe options once they reach the point of [60][61][62][63][64] and Level 5 evidence (from one study) 68 that colostomy reduces the number of hours spent on bowel care. There is Level 4 evidence (from one retrospective pre-post study) 60 that colostomy greatly simplifies bowel care routines.…”

Section: Resultsmentioning

confidence: 99%

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

et al. 2010

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Study design: Randomized-controlled trials (RCTs), prospective cohort, case-control, pre-post studies, and case reports that assessed pharmacological and non-pharmacological intervention for the management of the neurogenic bowel after spinal cord injury (SCI) were included. Objective: To systematically review the evidence for the management of neurogenic bowel in individuals with SCI. Setting: Literature searches were conducted for relevant articles, as well as practice guidelines, using numerous electronic databases. Manual searches of retrieved articles from 1950 to July 2009 were also conducted to identify literature. Methods: Two independent reviewers evaluated each study's quality, using Physiotherapy Evidence Database scale for RCTs and Downs and Black scale for all other studies. The results were tabulated and levels of evidence assigned. Results: A total of 2956 studies were found as a result of the literature search. On review of the titles and abstracts, 57 studies met the inclusion criteria. Multifaceted programs are the first approach to neurogenic bowel and are supported by lower levels of evidence. Of the non-pharmacological (conservative and non-surgical) interventions, transanal irrigation is a promising treatment to reduce constipation and fecal incontinence. When conservative management is not effective, pharmacological interventions (for example prokinetic agents) are supported by strong evidence for the treatment of chronic constipation. When conservative and pharmacological treatments are not effective, surgical interventions may be considered and are supported by lower levels of evidence in reducing complications. Conclusions: Often, more than one procedure is necessary to develop an effective bowel routine. Evidence is low for non-pharmacological approaches and high for pharmacological interventions.

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Section: Resultsmentioning

confidence: 99%

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

et al. 2010

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“…Previous publications describe the formation of an intestinal stoma in SCI patients for management problems, including chronic gastrointestinal symptoms, 10 decubitus ulcers, 9 anal cancer, 10 rectal cancer, Stoma formation in SCI patients G Branagan et al trauma, 11 bowel obstruction, 11 and rectovesical fistula.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] The failure of conservative measures to treat these chronic problems in some patients has led to the use of elective surgical treatments such as anterior sacral root stimulation, 4,5 antegrade colonic lavage [6][7][8] and stoma formation. 9,10 The effect of colostomy formation on both quality of life 11 and time taken for bowel care 9,10 is well recorded, including data from our own group.…”

Section: Introductionmentioning

confidence: 99%

Effect of stoma formation on bowel care and quality of life in patients with spinal cord injury

2003

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Introduction: Bowel management is a significant source of concern for patients with spinal cord injury (SCI) and may significantly alter quality of life. The effect of colostomy formation on both quality of life and time taken for bowel care is well recorded. We report our experience of intestinal stoma formation in SCI patients. Methods: Medical records from the spinal unit, operating theatres and stoma clinics were reviewed to identify SCI patients for whom a stoma had been formed. Patients were interviewed using a standard questionnaire. Average age at injury was 29 years (range 6-62 years). Mean time from injury to stoma formation was 17 years (range 0-36.25 years) and the mean period of poor bowel function prior to stoma was 8 years (range 1.5-25). Results: The average time spent on bowel care per week decreased from 10.3 h (range 3.5-45) prior to stoma formation to 1.9 h (range 0.5-7.75) afterwards (Po0.0001, paired t-test). In all, 18 patients felt that a stoma gave them greater independence and quality of life was described as much better by 25 patients. Complications occurred in 14 patients -eight described leakage of mucus and occasionally blood and pus per rectum, three developed parastomal hernias and three developed bowel obstruction. Conclusion: Elective stoma formation is a safe and well-accepted treatment for the management of chronic gastrointestinal symptoms in patients with SCI.

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“…Our results are partly in accordance to several previous studies, which have shown that colostomy improves QoL in individuals with SCI. 26,27,30,31,35 In contrast Randall et al 36 showed that QoL was not significantly different between spinal cord injured with or without colostomy. This is supported by Luther et al 37 who showed no significant difference in persons with SCI with or without colostomy concerning QoL but large numbers of respondents in both groups reported being very unsatisfied with their bowel care program.…”

Section: Discussionmentioning

confidence: 86%

Bowel function and quality of life after colostomy in individuals with spinal cord injury

Hansen

Staun

Kalhauge

et al. 2016

The Journal of Spinal Cord Medicine

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Objective: To evaluate the effect of colostomy on bowel function and quality of life (QoL) in individuals with spinal cord injury (SCI). Design: Cross-sectional descriptive study. Setting: Department for Spinal Cord Injuries and Departments of Gastroenterology and Radiology, Rigshospitalet. Participants: Eighteen individuals with SCI and a colostomy performed post injury, 12 males, 6 females, 8 with tetraplegia and 10 with paraplegia. Median age at time of study was 49.9 years, years since lesion was 3-56 years, and time since colostomy was performed 0.5 to 20 years. Interventions: Questionnaires and measurement of gastrointestinal transit time (GITT).Outcome measures: Retrospective data collection from patient records, a questionnaire on bowel management pre and post colostomy, quality of life (QoL) by SF-36, and GITT. Results: Seventy-two percent significantly reduced their use of time on bowel emptying after the colostomy. All but one reported being content with the colostomy. Thirty-nine percent reported one or more problems related to the colostomy. Seventy-five percent had a GITT within normal range for able-bodied populations. When disregarding the physical component, QoL was not significantly lower in the total study group compared to a Danish norm group, but significantly lower when compared the subgroup of persons with tetraplegia. Conclusion: A colostomy reduces the time necessary for bowel management. The majority of individuals with SCI and a colostomy did not perceive bowel management as being a problem. The results indicate that colostomy is a favourable option for individuals with SCI, who spend long hours on bowel management and for whom non-invasive procedures did not improve the situation enough.

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Does a colostomy alter quality of life in patients with spinal cord injury? A controlled study

Cited by 51 publications

References 8 publications

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

Effect of stoma formation on bowel care and quality of life in patients with spinal cord injury

Bowel function and quality of life after colostomy in individuals with spinal cord injury

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