Neurogenic bowel dysfunction score

Abstract

Study design: Cross-sectional questionnaire study. Objectives: To develop and validate a symptom-based score for neurogenic bowel dysfunction (NBD): NBD score. Setting: University Hospital of Aarhus, Denmark. Methods: A questionnaire including questions about background parameters (n ¼ 8), faecal incontinence (n ¼ 10), constipation (n ¼ 10), obstructed defecation (n ¼ 8), and impact on quality of life (QOL) (n ¼ 3) was sent to 589 Danish spinal cord injured (SCI) patients. The reproducibility and validity of each item was tested in 20 and 18 patients, respectively. Associations between items and impact on QOL were determined by logistic regression analysis. The NBD score was constructed from items with acceptable reproducibility and validity that were significantly associated with impact on QOL. Based on odds ratios for associations between items and impact on QOL, each item was given a corresponding number of points in the NBD score. Results: A total of 424 SCI patients responded. The following 10 items met the criteria above: frequency of bowel movements (0-6 points), headache, perspiration or discomfort before or during defecation (0-2 points), tablets and drops against constipation (0-2 points each), time used for each defecation (0-7 points), frequency of digital stimulation or evacuation (0-6 points), frequency of faecal incontinence (0-13 points), medication against faecal incontinence (0-4 points), flatus incontinence (0-2 points) and perianal skin problems (0-3 points). Differences in NBD score among patients reporting no, little, some or major impact on QOL were statistically significant (all Po0.001). Conclusion: Based on valid and reproducible questions, we have constructed a score for NBD that is correlated to impact on QOL.

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

“…20 The short questionnaire was structured to cover (a) urinary functionF bladder function, methods of bladder emptying, frequency of urinary tract infections and current prophylactic treatment; (b) bowel functionFduration of the evacuation disorder, method of defecation currently used as well as pharmaceuticals, dietary supplements and/or other products, the need for assistance for evacuation and the predominant intestinal symptom during and after defecation; (c) NBDFdifficulty and/or painful exertion in connection with evacuation, the feeling of incomplete evacuation, abdominal pain or discomfort before or after evacuation, leakage of feces, gas incontinence, time necessary for each evacuation or attempt at evacuation, the need to use the fingers to stimulate evacuation, time of the day at which evacuation usually occurs and opinion of the quality of intestinal functioning; and (d) QoLFopinion of daily activity and QoL and general satisfaction. The questionnaire was hospital administered during initial and control visits by medical personnel trained specifically for this purpose, using an out or in-patient regimen.…”

International bowel function basic spinal cord injury data set

“…16 The time given is from first transferring to the toilet or commode until the end of defecation and transferal to wheel chair or raising from the toilet. If bladder emptying, body washing, shaving and so on is also performed while sitting at the toilet, time for these is subtracted.…”

“…Infrequent defecation is an indicator of insufficient bowel management and is associated with impact on the quality of life. 16 This variable does not distinguish between spontaneous or assisted defecation.…”

Prediction of severe neurogenic bowel dysfunction in persons with spinal cord injury

“…4 Traditional questionnaires and means of assessing bowel dysfunction were not always appropriate for SCI patients because the tests could not always adequately evaluate the simultaneous presence of the participants' constipation and fecal incontinence. 5,6 Krogh et al 7 developed and validated a more advanced clinical assessment known as the 'NBD score', which allows quantitative measurement of the severity of a neurogenic bowel. This score makes it possible to accurately evaluate the bowel condition in persons with an SCI and has been shown to have acceptable validity and reproducibility for persons who suffered from either constipation and fecal incontinence or a combination of both.…”