Article

OBJECTIVE: To describe bowel management and its outcomes in individuals living
with a spinal cord injury (SCI) for at least 10 years. DESIGN: Cross-sectional
multicenter study.
SETTING: Dutch community. PARTICIPANTS: Individuals (N=258;
age range, 28-65y) who acquired their SCI between 18 and 35 years of age, who
were at least 10 years post-SCI, and who used a wheelchair for their daily
mobility. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The International
SCI Bowel Function Basic Data Set, the neurogenic bowel dysfunction (NBD) score,
and a single item on satisfaction with bowel management. RESULTS: Mean time since
injury (TSI) was 24+/-9 years. Seventy-four percent used >/=1 conservative bowel
management method, specifically digital evacuation (35%) and mini enemas (31%).
Transanal irrigation (TAI) and surgical interventions were used by 11% and 8%,
respectively. Perianal problems were reported by 45% of the participants. Severe
NBD was present in 36% of all participants and in 40% of those using a
conservative method. However, only 14% were (very) dissatisfied with their
current bowel management. Dissatisfaction with bowel management was significantly
associated with constipation and severe NBD. With increasing TSI, there was a
nonsignificant trend observed toward a decline in dissatisfaction with bowel
management and a significant decline in severe NBD. CONCLUSIONS: Although
satisfaction rates were high, more than a third of the participants reported
severe NBD and perianal problems. Apart from severe NBD, there were no
significant associations between bowel problems and TSI. Conservative methods
were most often used, but some of these methods were also significantly
associated with the presence of severe NBD. Longitudinal research is necessary to
provide more knowledge concerning the course of NBD with increasing TSI.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS