[Bowel dysfunction in patients with spinal cord injury: relation with neurological patterns].

BACKGROUND AND

OBJECTIVE

The study consisted of a clinical evaluation of bowel dysfunction and the relation with neurological patterns in spinal cord injury (SCI).

PATIENTS AND METHOD: 109 patients; 30% tetraplegics and 70% paraplegics; ASIA Impairment Scale: 65% A (complete), 12% B (sensitive incomplete), 11% C (motor incomplete with muscle grade <3), 13% D (motor incomplete with muscle grade >or= 3). 83% had spinal sacral reflexes (SSR). An interview and ano-rectal examination were performed.

RESULTS

77% patients required laxatives and 68% digital stimulation; 10% had bowel movements less than thrice a week and 18% spent more than one hour; 27% presented constipation, 31% fecal incontinence, 31% had ano-rectal pathology and 18% had autonomic dysreflexia (AD). Patients ASIA A,B,C with SSR took more suppositories, evacuated less frequently and spent more time than patients without SSR. Tetraplegics ASIA A,B,C had more constipation. Only patients with high level SCI and ASIA A,B,C with SSR had AD. ASIA D patients also needed laxatives, digital stimulation and presented colo-rectal symptoms.

CONCLUSIONS

The prevalence of colo-rectal symptoms is high in SCI patients and neurogenic bowel characteristics are related to neurological patterns.