Risk Factors Associated with Neurogenic Bowel Complications and Dysfunction in Spinal Cord Injury

Publication date: Available online 22 April 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Denise G. Tate, Martin Forchheimer, Gianna Rodriguez, Anthony Chiodo, Anne Pelletier Cameron, Michelle Meade, Andrei Krassioukov
ObjectiveThe objectives of this paper are: 1) to assess the factors associated with methods of bowel management and bowel related complications and; 2) to determine the risk factors that are associated with bowel complications and overall bowel dysfunction, using multivariate modeling.DesignCross-sectional observational study.SettingA Spinal Cord Injury Model System located in upper East Midwest region of the United States with additional participants recruited from other sites.Participants291 subjects who incurred traumatic SCI with resultant neurogenic bowel who were at least five years post-injury at the time of interview.InterventionsNot applicable.Main Outcome MeasuresConstipation, Bowel Incontinence and Neurogenic Bowel Dysfunction questionnaire scores. These measures were all derived from the Bowel and Bladder Treatment Index. Data analyses included descriptive and bivariate statistics as well as logistic and linear regression modeling.ResultsRisk factors contributing to bowel incontinence included overall bowel dysfunction as measured by the Neurogenic Bowel Dysfunction score, timing of bowel program, being married or having a significant other, urinary incontinence, constipation, and use of diuretics. Constipation was best predicted by age, race/ethnicity, using laxatives/oral medications, incomplete tetraplegia, frequency of bowel movements, abdominal pain, access to clinicians and caregivers and history of bowel surgeries. Neurogenic Bowel Dysfunction scores were predicted by neurological classification, use of laxatives and/or oral medications, bowel incontinence, and frequency of fiber intake.ConclusionsThese results suggest a number of factors that should be considered when treating neurogenic bowel complications and dysfunction in persons with SCI.



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