Bowel function in adults who have sustained spinal cord injury in childhood

The impact of neuropathic bowel dysfunction on bowel habits was studied in 35 adult spinal cord injury (SCI) patients, who had sustained their injury in childhood. The methods used in the study were clinical interview and examination, quantitative scoring of bowel function (BCS) and estimation of bowel transit time with radiopaque markers. Thirty five healthy subjects without previous anorectal disease or surgery and with similar age and sex distribution as the patients served as controls. Most of the SCI patients were content with their bowel function. Nine (26%) out of 35 of the SCI patients were completely satisfied with their bowel function and reported no limitations in social life. The majority (69%) of the patients considered their bowel function to be significantly altered, causing only mild problems in their social life. Two of the patients had major problems of bowel function, which caused severe limitations in their social life. The majority (77%) of the patients declared that they had a low frequency of bowel evacuation. Eight out of 35 patients were using laxatives to promote bowel emptying. The quantitative BCS of the patients was significantly lower than that of the controls (P < 0.001). Moreover, there was a significant difference between the scores of patients with complete high (C2-T6) and complete low (T7-S4-5) lesions. The difference between the BCS and overall satisfaction with bowel function can be explained by good habilitation to SCl and by the prolonged transit times which enables relatively rare and controlled bowel movements and firm consistency of stools.