P-3-02-01
CONSTIPATION AND SPINAL CORD INJURY
G. DEMIREL, N. KESIKTAS, H. YILMAZ: Istanbul Physical Medicine and Rehabilitation Centre, Istanbul, Turkey
The purpose of this study was to assess if constipation is due to physical immobilization or to the spinal cord lesion and the relationship between constipation and the level of the lesion.
Methods: The impact of neuropathic bowel dysfunction on bowel habits were studied in 30 SCI, 30 stabilized stroke, and 30 orthopaedic patients. The physical mobility was evaluated according to the APECS score. Constipation was defined according to international standardized criteria, quantitative scoring of bowel function.
Results: SCI 68%, stroke 27% and orthopaedic patients 21% have constipation. The continence scores of the SCI patients differed significantly from those of the others, (p<0.001). The patients with complete low spinal lesions (T7-S 1) had significantly better 5cores than the patients with complete high spinal lesions (C2-T7) (p< 0.05). Fecal incontinence was more prevalent in patients with complete lesions (CL) compared to patients with incomplete lesions (IL)(IL=56%, CL=74%, p<0.001).
Conclusion: Constipation, fecal incontinence and disturbed defecation are frequent following SCI lesions. Our data seem to indicate that constipation is secondary to tile SCI lesion and independent of physical immobilization. The level of the spinal cord lesion had important effect on fecal incontinence and constipation.
P-3-02-02
CHRONIC GASTROINTESTINAL PROBLEMS & BOWEL DYSFUNCTION IN SCI PATIENTS
B. S. Kwon, T. R. Han, J. H. Kim (Seoul National University College of Medicine, Seoul, Korea)
Purpose; To investigate the chronic gastrointestinal(G-I) problems and bowel dysfunction in the SCI patients, which are significant enough to have impacts on activities of daily living(ADL) and require the long-term medical management.
Method; Detailed interviews with semi-structured protocol were done individually for 72 patients who have had spinal cord injury(SCI) over 6 months.
Results; The incidence of chronic G-I problems was very high, that is 62.5% and most of the problems were associated with bowel dysfunction. These chronic G-I problems were vague and subjective, but significant enough to alter the quality of life in many ways. The bowel dysfunction was not related to various neurologic factors and most bowel care habits were settled relatively early stage, around 6 months.
Conclusion; Chronic G-I problems in SCI patients were very subjective and satisfaction of bowel habit, that is ideal bowel care for patients, were much individualized. It is important to make a properly designed bowel program and do training it in the early stage of rehabilitation.
