The pattern of colorectal dysfunction changes with time since spinal cord injury

Area of Science:

• Neuroscience
• Gastroenterology
• Rehabilitation Medicine

Background:

• Cross-sectional studies indicate worsening colorectal dysfunction over time following spinal cord injuries (SCI).
• Longitudinal data are crucial to confirm the progression of colorectal issues post-SCI.

Purpose of the Study:

• To investigate the long-term changes in colorectal function among individuals with spinal cord injuries.
• To quantify the progression of specific colorectal symptoms over a 10-year period in SCI patients.

Main Methods:

• A prospective cohort study involving members of the Danish Spinal Cord Injuries Association.
• A detailed colorectal function questionnaire was administered in 1996 and again in 2006 to assess changes over 10 years.
• Data from 159 patients who responded to both surveys were analyzed.

Main Results:

• The impact of colorectal dysfunction on quality of life increased from 25% in 1996 to 38% in 2006 (P<0.005).
• Constipation symptoms worsened, with the percentage of individuals defecating less than every second day rising from 11% to 19% (P<0.01), and time spent on defecation increasing from 16% to 25% (P<0.00001).
• Fecal incontinence decreased from 22% to 17% (P<0.001), while the use of digital anorectal stimulation/evacuation increased from 48% to 56% (P<0.0001).

Conclusions:

• Constipation-related symptoms and their severity significantly increase with time since spinal cord injury.
• A notable decrease in the frequency of fecal incontinence was observed over the 10-year follow-up period.
• These findings highlight the evolving nature of colorectal challenges in the SCI population over the long term.