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

Cross-sectional studies suggest that colorectal dysfunction after spinal cord injuries (SCI) worsens as time goes by. However, follow-up studies are needed to prove this.

Prospective study.

To describe long-term colorectal function in SCI patients.

Members of the Danish Spinal Cord Injuries Association.

In 1996, 424 members of the Danish Paraplegic Association answered a detailed questionnaire describing their colorectal function. In 2006, those who continued as members (n=284) received an identical questionnaire. Data for patients responding both in 1996 and in 2006 (n=159) were compared.

In 1996, 25% of the respondents reported that colorectal dysfunction had some or a major impact on their quality of life. At follow-up 10 years later, it was 38% (P<0.005). In 1996 11% defecated less than every second day and 16% spent more than 30 min at each defecation; in 2006, it was 19% (P<0.01) and 25% (P<0.00001), respectively. Digital anorectal stimulation or evacuation was performed at least once every week by 48% in 1996 and by 56% in 2006 (P<0.0001). Fecal incontinence was reported at least once a month by 22% in 1996 and by 17% in 2006 (P<0.001).

While the frequency and severity of constipation-related symptoms increase with time since SCI, there is a decrease in the frequency of fecal incontinence.