Gastrointestinal complications of chronic spinal cord injury

Gastrointestinal problems are important in the chronic stage of spinal cord injury. We review the literature on problems of specific segments of the alimentary tract in this setting and add observations based on clinical experience. Emphasis is placed on the colon and rectum, where most clinically apparent problems occur. While bowel management programs are often successful in the near-term, long-term dysfunctions are common and difficult to treat. Studies to determine colonic transit time and rectal physiologic responses are useful to provide scientific basis of management of such patients. More information is needed on the relative roles of extrinsic and intrinsic nervous system in GI function.