Bowel and Bladder Dysfunction after SCI: A Comparison between India and Canada

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Global Health

Background:

• Spinal cord injury (SCI) research highlights persistent challenges with bowel and bladder dysfunction.
• Global disparities in SCI outcomes are evident, particularly between high- and low-income countries.
• Direct comparative studies on SCI outcomes across different countries are lacking.

Purpose of the Study:

• To explore and compare bowel and bladder dysfunction in individuals with SCI in India and Canada.
• To understand the differences in SCI-related functional outcomes between two distinct global settings.

Main Methods:

• An exploratory study involving 33 participants with SCI.
• Online questionnaires assessed demographics, Neurogenic Bowel Dysfunction (NBD) score, Wexner score, Neurogenic Bladder Symptom Score (NBSS), and Incontinence Quality of Life (I-QOL).
• Statistical analyses included t tests, Mann-Whitney U tests, and chi-square tests for data comparison.

Main Results:

• Canadian participants reported poorer bowel function, evidenced by higher NBD scores and less frequent bowel movements.
• Canadian participants were more likely to experience autonomic dysreflexia symptoms during bowel movements.
• A higher proportion of Indian participants reported dissatisfaction with bladder function, though overall bladder scores were similar.

Conclusions:

• Significant differences in bowel dysfunction exist between Canadian and Indian individuals with SCI.
• Variations in lifestyle, management, resources, education, and societal factors likely contribute to these disparities.
• Further research is needed to address the global inequities in SCI care and outcomes.