Bowel management experiences of individuals with spinal cord injury: A meta-synthesis study

Bowel dysfunction is a common and distressing consequence of spinal cord injury (SCI), with profound effects on physical, psychological, and social well-being. Despite its high prevalence, there is limited consolidated evidence regarding patients' lived experiences, which are essential for improving care.

To synthesize qualitative research findings on the experiences of individuals with SCI regarding bowel management.

A qualitative meta-synthesis was conducted following PRISMA guidelines. Systematic searches were performed in Google Scholar, MEDLINE, CINAHL, PubMed, Web of Science, and Springer Nature Journals between June 3 and June 28, 2024. Studies were appraised using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (QARI). Data were analyzed through Sandelowski and Barroso's two-stage meta-synthesis method. The review was prospectively registered in PROSPERO (CRD420250578291).

Twelve qualitative studies involving 210 participants from seven countries were included. Three overarching themes emerged: (1) Challenges in bowel management, encompassing physical complications, emotional burden, and social restrictions; (2) Perceived shortcomings and expectations, reflecting inadequate professional support and a strong desire for independence; and (3) Managing the difficult process, highlighting self-care adjustments, social support, and consideration of invasive interventions such as colostomy.

Bowel management is a central yet challenging aspect of life for individuals with SCI, affecting all domains of quality of life. Findings underscore the need for patient-centered strategies, enhanced professional education, and early discussion of all management options to improve care outcomes.