Colonic dysfunction in patients with thoracic spinal cord injury

Area of Science:

• Neuroscience
• Gastroenterology
• Physiology

Background:

• Complete thoracic spinal cord injury (SCI) frequently causes severe constipation.
• The underlying pathophysiology of constipation in SCI patients requires further investigation.

Purpose of the Study:

• To investigate the pathophysiology of severe constipation in patients with complete thoracic spinal cord injury.
• To assess colonic compliance, motor, and myoelectrical activity in SCI patients.

Main Methods:

• Studied 9 patients with complete thoracic SCI and a control group.
• Assessed colonic compliance, motor, and myoelectrical activity in fasting and postprandial states.
• Administered neostigmine stimulation and performed electrophysiologic studies.

Main Results:

• SCI patients showed decreased colonic compliance compared to controls (p<0.01).
• Postprandial colonic motor and myoelectrical activity increases were absent in SCI patients (p<0.01).
• Neostigmine stimulation increased motor and myoelectrical activity, indicating intact myogenic response (p<0.02).

Conclusions:

• Decreased colonic compliance and absent postprandial activity in SCI patients may result from disrupted descending pathways.
• These findings suggest visceral neuropathy and correlate with severe constipation in thoracic SCI.