Colonic compliance in patients with spinal cord injury

While numerous communications have focused on urinary bladder dysfunction in the course of spinal cord injury, gastrointestinal disorders have received little attention. Abnormal bladder response to distention (automatic bladder) has been widely encountered among patients with complete thoracic spinal cord injury. To examine the similar concept in the colon, intracolonic pressure changes were measured in response to variable volumes of water introduced into the organ. Eight patients with complete spinal cord injury at the thoracic region (T6-T10) and 10 healthy volunteers were studied. Water was infused into the colon and intracolonic pressure was recorded using a rectilinear dynograph. The procedure was continued until the pressure reached 40mmHg or 2500ml of water had been administered. In spinal cord injury patients, the intracolonic pressure increased rapidly to a mean value of 35mmHg with as little as 300ml of water, whereas in normal controls this pressure was achieved only after 2200ml of water had been introduced into the colon. These findings indicate that the colon in patients with complete spinal cord injury of the thoracic region demonstrates an abnormal stretch response similar to that described in the bladder. This phenomenon could explain the frequent colonic symptoms experienced by these patients.