Risk factors associated with neurogenic bowel complications and dysfunction in spinal cord injury

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Study assessed the prevalence of bowel-related complications in people with spinal cord injury (SCI) and identified the factors associated with constipation and incontinence as well as overall bowel dysfunction. A total of 291 subjects who incurred traumatic SCI with resultant neurogenic bowel were evaluated. Constipation, bowel incontinence, and neurogenic bowel dysfunction questionnaire scores were all derived from the Bowel and Bladder Treatment Index. Data analyses included descriptive and bivariate statistics as well as logistic and linear regression modeling. Results showed that risk factors contributing to bowel incontinence included overall bowel dysfunction as measured by the neurogenic bowel dysfunction score, timing of bowel program, being married or having a significant other, urinary incontinence, constipation, and use of diuretics. Constipation was best predicted by age, race/ethnicity, using laxatives/oral medications, incomplete tetraplegia, frequency of bowel movements, abdominal pain, access to clinicians and caregivers, and history of bowel surgeries. Neurogenic bowel dysfunction scores were predicted by neurologic classification; use of laxatives, oral medications, or both; bowel incontinence; and frequency of fiber intake. These results suggest a number of factors that should be considered when treating neurogenic bowel complications and dysfunction in people with SCI.

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