Yazan F. H. Rawashdeh

Colorectal transport during defecation in subjects with supraconal spinal cord injury

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Study design: Clinical study.
Objectives: To explore how supraconal spinal cord injury (SCI) affects colorectal emptying at defecation. Further, to relate findings to
subject symptomatology expressed by bowel function scores and gastrointestinal transit time (GITT).
Setting: Aarhus University Hospital, Denmark.
Methods: Colorectal contents were marked by oral intake of 111In-coated resin pellets. Movement of stools at defecation was assessed by
comparing scintigrams performed before and just after defecation. Results from 15 subjects with SCI (14 males, median age¼47 years
(range: 22–74 years), SCI level: C5–Th9) were compared with those from 16 healthy volunteers (12 males, median age¼31 years (range:
24–42 years)). Bowel symptoms were described from standard symptom scores, and GITT was assessed by radiopaque markers.
Results: Median emptying at defecation was 31% of the rectosigmoid (range: 0% to complete emptying of the rectosigmoid and
49% of the descending colon) in subjects with SCI and 89% of the rectosigmoid (range: 53% to complete emptying of the
rectosigmoid and the descending colon, and 3% of the transverse colon) in the control group (Po0.01). Colorectal emptying at
defecation was associated with the St Mark’s fecal incontinence score (P¼0.02) but not with the Cleveland constipation score
(P¼0.17), the neurogenic bowel dysfunction score (P¼0.12) or GITT (P¼0.99).
Conclusion: Supraconal SCI results in significantly reduced emptying of stools at defecation. This is independent of changes in GITT.
Spinal Cord advance online publication, 18 June 2013; doi:10.1038/sc.2013.58
TidsskriftSpinal Cord
StatusUdgivet - 2013

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