A Community Perspective on Bowel Management and Quality of Life after Spinal Cord Injury: The Inﬂuence of Autonomic Dysreﬂexia

JOURNAL OF NEUROTRAUMA, 2018 · DOI: 10.1089/neu.2017.5343 · Published: May 1, 2018

Spinal Cord Injury Participation Neurology

Simple Explanation

This study investigates the impact of bowel management on the quality of life for individuals with spinal cord injuries (SCI), particularly focusing on the role of autonomic dysreflexia (AD). Autonomic dysreflexia, characterized by sudden hypertension, can be triggered by bowel care in individuals with high-level SCI. The research involved an online survey of 287 individuals with SCI, examining their bowel care routines, the presence of AD symptoms, and the effects on their overall quality of life. The study found that bowel management is a significant concern for many with SCI, impacting personal relationships and the ability to work or stay away from home. Longer bowel care durations and more severe AD symptoms were associated with a lower quality of life, indicating the need for improved bowel management strategies and interventions to mitigate the impact of AD and enhance the overall well-being of individuals with SCI.

Study Duration

3 years

Participants

287 individuals with SCI (injury levels C1-sacral)

Evidence Level

Not specified

Key Findings

1
Bowel management is a significant problem for many individuals with SCI, interfering with personal relationships, social life, and the ability to work or travel.
2
A high percentage (74%) of individuals at risk for AD experienced AD symptoms during bowel care, with common symptoms including goosebumps, spasticity, flushing, sweating, and headache.
3
Longer bowel care durations and more severe AD symptoms were associated with a lower quality of life, highlighting the need for improved bowel management strategies.

Research Summary

This study investigated the impact of bowel management and autonomic dysreflexia (AD) on the quality of life (QoL) in individuals with spinal cord injury (SCI). The online community survey of 287 individuals with SCI revealed that bowel management is a key concern, commonly associated with symptoms of AD, and significantly impacting QoL. The study suggests further research into managing bowel dysfunction, increasing self-efficacy, and ameliorating the impact of AD to improve QoL for individuals with SCI.

Practical Implications

Improved Bowel Management Strategies

The study highlights the need for developing and implementing more efficient bowel management strategies to reduce the time required for bowel care routines and minimize the number of approaches used.

Targeted Interventions for Autonomic Dysreflexia

Interventions should be developed and implemented to mitigate the impact of autonomic dysreflexia during bowel care, potentially through pharmacological or behavioral approaches.

Holistic Approach to SCI Management

Healthcare providers should adopt a holistic approach to managing bladder and bowel care, emphasizing the importance of adequate fluid intake and addressing fatigue to improve overall quality of life.

Study Limitations

1
The majority of respondents were from Canada, which may limit the generalizability of the findings.
2
The study relied on self-reported data, which may be subject to recall bias and inaccuracies in reporting spinal levels.
3
Some survey items had not undergone rigorous psychometric evaluation.

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