Bowel burdens: a systematic review and meta-analysis examining the relationships between bowel dysfunction and quality of life after spinal cord injury

Spinal Cord, 2024 · DOI: https://doi.org/10.1038/s41393-024-01002-8 · Published: July 16, 2024

Spinal Cord Injury Participation Gastroenterology

Simple Explanation

This review examines bowel dysfunction following spinal cord injury (SCI) and its impact on quality of life (QoL). It looks at issues like fecal incontinence, constipation, and bowel care-related autonomic dysreflexia. The study found that bowel dysfunction is prevalent and significantly reduces QoL for individuals with SCI, affecting their physical, emotional, and social well-being. The review suggests that improving bowel management is crucial for enhancing QoL in people with SCI.

Study Duration

Not specified

Participants

Systematic review of 39 articles

Evidence Level

Systematic review and meta-analysis

Key Findings

1
Bowel dysfunction is highly prevalent among individuals with SCI, with 74.7% reporting problems.
2
Fecal incontinence affects 56.9% of individuals with SCI.
3
Moderate to severe deterioration in QoL due to NBD was reported by 55.5% of individuals with SCI.

Research Summary

This systematic review and meta-analysis investigated the extent of bowel dysfunction after SCI and its impact on QoL. The study analyzed data from 39 articles, incorporating both quantitative and qualitative evidence. The findings revealed high rates of bowel dysfunction, fecal incontinence, constipation, and bowel care-related autonomic dysreflexia among individuals with SCI. These issues significantly impair QoL, affecting physical, emotional, and social well-being. The review concludes that improving bowel management strategies is essential for enhancing the QoL of individuals living with SCI, focusing on shorter care times, maximized independence, and reduced risks of complications.

Practical Implications

Clinical Practice

Prioritize bowel management in SCI patients, focusing on reducing care time and maximizing independence.

Research

Future research should employ common outcome measures to facilitate data aggregation and comparison between studies.

Patient Support

Provide access to resources and peer support for discussing bowel care routines and improving self-management.

Study Limitations

1
Inconsistent reporting of participant characteristics (e.g., sex, age, level of injury) prevented stratified analyses.
2
Lack of common outcome measures limited the extent of meta-analysis.
3
B-AD data were sometimes reported for all individuals, including those not at risk, potentially underestimating prevalence.

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