Bowel dysfunctions after acquired brain injury: a scoping review

Frontiers in Human Neuroscience, 2023 · DOI: 10.3389/fnhum.2023.1146054 · Published: October 12, 2023

Neurology Gastroenterology Rehabilitation

Simple Explanation

Bowel dysfunction, including fecal incontinence and constipation, is a common issue after acquired brain injury (ABI). This review looks at current evidence on this problem and its treatment. The review found that oral laxatives are the most frequently used treatment. Assessment scales like the Functional Independence Measure (FIM) are commonly used. The authors suggest a need for consensus between rehabilitation and gastroenterology experts to improve diagnosis and care for bowel dysfunction after ABI.

Study Duration

Not specified

Participants

1,507 ABI patients

Evidence Level

Systematic Review

Key Findings

1
The incidence of fecal incontinence ranges from 41 to 68% during admission to rehabilitation, dropping to 12–36% at discharge, and reaching 5% 1 year after discharge.
2
The Functional Independence Measure (FIM) instrumental subscale is the most frequently used tool (60%) to assess bowel symptoms in patients with ABI.
3
Oral laxatives are the most common treatment option reported in the reviewed studies.

Research Summary

This scoping review examined the evidence on neurogenic bowel dysfunction (NBD) following acquired brain injury (ABI) and identified ten relevant studies. The review highlights the complex interplay between central nervous system alterations, intestinal dysfunctions, and microbiota dysbiosis in the development of NBD after ABI. The authors emphasize the need for a multidisciplinary approach to NBD management, incorporating neurological, intestinal, and nutritional considerations, and advocate for the development of an international consensus on bowel management after ABI.

Practical Implications

Improved Assessment

Standardized diagnostic protocols can improve the identification of individuals suffering from NBD after ABI.

Holistic Treatment Strategies

Rehabilitation strategies should address neurological damage, intestinal dysbiosis, and nutritional aspects.

Collaborative Care

Fostering consensus between rehabilitative and gastroenterological societies can improve patient care and quality of life.

Study Limitations

1
The characteristics of the ABI population are unknown in most of the articles.
2
The sample of patients with NBD in ABI has been briefly studied in the literature.
3
Most of the samples were from a single US database.

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