The role of intestinal stoma in patients with spinal cord injury

In the long term following spinal cord injury, bowel dysfunction causes maj or physical and psychological problems. A retrospective review of intestina l stomas performed in patients with spinal cord injury over a 10 year perio d was performed to investigate their role in alleviating these problems. Tw elve patients underwent left iliac fossa end colostomy and two patients rig ht iliac fossa end ileostomy. The mean age of patients at operation was 54. 8 years (20-65), and the mean time from injury to stoma formation was 15 ye ars (2-37). The mean period of unsatisfactory bowel management before stoma formation was 5.4 years (1.5-25). Following colostomy the mean time spent on bowel care per week fell from 8.8 h (0.6-12.2) to 1.4 h (0.3-3.5) and in dependence in bowel care rose from 50 to 92%. All patients stated that thei r bowel care was easier and 83% said their independence had increased. Nine ty-two per cent wished colostomy had been offered earlier and no patient un dergoing colostomy wanted it reversed. The most common complication followi ng colostomy was exclusion colitis. The mean time of follow-up post colosto my formation was 38 months (7-130). Formation of an intestinal stoma is a s afe, effective and well accepted treatment for selected patients with intra ctable problems of bowel management following spinal cord injury.