Antegrade continence enema for the treatment of neurogenic constipation and fecal incontinence after spinal cord injury

Objective: To describe the effects of an antegrade continence enema stoma f ormed in a paraplegic man with intractable constipation and fecal incontine nce. Design: Case report. Setting: Spinal cord injury unit, Veterans Affairs hospital. Participants: Spinal cord injury (SCI) patient with T12 paraplegia. Intervention: Surgical formation of antegrade continence enema stoma. Main Outcome Measures: Time of bowel program care, ease of fecal eliminatio n, safety of procedure. Results: Bowel care time was decreased from 2 hours to 50 minutes daily; 6 bowel medications were discontinued; fecal incontinence was eliminated; and no surgical or medical side effects noted after the procedure. Conclusion: The antegrade continence enema procedure is a safe and effectiv e means of treating intractable constipation and fecal incontinence in the adult SCI patient. This option should be considered for those persons in wh om medical management of bowel care has been unsuccessful.