BOWEL MANAGEMENT OUTCOMES IN INDIVIDUALS WITH LONG-TERM SPINAL-CORD INJURIES

Outcomes of bowel management were evaluated in 1993 among 221 British long-term spinal cord injury survivors who were followed-up as part of a longitudinal study of aging with spinal cord injury. Representing a population-based sample followed up by two regional spinal cord injur y treatment centres - Stoke Mandeville Hospital in Aylesbury and the D istrict General Hospital in Southport, England - all had been injured at least 20 years when the study was begun in 1990; all underwent comp rehensive assessments and extensive interviewing at their centres in 1 990 and 1993. When assessed in 1993, 42% of the entire sample reported constipation, 35% reported gastrointestinal pain, and 27% complained of bowel accidents, Physician examiners diagnosed significantly more h emorrhoids among those using primarily suppositories and enemas to man age their bowels (P < 0.05) and more constipation among persons with p araplegia (P < 0.05) and those using digital stimulation, manual evacu ation, or increased abdominal pressure in their bowel programs. Fecal incontinence and diarrhea was diagnosed three times more often in part icipants with tetraplegia as in other neurological groupings. These an d other findings suggest future research needs and directions relative to long-term bowel management for spinal cord injury survivors.