The need for manual evacuation and oral laxatives in the management of neurogenic bowel dysfunction after spinal cord injury: a randomized controlled trial of a stepwise protocol

Spinal Cord
M J Coggrave, C Norton

Abstract

Randomised controlled trial. High-quality evidence for interventions in bowel management (BM) after spinal cord injury (SCI) is lacking and BM programs are developed empirically. This randomized, controlled trial compared usual care with a stepwise protocol based on earlier published work to examine whether systematic use of less invasive interventions could reduce the need for oral laxatives and invasive interventions such as manual evacuation, and improve BM outcomes in individuals with chronic SCI. United Kingdom. In all, 68 individuals were recruited (35 in intervention group), median age 47 years (range 24-73 years), median duration of injury 16 years (range 1-47 years). Bowel diaries were maintained for a maximum of 6 weeks while the intervention group followed a stepwise protocol designed to test interventions singly and in combination. Measures of quality of life and preferences for different bowel care interventions were recorded. The stepwise protocol did not improve BM outcomes; fecal incontinence was more frequent (P=0.04); the need for oral laxatives and invasive interventions was not reduced (P=0.4). Bowel care took consistently longer in the intervention group. The study findings support the need for manual evacu...Continue Reading

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Citations

Jul 27, 2012·Disability and Rehabilitation. Assistive Technology·Emma FriesenTrevor Russell
Aug 25, 2012·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·M D Schiller, R J Mobbs
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Sep 17, 2020·European Journal of Physical and Rehabilitation Medicine·Stefania MuscoGiulio Del Popolo
Feb 3, 2021·Archives of Physical Medicine and Rehabilitation·Joanne WincentakShauna Kingsnorth
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Oct 12, 2020·Medicina clínica·Miguel Ángel González ViejoJean-Claude Perrot Gonzalez

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