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Effective bowel management in spinal cord injury during inpatient rehabilitation: data from the Dutch spinal cord injury database

Spinal Cord volume 61, pages 492–498 (2023)Cite this article

Subjects

Abstract

Study Design

Retrospective Observational Study.

Objectives

To describe bowel management in individuals with a recently acquired spinal cord injury (SCI) both at admittance and discharge from first inpatient rehabilitation, and to determine factors that contribute to effective bowel management (EBM) at discharge.

Setting

Specialized rehabilitation centers in the Netherlands.

Methods

Data from the Dutch Spinal Cord Injury Database (DSCID) collected between 2015 and 2019 was used. EBM was defined by the variables of stool frequency and fecal incontinence. After univariate analysis, a multivariate regression analysis was conducted.

Results

Of 1,210 participants, 818 (68%) did not have EBM at admittance. At discharge, 308 (38%) did still not have EBM (in total 33% of all participants). The odds of having EBM at discharge was 2.82 times higher for participants with ASIA Impairment Scale (AIS) D compared to those with AIS-A (95% CI: 1.38–5.78). Participants with non-traumatic SCI had higher odds of having EBM than those with traumatic SCI (OR: 0.59, 95% CI 0.38–0.91). Use of suppositories, small enema, medication influencing bowel function, and oral laxatives at admittance did not influence EBM significantly at discharge.

Conclusions

Bowel management improves during first inpatient rehabilitation. However, realizing EBM after a recently acquired SCI is a challenge. This endorses the importance of bowel management during inpatient rehabilitation, especially for people with AIS-A and non-traumatic etiology.

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Fig. 1: Exclusion flowchart.

Data availability

Additional data are available on request from the corresponding author.

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Author information

Authors and Affiliations

  1. Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands

    Nikki van der Veldt, Willemijn X. M. Faber & Janneke Nachtegaal

  2. Division of Human Nutrition and health, Wageningen University and Research, Wageningen University, Wageningen, The Netherlands

    Willemijn X. M. Faber & Ben J. M. Witteman

  3. Department of Gastroenterology and Hepatology, Gelderse Vallei Hospital, Ede, The Netherlands

    Ben J. M. Witteman

  4. Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands

    Janneke M. Stolwijk-Swüste

Authors
  1. Nikki van der Veldt
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  2. Willemijn X. M. Faber
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  3. Ben J. M. Witteman
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  4. Janneke M. Stolwijk-Swüste
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  5. Janneke Nachtegaal
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Contributions

NV was responsible for writing the report, extracting and analyzing data and compiling the reference lists. JN contributed to data extraction, analyzing data and interpreting results, contributed to the design of the report and provided feedback on the report. WF and JS contributed to the design of the report and provided feedback on the report. BW provided feedback on the report.

Corresponding author

Correspondence to Willemijn X. M. Faber.

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Competing interests

The authors declare no competing interests.

Ethical approval

The board of the DSCID approved the study protocol.

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van der Veldt, N., Faber, W.X.M., Witteman, B.J.M. et al. Effective bowel management in spinal cord injury during inpatient rehabilitation: data from the Dutch spinal cord injury database. Spinal Cord 61, 492–498 (2023). https://doi.org/10.1038/s41393-023-00916-z

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