A comparison of bowel care patterns in patients with spinal cord injury: Upper motor neuron bowel vs lower motor neuron bowel

Abstract

Study design: A face-to-face interview survey. Objective: To compare bowel care patterns in spinal cord injury (SCI) patients based on type of neurogenic bowel. Setting: Department of Physical Medicine and Rehabilitation of a tertiary university hospital in Suwon, Korea. Methods: Among chronic SCI patients, 22 patients with upper motor neuron bowel (UMNB) and 20 patients with lower motor neuron bowel (LMNB) participated in an interview survey for the evaluation of bowel care patterns. Results: The patients with LMNB demonstrated increased frequency of defecation, increased frequency of fecal incontinence, increased use of oral medications for bowel care, increased required time for defecation and more diet modification than those with UMNB (P<0.05). However, there was no significant difference in the subjective difficulty of bowel care. Among several available bowel care methods, suppositories were used most frequently by the UMNB group, whereas the Valsalva maneuver was the most frequently used method by the LMNB group. Conclusions: Patients with LMNB tend to suffer more difficulties in management of their neurogenic bowel than those with UMNB. Therefore, more intensive and aggressive bowel care programs should be provided for SCI patients with LMNB.