Bowel burdens: a systematic review and meta-analysis examining the relationships between bowel dysfunction and quality of life after spinal cord injury.

Autor: Sober-Williams EK; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.; International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada., Lee RHY; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.; International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada., Whitehurst DGT; International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada., McBride CB; Spinal Cord Injury British Columbia, Vancouver, BC, Canada., Willms R; International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.; GF Strong Rehabilitation Centre, Spinal Cord Injury Program, Vancouver Coastal Health, Vancouver, BC, Canada.; Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada., Claydon VE; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada. victoria_claydon@sfu.ca.; International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. victoria_claydon@sfu.ca.
Jazyk: angličtina
Zdroj: Spinal cord [Spinal Cord] 2024 Sep; Vol. 62 (9), pp. 495-506. Date of Electronic Publication: 2024 Jul 16.
DOI: 10.1038/s41393-024-01002-8
Abstrakt: Study Design: Systematic review and meta-analysis.
Objectives: Many individuals with spinal cord injury (SCI) experience autonomic dysfunction, including profound impairments to bowel and cardiovascular function. Neurogenic bowel dysfunction (NBD) is emerging as a potential determinant of quality of life (QoL) after SCI. For individuals with high-level lesions ( > T6), bowel care-related autonomic dysreflexia (B-AD; profound episodic hypertension) further complicates bowel care. We aimed to evaluate the extent of bowel dysfunction after SCI, and the impact of bowel dysfunction on QoL after SCI.
Methods: We searched five databases to identify research assessing the influence of NBD or B-AD on QoL after SCI. Metrics of bowel dysfunction (fecal incontinence [FI], constipation, time to complete, and B-AD) and QoL data were extracted and synthesised. Where possible, meta-analyses were performed.
Results: Our search identified 2042 titles, of which 39 met our inclusion criteria. Individuals with SCI identified problems with NBD (74.7%), FI (56.9%), and constipation (54.6%), and 49.3% of individuals with SCI > T6 experienced B-AD. Additionally, 40.3% of individuals experienced prolonged defecation ( > 30 min). Moderate/severe deterioration in QoL due to NBD was reported by 55.5% of individuals with SCI, with negative impacts on physical, emotional, and social health-related QoL associated with inflexibility of bowel routines, fear of accidents, and loss of independence.
Conclusion: Bowel dysfunction and bowel care challenges are prevalent and disabling for individuals with SCI, with a profoundly negative impact on QoL. Improving bowel management is a key target to improve QoL for those living with SCI.
(© 2024. The Author(s).)
Databáze: MEDLINE
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