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Neurogenic bowel dysfunction is one of the common complications after spinal cord injury. Long-term constipation and fecal incontinence can cause great troubles in the daily life of patients and seriously affect their quality of life. The key to the solution is effective intestinal intervention, including the establishment of defecation patterns, dietary interventions, and drug interventions, enema, electromagnetic stimulation, and enterostomy, etc. At the same time, a personalized bowel management plan is formulated based on the specific conditions of the patient to better manage the bowel and improve the patient′s quality of life.
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Objective:To explore the effect of functional magnetic stimulation(FMS) on the intestinal function of patients with neurogenic bowel dysfunction (NBD) after spinal cord injury using anorectal manometry technology.Methods:36 NBD patients were divided into FMS group and control group by random number table method. Patients in the control group received conventional treatment, including diet adjustment, abdominal massage, and pelvic floor muscle training. Patients in the FMS group received FMS treatment on the basis of conventional treatment. Using 3D high-resolution anorectal manometry and neurogenic intestinal dysfunction score, the intestinal function of the two groups of patients before and after the treatment were evaluated.Results:After receiving conventional treatment + FMS treatment, the high-pressure belt length, anal systolic pressure, rectal pressure, rectal-anal pressure difference, initial sensory threshold, bowel sensation threshold, maximum tolerance threshold, rectal compliance of the patients in the FMS group received were better than those before the treatment (all P<0.05). After receiving conventional treatment, only the rectal-anal pressure difference, initial sensory threshold and maximum tolerance threshold of the patients in the control group were significantly improved (all P<0.05). The improvement of the FMS group on the length of the high-pressure belt, anal systolic pressure, rectal pressure, and initial sensory threshold was significantly better than those of the control group (all P<0.05). Conclusions:The implementation of FMS therapy on the basis of conventional treatment can better improve the intestinal motility and intestinal sensation of the patients with NBD. The 3D high-resolution anorectal manometry technique can be used to quantitatively evaluate the intestinal function of NBD patients.
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Neurogenic bowel dysfunction is one of the common complications after spinal cord injury. This paper reviewed the acupuncture and moxibustion used for neurogenic bowel dysfunction after spinal cord injury, from the aspects of prescription, acupoint selection, evaluation and possible mechanism. The ideas for further researches were discussed.
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Objective To study the dynamic changes of the intestinal function of neurogenic bowel dysfunction rats caused by spi-nal cord injury using X-ray radiography. Methods Twenty-four female Sprague-Dawley rats were divided into control group (n=12) and spinal cord injury group (n=12). The T10spinal cord injury model was established using aneurysm clip (70 grams calibration force) for 60 seconds. The control group exposed the dura only. X-ray Barium was used to observe the dynamic changes of in-testinal function, and HE staining was used to observe the pathology of the colon before and four weeks after modeling. Results Compared with the control group, gastric emptying and intestinal transit function significantly reduced in the spinal cord injury group (P<0.05). Conclusion The spinal cord injury model can be successfully duplicated with aneurysm clip in rats; neurogenic bowel dysfunction occurs after spinal cord injury, gastric emptying and intestinal transit function are weakened.
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Neurogenic bowel dysfunction is one of the most common complications of spinal cord injury.It can cause abdominal distension,constipation,fecal incontinence,difficult defecation,prolonged defecation and other symptoms.At present, neurogenic bowel dysfunction is mainly evaluated through general condition,physical examination,experimental exami-nation,professional scales and intestinal microbiota,etc.
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Spinal cord injury has the characteristics of high incidence, high disability, high cost and younger age. It imposes a huge burden on patients and society. Neurogenic bowel dysfunction is one of the serious complications of spinal cord injury. It often manifests as constipation and fecal incontinence, which severely limit the social activities of patients and reduce the quality of life. It is a major problem for clinicians to solve. In recent years, the concern for neurogenic bowel dysfunction after spinal cord injury has been increasing. This article reviewed its epidemiology, classification, pathophysiological, diagnosis and treatment.
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Objective To observe the therapeutic efficacy of hyperbaric oxygen with needles retained after BO's abdominal acupuncture in treating neurogenic bowel dysfunction after spinal cord injury. Method Ninety patients diagnosed with neurogenic bowel dysfunction after spinal cord injury were randomized into hyperbaric oxygen with needles retained group, hyperbaric oxygen followed by acupuncture group, and acupuncture followed by hyperbaric oxygen group, 30 cases each. The clinical efficacies of the three groups were observed. Result The three treatment protocols were all effective in treating neurogenic bowel dysfunction due to spinal cord injury, but the hyperbaric oxygen with needles retained group was superior to the other two groups(P<0.05), and the hyperbaric oxygen followed by acupuncture group was better than the acupuncture followed by hyperbaric oxygen group(P<0.05). Conclusion Hyperbaric oxygen with needles retained can effectively treat neurogenic bowel dysfunction due to spinal cord injury, and generally enhance the quality of life of spinal cord injury patients.
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Objective To analyze the clinical characteristics of spinal cord injury patients with postoperative adhesive intestinal obstruc-tion, and summarize the clinical experience of diagnosis and treatment. Methods 35 spinal cord injury patients with postoperative adhesive intestinal obstruction in our department from August 2008 to August 2013 were reviewed. Results All of them had a history of abdominal surgery for various reasons, 22 cases received sigmoid colon pouch procedure and 13 cases received cholecystectomy. 25 cases suffered T10-L1 spinal cord injury, 10 cases suffered cervical spinal cord injury;26 cases (74.3%) received non-operative treatment and recovered, 9 cases (25.7%) were transferred to surgery. Conclusion There is no typical clinical symptom and sign in spinal cord injury patients with adhe-sive intestinal obstruction after abdominal surgery, so early diagnosis is difficult, and the imaging examination is necessary. When non-opera-tion treatment is not effective to these patients, surgical treatment should be timely carried out.
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@#Objective To analyze the clinical characteristics of spinal cord injury patients with postoperative adhesive intestinal obstruction, and summarize the clinical experience of diagnosis and treatment. Methods 35 spinal cord injury patients with postoperative adhesive intestinal obstruction in our department from August 2008 to August 2013 were reviewed. Results All of them had a history of abdominal surgery for various reasons, 22 cases received sigmoid colon pouch procedure and 13 cases received cholecystectomy. 25 cases suffered T10-L1 spinal cord injury, 10 cases suffered cervical spinal cord injury; 26 cases (74.3%) received non-operative treatment and recovered, 9 cases (25.7%) were transferred to surgery. Conclusion There is no typical clinical symptom and sign in spinal cord injury patients with adhesive intestinal obstruction after abdominal surgery, so early diagnosis is difficult, and the imaging examination is necessary. When non-operation treatment is not effective to these patients, surgical treatment should be timely carried out.
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Objective To investigate the relationship between neurogenic bowel dysfunction (NBD) and substance P in rats suffering from spinal cord injury (SCI). Methods 60 male Sprague-Dawley rats, weighted (220±40) g, were randomly divided into three groups:sham group (n=20), normal group (n=20) and model group (n=20) and then were subdivided into subgroups of 24 h, 1 week, 3 weeks, and 5 weeks respectively after SCI. SCI model was established at thoracic 10 segment of rat with NYU impactor device. The colon tissue of the rats was resected and stored. Substance P in serum and tissue was measured by ELISA. The tissue was examined by real-time RT-PCR and Western blotting to analyze the expression of substance P. Results The colon intestinal transmission function decreased and delineated at minimum value at 3 weeks in the model group. There was statistical significance with respect to the content of substance P in serum and tis-sue between the sham group and model group at 3 weeks. The expression of substance P in the sham group was (3.12 ± 0.51) times of the model group (P<0.05). Conclusion Substance P may take part in NBD after SCI in rats.
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@#Objective To investigate the relationship between neurogenic bowel dysfunction (NBD) and substance P in rats suffering from spinal cord injury (SCI). Methods 60 male Sprague-Dawley rats, weighted (220±40) g, were randomly divided into three groups: sham group (n=20), normal group (n=20) and model group (n=20) and then were subdivided into subgroups of 24 h, 1 week, 3 weeks, and 5 weeks respectively after SCI. SCI model was established at thoracic 10 segment of rat with NYU impactor device. The colon tissue of the rats was resected and stored. Substance P in serum and tissue was measured by ELISA. The tissue was examined by real-time RT-PCR and Western blotting to analyze the expression of substance P. Results The colon intestinal transmission function decreased and delineated at minimum value at 3 weeks in the model group. There was statistical significance with respect to the content of substance P in serum and tissue between the sham group and model group at 3 weeks. The expression of substance P in the sham group was (3.12±0.51) times of the model group (P<0.05). Conclusion Substance P may take part in NBD after SCI in rats.
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@#The International Bowel Function Basic SCI Data Set is to present a standardized format for the collection and report of a minimal amount of information on bowel function in clinical practice. Furthermore, the Bowel Function Basic SCI Data Set will make it possible to evaluate and compare results from various published studies on bowel dysfunction after SCI. Studying and using the International Bowel Function Basic SCI Data Set will make it possible to improve the evaluation and rehabilitative treatment level of neurogenic bowel dysfunction in China.
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@# The present International Bowel Function Extended Spinal Cord Injury(SCI) Data Set is mainly intended for research and should provide a standardized format for the collection and reporting of extended information on bowel function after SCI，which will make it possible to evaluate and compare results from various published studies on bowel dysfunction after SCI. Studying and using the International Bowel Function Extended SCI Data Set will make it possible to improve the research level of neurogenic bowel dysfunction in China.
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@#Spinal cord injury can lead to neurogenic bowel dysfunction. With the research of the enteric nervous system, slow transit constipation had a better understanding of the pathogenesis. This article reviewed gastrointestinal motility after spinal cord injury and motilin, substance P, and vasoactive intestinal peptide.
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OBJECTIVE: To investigate the change of neurogenic bowel dysfunction (NBD) in spinal cord injury (SCI) patients during admission. METHOD: Thirty eight SCI patients were enrolled. The NBD score by Krogh was converted to the Korean-version of NBD score. The questionnaires of NBD score included questions about neurogenic bowel symptoms, signs, gender, age, duration, injury level, American spinal cord injury association impairment scale (AIS) and Spinal cord independence measure (SCIM) were used for evaluation of the functional impairment of the SCI. The Korean version of NBD score was applied to the SCI patients at the time of admission and discharge. Neurogenic bowel was treated according to scheduled bowel care. The subcomponents of bowel care protocol were education of bowel habit, abdominal massage, triggered defecation, oral medication and rectal stimulants insertion. RESULTS: The NBD score at the time of discharge decreased significantly in all patients within three months after SCI (p0.05). CONCLUSION: We could reveal the significant improvement of NBD in patients within three months after SCI during admission. The change was more evident in AIS A, C, D patients.
Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols , Cytarabine , Defecation , Etoposide , Massage , Methotrexate , Neurogenic Bowel , Polyradiculopathy , Quality of Life , Surveys and Questionnaires , Spinal Cord , Spinal Cord InjuriesABSTRACT
0.05). (2) The average squeezing anal pressure and the duration of anal squeezing decreased in the experiment group, which were significantly different from those in the control group ( P
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@#ObjectiveTo investigate changes of anorectal dysfunction in patients with complete cervical and thoracic spinal cord injury.Methods30 hospitalized cases with complete spinal cord injury and 30 healthy volunteers were performed with anorectal manometry. Changes of manometric characteristics of anorectal and sphincter function were recorded when subjects were resting and bearing down.ResultsDuring defecation, the decreased amplitude of the anal pressure, the pressure gradient between rectal and anal and the index of defecation in patients with complete spinal cord injury were lower than that of in healthy volunteers (P<0.01).Conclusions The anorectal coordination during attempting to defecate and mechanism of initiative defecation were impaired. The mechanism of the reflectivity defecation was the main approach to defecate for patients with complete cervical and thoracic spinal cord injury.