Anorectal Biofeedback for Neurogenic Bowel Dysfunction in Incomplete Spinal Cord Injury

Overview

Journal Spinal Cord

Specialty Neurology

Date 2016 May 18

PMID 27184916

Citations 10

Authors

Y Mazor

M Jones

A Andrews

J E Kellow

A Malcolm

Affiliations

Soon will be listed here.

Abstract

Study Design: A case-control study of prospectively collected data was performed.

Objectives: To compare anorectal biofeedback (BF) outcomes in patients with incomplete motor spinal cord injury (SCI) and neurogenic bowel dysfunction (NBD) with a group of functional anorectal disorder-matched control patients.

Setting: Neurogastroenterology Unit affiliated with a Spinal Injury Unit in a tertiary referral centre in Sydney, Australia.

Methods: All consecutive patients with SCI and NBD referred for anorectal manometry and BF were matched in a 1:2 ratio with age, gender, parity and functional anorectal disorder-matched control patients. Instrumented BF was performed in six nurse-guided weekly visits. Outcomes included changes in anorectal physiology measures, symptom scores and quality-of-life measures.

Results: Twenty-one patients were included. These were matched with 42 patient controls. Following BF, symptom scores improved significantly in both groups, as did effect of bowel disorder on quality of life. Improvement in these measures did not differ between the groups. Patients with SCI and NBD showed improvement in their sensory and motor anorectal function, including lowering of first sensation threshold and more effective balloon expulsion.

Conclusions: Patients with incomplete motor SCI responded as well to anorectal BF as functional anorectal disorder-matched controls. Spinal cord-injured patients also showed improvement in anorectal sensorimotor dysfunction and balloon expulsion. These novel findings indicate that clinicians should not be dissuaded from considering behaviour-based therapeutic interventions such as anorectal BF in selected spinal cord-injured patients.

Citing Articles

How Can We Treat If We Do Not Measure: A Systematic Review of Neurogenic Bowel Objective Measures.

Stampas A, Patel A, Luthra K, Dicks M, Korupolu R, Neshatian L Top Spinal Cord Inj Rehabil. 2024; 30(3):10-40.

PMID: 39139772 PMC: 11317643. DOI: 10.46292/sci23-00065.

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

Sober-Williams E, Lee R, Whitehurst D, McBride C, Willms R, Claydon V Spinal Cord. 2024; 62(9):495-506.

PMID: 39014196 PMC: 11368817. DOI: 10.1038/s41393-024-01002-8.

Neurogenic Bowel Dysfunction in Patients with Spinal Cord Injury and Multiple Sclerosis-An Updated and Simplified Treatment Algorithm.

Magnuson F, Christensen P, Krassioukov A, Rodriguez G, Emmanuel A, Kirshblum S J Clin Med. 2023; 12(22).

PMID: 38002586 PMC: 10672578. DOI: 10.3390/jcm12226971.

Differential Findings on Anorectal Manometry in Patients with Parkinson's Disease and Defecatory Dysfunction.

Zhou W, Triadafilopoulos G, Gurland B, Halawi H, Becker L, Garcia P Mov Disord Clin Pract. 2023; 10(7):1074-1081.

PMID: 37476327 PMC: 10354598. DOI: 10.1002/mdc3.13755.

Integrated Neuroregenerative Techniques for Plasticity of the Injured Spinal Cord.

Leemhuis E, Favieri F, Forte G, Pazzaglia M Biomedicines. 2022; 10(10).

PMID: 36289825 PMC: 9599452. DOI: 10.3390/biomedicines10102563.

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