How do patients with chronic spinal injury in Pakistan manage their bowels? A cross-sectional survey of 50 patients

Abstract

A cross-sectional survey. To document bowel care practices of chronic spinal cord injury (SCI) patients in Pakistan. Outpatient Department, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan. A total of 50 adult patients (18-65 years) with SCI of duration >12 months were sampled by convenience sampling. Medical record was reviewed, detailed neurological examination was performed and face-to-face semistructured interviews were conducted. Data were collected and analysed using SPSS v10. Frequencies and descriptive statistics were calculated for the various variables. Most of the patients (29) were males. The mean age was 33±11 years. Majority of the patients (76%) had thoracic-level injury. In all, 43 patients gave a history of occasional or regular faecal incontinence. In addition, 17 patients reported the regular use of laxatives whereas 22 used bulk-forming agents on a regular basis. Majority of the patients (56%) had at least one bowel evacuation daily. In addition, 31 patients required 16-30 min to complete the bowel evacuation. Approximately half (54%) required assistance in bowel evacuation. A large number of patients with chronic SCI in Pakistan had faecal incontinence. A majority of patients used methods such as suppositories, laxatives and bulk-forming agents to control the frequency and duration of the bowel programme. Adherence to standard bowel care programme and practices are influenced by sociocultural factors and lack of education on the part of the patients.