International standards to document remaining autonomic Function in persons with SCI and neurogenic bowel dysfunction: Illustrative cases

Spinal Cord Series and Cases, 2018 · DOI: 10.1038/s41394-017-0030-y · Published: January 1, 2018

Spinal Cord Injury Neurology Gastroenterology

Simple Explanation

Neurogenic bowel dysfunction (NBD) is a common issue after spinal cord injury (SCI), significantly impacting health and quality of life. The international standards aim to standardize communication among professionals regarding neurogenic bowel and other autonomic functions after SCI. Three cases illustrate differences in presentation and scoring based on varying injury severity and location, enhancing understanding of the bowel subsection.

Study Duration

Not specified

Participants

Three cases with varying injury severity and location

Evidence Level

Case Report

Key Findings

1
Determination of neurologic level of injury alone is insufficient for assessing autonomic function; surrogate markers are necessary.
2
The bowel subsection of the International Standards is an easy-to-use tool for assessing autonomic function related to bowel dysfunction after SCI.
3
The cases demonstrate how the scoring of sensation, continence, and voluntary sphincter contraction differs based on the specific characteristics of the SCI.

Research Summary

Neurogenic bowel dysfunction (NBD) significantly impacts quality of life after spinal cord injury (SCI). International standards were developed to standardize communication about autonomic function after SCI, including bowel function. Three case presentations demonstrate the application of these standards, showing how injury severity and location affect scoring and presentation of NBD.

Practical Implications

Standardized Assessment

The international standards provide a consistent framework for assessing and documenting bowel function in individuals with SCI.

Improved Communication

Using standardized terminology facilitates better communication among healthcare professionals involved in the care of individuals with SCI.

Personalized Management

Understanding the specific impairments in sensation, continence, and sphincter control allows for tailored bowel management strategies.

Study Limitations

1
The bowel function assessment relies on surrogate markers due to the lack of direct methods for assessing autonomic innervation of the bowel.
2
Variation between subjects is large, and there is substantial overlap between able bodied and subjects with SCI.
3
The study is based on a limited number of illustrative cases, which may not represent the full spectrum of presentations of NBD.

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