The Addition of Transdermal Delivery of Neostigmine and Glycopyrrolate by Iontophoresis to Thrice Weekly Bowel Care in Persons with Spinal Cord Injury: A Pilot Study

Journal of Clinical Medicine, 2021 · DOI: 10.3390/jcm10051135 · Published: March 8, 2021

Spinal Cord Injury Pharmacology Gastroenterology

Simple Explanation

This study investigates a new method for managing bowel dysfunction in people with spinal cord injuries (SCI). It explores whether delivering two medications, neostigmine and glycopyrrolate, through the skin using a technique called iontophoresis, can improve bowel care when added to the standard bowel management routine. Iontophoresis is a pain-free method that delivers drugs through the skin without needles. The study aims to determine if this approach can lead to more predictable and effective bowel movements for individuals with SCI. The researchers compared the standard bowel care routine alone to the standard routine plus the new drug delivery method, looking at factors like the time it takes to have a bowel movement and the patients' satisfaction with their bowel care.

Study Duration

Two weeks

Participants

Six medically stable male in-patients with chronic SCI

Evidence Level

Pilot Study

Key Findings

1
The addition of transdermal neostigmine and glycopyrrolate significantly reduced the time to bowel evacuation compared to standard of care alone.
2
Patients experienced a decrease in body weight, confirmed by abdominal radiographs, suggesting a more complete stool evacuation.
3
Subjective improvements in bowel care and greater satisfaction with the treatment regimen were reported by the patients after the dual drug intervention.

Research Summary

This pilot study investigated the efficacy and safety of adding transdermal neostigmine and glycopyrrolate, delivered via iontophoresis, to the standard bowel care (SOC) regimen for individuals with spinal cord injury (SCI) and difficulty with evacuation (DWE). The results demonstrated a significant reduction in bowel evacuation time, decreased body weight, and subjective improvements in bowel care, as reported by the patients. The study suggests that this dual-drug transdermal approach could be a safe and effective addition to SOC for bowel management in persons with SCI and DWE.

Practical Implications

Improved Bowel Management

The transdermal delivery of neostigmine and glycopyrrolate offers a potential alternative to traditional bowel management methods, leading to more predictable and efficient bowel evacuation.

Enhanced Quality of Life

By reducing bowel evacuation time and improving overall bowel care, this approach may enhance the quality of life for individuals with SCI and DWE.

Reduced Complications

The more complete bowel evacuation achieved with this method could potentially reduce complications associated with constipation, stool impaction, and stool incontinence.

Study Limitations

1
Small sample size (n=6)
2
Study was conducted on hospitalized patients, limiting generalizability to the home setting
3
The iontophoresis device used was wired, posing a challenge for routine clinical use

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury