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Abdominal pain in long-term spinal cord injury.

https://arctichealth.org/en/permalink/ahliterature86843
Source
Spinal Cord. 2008 Mar;46(3):198-203
Publication Type
Article
Date
Mar-2008
Author
Finnerup N B
Faaborg P.
Krogh K.
Jensen T S
Author Affiliation
Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark. finnerup@ki.au.dk
Source
Spinal Cord. 2008 Mar;46(3):198-203
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Abdominal Pain - etiology - physiopathology
Adolescent
Adult
Aged
Aged, 80 and over
Chronic Disease
Colon - physiopathology
Constipation - complications - physiopathology
Denmark
Female
Health Surveys
Humans
Male
Middle Aged
Prevalence
Rectum - physiopathology
Spinal Cord Injuries - complications - physiopathology
Abstract
OBJECTIVES: To describe the prevalence and character of chronic abdominal pain in a group of patients with long-term spinal cord injury (SCI) and to assess predictors of abdominal pain. STUDY DESIGN: Postal survey. SETTING: Members of the Danish Paraplegic Association. METHODS: We mailed a questionnaire to 284 members of the Danish Paraplegic Association who met the inclusion criteria (member for at least 10 years). The questionnaire contained questions about cause and level of spinal injury, colorectal function and pain/discomfort. RESULTS: Seventy percent returned the questionnaire (133 men and 70 women). Mean age was 47 years. Thirty-four percent reported having chronic abdominal pain or discomfort. Onset of pain was later than 5 years after their SCI in 53%. Low defecation frequency was more common in patients with abdominal pain/discomfort and constipation more often affected their quality of life compared to patients without abdominal pain/discomfort. The most common descriptors were annoying, cramping/tightening, tender, sickening and shooting/jolting. There was no relation to age, time since injury or level of injury, but more women than men reported abdominal pain/discomfort. There was no relation of abdominal pain to other types of pain. CONCLUSION: Chronic pain located in the abdomen is frequent in patients with long-term SCI. The delayed onset following SCI and the relation to constipation suggest that constipation plays an important role for this type of pain in the spinal cord injured.
PubMed ID
17621311 View in PubMed
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Long-term outcome and safety of transanal colonic irrigation for neurogenic bowel dysfunction.

https://arctichealth.org/en/permalink/ahliterature90663
Source
Spinal Cord. 2009 Jul;47(7):545-9
Publication Type
Article
Date
Jul-2009
Author
Faaborg P M
Christensen P.
Kvitsau B.
Buntzen S.
Laurberg S.
Krogh K.
Author Affiliation
Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark. pmfaaborg@gmail.com
Source
Spinal Cord. 2009 Jul;47(7):545-9
Date
Jul-2009
Language
English
Publication Type
Article
Abstract
STUDY DESIGN: Long-term follow-up study. OBJECTIVES: Short-term results find transanal colonic irrigation (TAI) favourable in the treatment of neurogenic bowel dysfunction (NBD). Therefore, long-term results need to be described. SETTING: Department of Surgery P, Aarhus University Hospital, Denmark. METHODS: Between 1994 and 2007, 211 (115 female) patients with NBD (age: 7-81 years (median 49)) were introduced to TAI. One hundred and seventy-three patients had spinal cord injury and 38 had other neurological disorders. Data were obtained from hospital records and a mailed questionnaire. Treatment was considered successful in patients still using TAI, patients who had used TAI until they died and patients whose symptoms had resolved while using TAI. RESULTS: Successful outcome was achieved in 98 (46%) patients after a mean follow-up of 19 months (range 1-114 months). A Kaplan-Meier plot showed a dropout of 20% in the first 3 months. After 3 years, the rate of success was 35% and remained almost unchanged afterwards. A regression analysis showed male gender (odds ratio (OR) 2.1), mixed symptoms (OR 2.9) and prolonged colorectal transit time (OR 2.4) to be significantly associated with successful outcome. One non-lethal bowel perforation occurred in approximately 50,000 irrigations (0.002%), whereas minor side effects were observed in 48%. CONCLUSION: After a mean follow-up of 19 months, 46% was successfully treated. The rate of success was 35% after 3 years and remained almost unchanged afterwards. TAI is safe and can be introduced to most patients suffering from NBD.
PubMed ID
19104513 View in PubMed
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Source
Spinal Cord. 2006 Oct;44(10):625-31
Publication Type
Article
Date
Oct-2006
Author
Krogh K.
Christensen P.
Sabroe S.
Laurberg S.
Author Affiliation
Surgical Research Unit, Department of Surgery L, Section THG, University Hospital of Aarhus, Aarhus, Denmark.
Source
Spinal Cord. 2006 Oct;44(10):625-31
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Constipation - etiology
Cross-Sectional Studies
Disability Evaluation
Fecal Incontinence - etiology
Female
Gastrointestinal Diseases - etiology - psychology
Humans
Logistic Models
Male
Middle Aged
Quality of Life
Questionnaires
Reproducibility of Results
Sickness Impact Profile
Spinal Cord Injuries - complications - psychology
Urinary Incontinence - etiology
Abstract
STUDY DESIGN: Cross-sectional questionnaire study. OBJECTIVES: To develop and validate a symptom-based score for neurogenic bowel dysfunction (NBD): NBD score. SETTING: University Hospital of Aarhus, Denmark. METHODS: A questionnaire including questions about background parameters (n=8), faecal incontinence (n=10), constipation (n=10), obstructed defecation (n=8), and impact on quality of life (QOL) (n=3) was sent to 589 Danish spinal cord injured (SCI) patients. The reproducibility and validity of each item was tested in 20 and 18 patients, respectively. Associations between items and impact on QOL were determined by logistic regression analysis. The NBD score was constructed from items with acceptable reproducibility and validity that were significantly associated with impact on QOL. Based on odds ratios for associations between items and impact on QOL, each item was given a corresponding number of points in the NBD score. RESULTS: A total of 424 SCI patients responded. The following 10 items met the criteria above: frequency of bowel movements (0-6 points), headache, perspiration or discomfort before or during defecation (0-2 points), tablets and drops against constipation (0-2 points each), time used for each defecation (0-7 points), frequency of digital stimulation or evacuation (0-6 points), frequency of faecal incontinence (0-13 points), medication against faecal incontinence (0-4 points), flatus incontinence (0-2 points) and perianal skin problems (0-3 points). Differences in NBD score among patients reporting no, little, some or major impact on QOL were statistically significant (all P
PubMed ID
16344850 View in PubMed
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