Clinical–alimentary tractA Randomized, Controlled Trial of Transanal Irrigation Versus Conservative Bowel Management in Spinal Cord–Injured Patients
Section snippets
Patients
Between December 2003 and June 2005, 87 patients (Figure 1 and Table 1) with spinal cord injury and neurogenic colorectal dysfunction were randomly assigned to either transanal irrigation or conservative bowel management. Patients were recruited from 5 spinal cord injury centers in 5 European countries (Spinalis, Karolinska Sjukhuset, Stockholm, Sweden; Montecatone Rehabilitation Institute, Bologna, Italy; Orthopädische Universitätsklinik, Heidelberg, Germany; National Spinal Injuries Centre,
Results
Of the 124 eligible patients, 37 patients could not be included in the study. Therefore, 87 patients were included and randomly assigned to the 2 treatment groups: 45 patients to conservative bowel management and 42 patients to transanal irrigation (Figure 1). At baseline, there was no systematic difference between groups on comparing outcome parameters (Table 2).
Of the 45 patients in the conservative bowel management group, 2 patients discontinued before training with the specialist nurse; one
Discussion
Bowel dysfunction exerts a major impact on the life situation of patients with spinal cord injury.1, 2, 4 The present study is the largest randomized, controlled, multicenter trial addressing bowel management in patients with spinal cord injury. The aim of the study was to compare transanal irrigation with conservative bowel management, defined as best supportive bowel management without using irrigation.
Before the study, many of the patients had struggled with bowel dysfunction for years. With
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Supported by Coloplast A/S, Continence Care Division, Kokkedal, Denmark.