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Neurogenic Bowel Dysfunction in Children and Adolescents
Article

Neurogenic Bowel in Acute Rehabilitation Following Spinal Cord Injury: Impact of Laxatives and Opioids

1
International Collaboration on Repair Discoveries (ICORD), Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
2
Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
3
Department of Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, ON K1H 8M2, Canada
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Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan 570-749, Korea
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Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada
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Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
7
GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC V5Z 2G9, Canada
*
Author to whom correspondence should be addressed.
Co-first authors.
Academic Editors: Mark A. Korsten and Gian Paolo Caviglia
J. Clin. Med. 2021, 10(8), 1673; https://doi.org/10.3390/jcm10081673
Received: 26 February 2021 / Revised: 16 March 2021 / Accepted: 10 April 2021 / Published: 14 April 2021
(This article belongs to the Special Issue Neurogenic Bowel Dysfunction)
Objective: To explore the association between bowel dysfunction and use of laxatives and opioids in an acute rehabilitation setting following spinal cord injury (SCI). Methods: Data was collected regarding individuals with acute traumatic/non-traumatic SCI over a two-year period (2012–2013) during both the week of admission and discharge of their inpatient stay. Results: An increase in frequency of bowel movement (BM) (p = 0.003) and a decrease in frequency of fecal incontinence (FI) per week (p < 0.001) between admission and discharge was found across all participants. There was a reduction in the number of individuals using laxatives (p = 0.004) as well as the number of unique laxatives taken (p < 0.001) between admission and discharge in our cohort. The number of individuals using opioids and the average dose of opioids in morphine milligram equivalents (MME) from admission to discharge were significantly reduced (p = 0.001 and p = 0.02, respectively). There was a positive correlation between the number of laxatives and frequency of FI at discharge (r = 0.194, p = 0.014), suggesting that an increase in laxative use results in an increased frequency of FI. Finally, there was a significant negative correlation between average dose of opioids (MME) and frequency of BM at discharge, confirming the constipating effect of opioids (r = −0.20, p = 0.009). View Full-Text
Keywords: bowel dysfunction; acute rehabilitation; spinal cord injury; laxatives; opioids; SCI bowel management bowel dysfunction; acute rehabilitation; spinal cord injury; laxatives; opioids; SCI bowel management
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MDPI and ACS Style

Round, A.M.; Joo, M.C.; Barakso, C.M.; Fallah, N.; Noonan, V.K.; Krassioukov, A.V. Neurogenic Bowel in Acute Rehabilitation Following Spinal Cord Injury: Impact of Laxatives and Opioids. J. Clin. Med. 2021, 10, 1673. https://doi.org/10.3390/jcm10081673

AMA Style

Round AM, Joo MC, Barakso CM, Fallah N, Noonan VK, Krassioukov AV. Neurogenic Bowel in Acute Rehabilitation Following Spinal Cord Injury: Impact of Laxatives and Opioids. Journal of Clinical Medicine. 2021; 10(8):1673. https://doi.org/10.3390/jcm10081673

Chicago/Turabian Style

Round, Andrew M., Min C. Joo, Carolyn M. Barakso, Nader Fallah, Vanessa K. Noonan, and Andrei V. Krassioukov. 2021. "Neurogenic Bowel in Acute Rehabilitation Following Spinal Cord Injury: Impact of Laxatives and Opioids" Journal of Clinical Medicine 10, no. 8: 1673. https://doi.org/10.3390/jcm10081673

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