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Three Decades of Spinal Cord Injury in Saudi Arabia: Trends in Incidence, Prevalence, and Disability Outcomes
 
 
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Volume 15
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10.3390/jcm15020760
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Gastrointestinal Diagnostic Coding After Spinal Cord Injury: Health Behavior Correlates and Implications for Neurogenic Bowel Management in a Nationwide Claim-Based Cohort

by
Young-Hwan Lim
1,
Jae-Hyeong Yoo
1,
Jeong-Won Park
1,
Jong-Moon Hwang
2,
Dongwoo Kang
3,
Jungkuk Lee
3,
Hyun Wook Han
4,5,
Kyung-Tae Kim
6,7,
Myung-Gwan Kim
4,5,* and
Tae-Du Jung
8,9,*
1
Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
2
Department of Rehabilitation Medicine, Happy Rehabilitation Medicine Clinic, Daegu 42122, Republic of Korea
3
Department of Data Science, Hanmi Pharmaceutical Co., Ltd., Seoul 05545, Republic of Korea
4
Department of Biomedical Informatics, Graduate School of Medicine, CHA University, Seongnam 13488, Republic of Korea
5
Institute for Biomedical Informatics, Graduate School of Medicine, CHA University, Seongnam 13488, Republic of Korea
6
Department of Neurosurgery, Bokwang Hospital, Daegu 42734, Republic of Korea
7
Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
8
Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
9
Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(2), 760; https://doi.org/10.3390/jcm15020760 (registering DOI)
Submission received: 8 December 2025 / Revised: 27 December 2025 / Accepted: 2 January 2026 / Published: 16 January 2026
(This article belongs to the Special Issue State of the Art in Spinal Cord Injuries: Clinical Rehabilitation and Management)
Versions Notes

Abstract

Background: Neurogenic bowel dysfunction (NBD) is a major chronic sequela of spinal cord injury (SCI) with substantial implications for rehabilitation and long-term management. However, population-level evidence describing how gastrointestinal (GI) diagnostic codes are used following SCI, particularly within administrative healthcare systems, remains limited. Methods: We conducted a nationwide retrospective cohort study using administrative claims data from the Korean National Health Insurance Service (NHIS). A total of 584,266 adults with trauma-related SCI encounters between 2009 and 2019 were identified. GI diagnostic codes—paralytic ileus (K56), irritable bowel syndrome (K58), and functional bowel disorders (K59)—were evaluated as administrative proxies for bowel dysfunction. Demographic characteristics, disability status, regional factors, and health behaviors were analyzed using multivariable logistic regression. Results: GI diagnostic codes were frequently recorded after SCI, most commonly irritable bowel syndrome (approximately 30%) and functional bowel disorders (approximately 37%), whereas paralytic ileus was uncommon. Greater disability severity, female sex, older age, and rural residence were consistently associated with higher odds of GI diagnostic coding. Physical activity showed robust inverse associations across all models. Inverse associations observed with smoking and alcohol consumption were interpreted as reflecting residual confounding or health-related selection, rather than biological protective effects. Conclusions: Patterns of GI diagnostic coding after SCI likely reflect the clinical burden and management needs of neurogenic bowel dysfunction within healthcare systems, rather than the development of new gastrointestinal diseases. These findings underscore the importance of individualized bowel management, incorporation of structured physical activity into rehabilitation programs, and equitable access to SCI rehabilitation services, particularly for individuals with greater disability or those living in rural areas.
Keywords: spinal cord injury; gastrointestinal diagnostic codes; neurogenic bowel dysfunction; physical activity; nationwide cohort study spinal cord injury; gastrointestinal diagnostic codes; neurogenic bowel dysfunction; physical activity; nationwide cohort study

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MDPI and ACS Style

Lim, Y.-H.; Yoo, J.-H.; Park, J.-W.; Hwang, J.-M.; Kang, D.; Lee, J.; Han, H.W.; Kim, K.-T.; Kim, M.-G.; Jung, T.-D. Gastrointestinal Diagnostic Coding After Spinal Cord Injury: Health Behavior Correlates and Implications for Neurogenic Bowel Management in a Nationwide Claim-Based Cohort. J. Clin. Med. 2026, 15, 760. https://doi.org/10.3390/jcm15020760

AMA Style

Lim Y-H, Yoo J-H, Park J-W, Hwang J-M, Kang D, Lee J, Han HW, Kim K-T, Kim M-G, Jung T-D. Gastrointestinal Diagnostic Coding After Spinal Cord Injury: Health Behavior Correlates and Implications for Neurogenic Bowel Management in a Nationwide Claim-Based Cohort. Journal of Clinical Medicine. 2026; 15(2):760. https://doi.org/10.3390/jcm15020760

Chicago/Turabian Style

Lim, Young-Hwan, Jae-Hyeong Yoo, Jeong-Won Park, Jong-Moon Hwang, Dongwoo Kang, Jungkuk Lee, Hyun Wook Han, Kyung-Tae Kim, Myung-Gwan Kim, and Tae-Du Jung. 2026. "Gastrointestinal Diagnostic Coding After Spinal Cord Injury: Health Behavior Correlates and Implications for Neurogenic Bowel Management in a Nationwide Claim-Based Cohort" Journal of Clinical Medicine 15, no. 2: 760. https://doi.org/10.3390/jcm15020760

APA Style

Lim, Y.-H., Yoo, J.-H., Park, J.-W., Hwang, J.-M., Kang, D., Lee, J., Han, H. W., Kim, K.-T., Kim, M.-G., & Jung, T.-D. (2026). Gastrointestinal Diagnostic Coding After Spinal Cord Injury: Health Behavior Correlates and Implications for Neurogenic Bowel Management in a Nationwide Claim-Based Cohort. Journal of Clinical Medicine, 15(2), 760. https://doi.org/10.3390/jcm15020760

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