Ann Rehabil Med.  2012 Jun;36(3):371-378. 10.5535/arm.2012.36.3.371.

Bowel Dysfunction and Colon Transit Time in Brain-Injured Patients

• Lim YH
• Kim DH
• Lee MY
• Joo MC

• KMID: 2266743
• DOI: http://doi.org/10.5535/arm.2012.36.3.371

Abstract

OBJECTIVE
To report the defecation patterns of brain-injured patients and evaluate the relationship between functional ability and colon transit time (CTT) in stroke patients. METHOD: A total of 55 brain-injured patients were recruited. Patient interviews and medical records review of pattern of brain injury, anatomical site of lesion, bowel habits, constipation score, and Bristol scale were conducted. We divided the patients into constipation (n=29) and non-constipation (n=26) groups according to Rome II criteria for constipation. The CTTs of total and segmental colon were assessed using radio-opaque markers Kolomark(R) and functional ability was evaluated using the functional independence measure (FIM).
RESULTS
Constipation scores in constipation and non-constipation groups were 7.32+/-3.63 and 5.04+/-2.46, respectively, and the difference was statistically significant. The CTTs of the total colon in both groups were 46.6+/-18.7 and 32.3+/-23.5 h, respectively. The CTTs of total, right, and left colon were significantly delayed in the constipation group (p<0.05). No significant correlation was found between anatomical location of brain injury and constipation score or total CTT. Only the CTT of the left colon was delayed in the patient group with pontine lesions (p<0.05).
CONCLUSION
The constipation group had significantly elevated constipation scores and lower Bristol stool form scale, with prolonged CTTs of total, right, and left colon. In classification by site of brain injury, we did not find significantly different constipation scores, Bristol stool form scale, or CTTs between the groups with pontine and suprapontine injury.

Keyword

Bowel dysfunction; Colon transit time; Brain injury

MeSH Terms

Brain Injuries
Colon
Constipation
Defecation
Humans
Medical Records
Rome
Stroke

Figure

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  Fig. 1 The comparison of constipation score and Bristol scale in constipation and non-constipation group. Values are expressed mean±SD. *Denotes significant difference between constipation and non-constipation group (*p<0.05).

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  Fig. 2 The results of total and segmental colon transit time between constipation and non-constipation group. Values are expressed mean±SD. *Denotes significant difference between constipation and non-constipation group in right, left and total colon transit time (*p<0.05).

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  Fig. 3 The comparison of constipation score and Bristol scale between suprapontine and pontine lesion group. Values are expressed mean±SD. There was no significant difference in constipation score and Bristol scale.

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  Fig. 4 The results of total and segmental colon transit time between suprapontine and pontine lesion group. Values are expressed mean±SD. *Denotes significant difference between suprapontine and pontine lesion group in left colon transit time (*p<0.05).

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