Written by: Dr. Kim Anderson
As part of the MetroHealth Spinal Cord Injury (SCI) Model Systems program, we are participating in a multi-center collaborative study being led by the Rancho Los Amigos Rehabilitation Center in Los Angeles, California. This study is about bowel function, which we know is very important to many people living with SCI.
- The main goal of this study is to find out how bowel function after SCI impacts a person’s quality of life. This includes things like life satisfaction, choices related to food, relationships with family/friends, limitations on daily activities, and decisions about participation in sexual activity.
- Another goal is to learn whether there are factors that can be changed to improve a person’s bowel function. These would be considered modifiable factors.
- A final goal is to better understand how bowel function and bladder function are related to each other after SCI. The bladder and bowel are controlled by similar nerves in the body. If we can better understand their relationship, we may be able to target improvement in one and see benefits in both.
This study will involve 2 groups of people with SCI:
- Acute – those who are newly injured and within 6 months of injury onset
- Chronic – those who have been living with SCI for 5 or more years.
The reason for enrolling 2 groups of people and following them is that we do not really understand how bowel function changes across long periods of time and how similar or different those changes are early after injury (acute) versus later after injury (chronic).
In the acute group, people with new SCI will be enrolled while they are in their initial inpatient rehabilitation hospital stay and we will follow them for three years. During that time, we will interview them at 3 time points (6-months post-injury and 1- and 2-years post injury) to learn information related to the 3 goals described above. In the chronic group, people who are already participating in the National SCI Database and who are at least 5 years post-injury will be enrolled and followed for two years. During that time, we will interview them at 2 time points (when they are initially enrolled and then 2 years later). Overall, we will enroll 324 participants across four SCI Model System centers (our site in Cleveland plus Rancho Los Amigos, Santa Clara Valley in San Francisco, and Kessler in West Orange New Jersey).
Results of this multi-center study will quantify the effect of bowel function on quality of life and identify what factors can be modified to improve quality of life. It will also contribute to understanding the progression of bowel dysfunction during the first three years of injury, which could allow clinicians to intervene at the right time points to improve bowel outcomes before they become really difficult to manage. Finally, we will learn how to better manage bladder and bowel function simultaneously by understanding how they are interrelated in the real-world experience.