Sensation of defecation in patients with spinal cord injury

Study design: For this study, a descriptive, explorative design was used. Objectives: As a result of spinal cord injury (SCI) patients may have a partial or complete loss of the sensations of defecation. To compensate this impairment, nurses initiate bowel management programs. Therefore, they need information about sensations of defecation. Accordingly, the research questions explore which sensations of defecation are reported by patients with SCI and whether they can be used to improve bowel care. Setting: The Gemeinschaftskrankenhaus Herdecke and the Berufsgenossenschaftlichen Kliniken Bergmannsheil in Bochum, Germany. Methods: A convenience sample of 27 patients with SCI was interviewed using a semistructured questionnaire. For data analysis, the frequency of the reported sensations was counted. Results: The results of the study show that the participants' defecation was indicated by abdominal sensations (n = 20) or a prickling sensation (n = 11) emerging mainly in the head. Additional signals comprised increased spasticity (n = 10), cutis anserina (n = 8) and sweating (n = 6). Seventeen participants sensed actual defecation and 15 perceived its cessation. Six participants were able to initiate defecating according to their sensations. Conclusions: The assessment of sensations of defecation in patients with SCI may indicate whether a bowel-management program with a consistent schedule for defecation is needed or if physiological defecation can be trained.