Effect of stoma formation on bowel care and quality of life in patients with spinal cord injury

Abstract

Introduction: Bowel management is a significant source of concern for patients with spinal cord injury (SCI) and may significantly alter quality of life. The effect of colostomy formation on both quality of life and time taken for bowel care is well recorded. We report our experience of intestinal stoma formation in SCI patients.

Methods: Medical records from the spinal unit, operating theatres and stoma clinics were reviewed to identify SCI patients for whom a stoma had been formed. Patients were interviewed using a standard questionnaire. Average age at injury was 29 years (range 6-62 years). Mean time from injury to stoma formation was 17 years (range 0-36.25 years) and the mean period of poor bowel function prior to stoma was 8 years (range 1.5-25).

Results: The average time spent on bowel care per week decreased from 10.3 h (range 3.5-45) prior to stoma formation to 1.9 h (range 0.5-7.75) afterwards (P<0.0001, paired t-test). In all, 18 patients felt that a stoma gave them greater independence and quality of life was described as much better by 25 patients. Complications occurred in 14 patients - eight described leakage of mucus and occasionally blood and pus per rectum, three developed parastomal hernias and three developed bowel obstruction.

Conclusion: Elective stoma formation is a safe and well-accepted treatment for the management of chronic gastrointestinal symptoms in patients with SCI.