Chronic abdominal pain in long-term spinal cord injury: a follow-up study

Abstract

Study design: A longitudinal postal survey. Objectives: To evaluate the prevalence and characteristics of abdominal pain in long-term spinal cord injury (SCI). Setting: Members of the Danish SCI Association. Methods: In 2006, a questionnaire on chronic abdominal pain and discomfort was sent to the 284 members of the Danish SCI association who had been members for at least 10 years; 203 of them responded. An almost identical questionnaire including questions on intensity and interference of pain within the past 7 days, as well as descriptors and treatment, was sent to the 178 surviving members in 2015.Results: Of 130 (73%) responders, 125 answered the question on chronic abdominal pain. The mean time since injury was 30.5 (9.8) years. Chronic abdominal pain or discomfort was reported by 32.8% (41/125), and 23% (29/125) of responders had been at least moderately bothered by this in the past week. Abdominal pain or discomfort was more common in women and in those with self-reported constipation. The median intensity (numeric rating scale) was 6.0 (range 3-10) and it was often associated with autonomic symptoms. Nine (8%) of the 115 individuals who responded in both 2006 and 2015 had developed new abdominal pain or discomfort, 30 (26%) no longer reported it, and 28 (24%) reported it at both time points with a similar intensity. Conclusions: Chronic abdominal pain or discomfort is common and bothersome in long-term SCI. It has a late onset, but the prevalence and severity do not seem to further increase between 20 and 30 years following SCI.

Ageing with neurogenic bowel dysfunction

“…8 An ongoing multicentre study from the Netherlands will further address this question. 20 It is well known from the general population that advancing age is associated with a higher prevalence of constipation [21][22][23] and faecal incontinence. 21,24 The aim of the present study was not to compare bowel symptoms between participants with SCI and the general population.…”

“…Nine questions regarding abdominal pain and discomfort were also included but these results are published elsewhere. 20 The validity and reproducibility of the questionnaire were tested in the original 1996 study. 8 Members who did not respond after a 3-week period were sent a reminder, encouraging them to participate.…”

Neural pathways for colorectal control, relevance to spinal cord injury and treatment: a narrative review

“…Chronic abdominal pain was found to affect over 30% of paraplegic respondents to a longitudinal postal survey with a mean time post injury of 30 years [50]. The abdominal pain was related to constipation with a higher frequency of self-reported constipation.…”

Dolor en la persona con lesión medular

“…Este dolor incluye la cefalea de la disreflexia autonómica. Se puede manifestar como dolor o malestar abdominal, es más frecuente en mujeres y se asocia a constipación, infecciones vesicales, ingesta de alimentos, estrés y defecación, aunque en algunos pacientes esta últimao la micción-pueden mejorar los síntomas 17 . Debe recordarse que, tanto los órganos abdominales como los pélvicos, no están inervados en forma segmentaria, por lo cual el dolor que proviene de su distensión, isquemia o inflamación es poco localizado; además, el nervio vago puede llevar alguna información nociceptiva visceral que explique el malestar abdominal impreciso que reportan algunos pacientes con lesiones completas y enfermedad abdominal sobreagregada.…”