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Autonomic Dysreflexia

Prevention of AD With Stoma

Neurogenic bowel dysfunction is increasingly recognized as a major barrier to increasing quality of life in people with SCI. Bowel management difficulties include constipation, abdominal pain, faecal incontinence, prolonged transit time, and AD. The treatment of neurogenic bowel dysfunction with stoma usually takes place when other interventions such as transanal irrigation, pharmacological agents, etc. have failed.

Author Year; Country
Research Design
Sample Size
Methods Outcome
Coggrave et al. 2012;




Population: 92 subjects with SCI and stoma (64M, 28F); mean (SD) age in yrs: 56(9), range 24-86; mean (SD) age at injury (yrs): 30(13), range 6-64; 26 cervical (15 complete, 10 incomplete, 1 unknown), 61 thoracic (49 complete, 10 incomplete, 2 unknown), 1 missing data on level of injury; 91% colostomy, 9% ileostomy.

Treatment: Retrospective analysis of a self-report postal survey of individuals with SCI who had a stoma.

Outcome Measures: Tennessee Self-Concept Scale; Satisfaction with Life Scale; Hospital Anxiety and Depression Scale; rating scales for satisfaction, ability to live with bowel dysfunction and how much bowel care restricts life.

1.     19 respondents reported autonomic dysreflexia as their reason for stoma surgery.

2.     Autonomic dysreflexia associated with bowel management was reported by significantly fewer respondents following stoma surgery (37% before, 18% afte


One cross-sectional study (n=92) completed a retrospective analysis participants who had stomas. Following stoma surgery, significantly fewer respondents reported AD associated with bowel management (37% before, 18% after).


There is level 4 evidence (Coggrave et al. 2012) that AD associated with bowel management decreases following stoma surgery.

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