Assistive Devices
In addition to standard bowel protocols and pharmacological modalities, numerous devices were evaluated as means to improve bowel evacuation in individuals with SCI. These include a standing table and a modified toilet seat.
Discussion
Hoenig et al. (2001) reported the case of an individual with SCI who, through the use of a standing table, doubled the frequency of his bowel movements and reduced time spent on bowel care. Uchikawa et al. (2007) developed a new procedure to induce bowel movements using a toilet seat equipped with an electronic bidet that provides water flow to the anorectal area. A CCD camera and light are included to facilitate location of the anorectal area. The authors report that a reduction in the time needed for bowel management, with an additional 8 (40%) subjects who can complete defecation in less than 30 minutes.
Conclusion
There is level 5 evidence (from one case report with one subject: Hoenig et al. 2001) that a standing table alleviates constipation in an individual with SCI.
There is level 4 evidence (from one cross-sectional study: Uchikawa et al. 2007) that a newly developed washing toilet seat with a CCD camera monitor for visual feedback reduces time spent on bowel care.