start-ver=1.4
cd-journal=joma
no-vol=61
cd-vols=
no-issue=4
article-no=
start-page=221
end-page=227
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2007
dt-pub=200708
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Autonomic Dysreflexia during a Bowel Program in Patients with Cervical Spinal Cord Injury.
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=The purpose of the present study was to investigate the relationship between bowel maneuvers and autonomic dysreflexia (AD) in patients with cervical spinal cord injuries (CSCI). Fifteen consecutive, clinically stable patients with CSCI participated. We evaluated changes in blood pressure (BP), pulse rate (PR) and classic symptoms of AD before, during and after a bowel program involving the manual removal of stool in lateral recumbency. The insertion of rectal medication induced a significant increase in systolic BP, which persisted during additional digital rectal stimulation. Furthermore, the manual removal of stool induced AD, with maximal increases of systolic BP (169.1(+-)19.5 mmHg, mean(+-)SD). However, the insertion of a finger into the anus after the end of stool flow did not cause a further increase in systolic BP. Systolic BP recovered to pre-program values within 5 min after defecation. Our study demonstrated that the combined effects of rectal and/or anal sphincter distension and uninhibited rectal contraction in response to the manual removal of stool might induce AD. We recommend avoiding, if at all possible, the manual removal of stool in order to prevent AD in patients with CSCI.
en-copyright=
kn-copyright=

en-aut-name=FurusawaKazunari
en-aut-sei=Furusawa
en-aut-mei=Kazunari
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=

en-aut-name=SugiyamaHiroyuki
en-aut-sei=Sugiyama
en-aut-mei=Hiroyuki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=

en-aut-name=IkedaAtsushi
en-aut-sei=Ikeda
en-aut-mei=Atsushi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=

en-aut-name=TokuhiroAkihiro
en-aut-sei=Tokuhiro
en-aut-mei=Akihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=

en-aut-name=KoyoshiHiroko
en-aut-sei=Koyoshi
en-aut-mei=Hiroko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=

en-aut-name=TakahashiMasanori
en-aut-sei=Takahashi
en-aut-mei=Masanori
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=

en-aut-name=TajimaFumihiro
en-aut-sei=Tajima
en-aut-mei=Fumihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=

affil-num=1
en-affil=
kn-affil=Kibikogen Rehabilitation Center for Employment Injuries

affil-num=2
en-affil=
kn-affil=Kibikogen Rehabilitation Center for Employment Injuries

affil-num=3
en-affil=
kn-affil=Kibikogen Rehabilitation Center for Employment Injuries

affil-num=4
en-affil=
kn-affil=Kibikogen Rehabilitation Center for Employment Injuries

affil-num=5
en-affil=
kn-affil=Kibikogen Rehabilitation Center for Employment Injuries

affil-num=6
en-affil=
kn-affil=University of Occupational and Environmental Health

affil-num=7
en-affil=
kn-affil=Wakayama Medical University
en-keyword=spinal cord injury
kn-keyword=spinal cord injury
en-keyword=autonomic dysrefl exia
kn-keyword=autonomic dysrefl exia
en-keyword=blood pressure
kn-keyword=blood pressure
en-keyword=bowel program
kn-keyword=bowel program
END