Method: To determine the baseline differences, thirty three patients were classified into two groups: cord injured level above T9 and from T9 to L2. And thirteen patients were included in follow-up study to evaluate the effects of 4 weeks electrical stimulation.

Results: There was no significant difference in the baseline colon transit time on two groups. After electrical stimulation, the left and rectosigmoid transit time was more improved in lower level injured group comparing with upper level injured group. In the rectoanal manometry the mean resting anal pressure, mean squeezing pressure, high pressure zone, and threshold of rectoanal inhibitory reflex were increased after the electrical stimulation on two groups. And the mean squeezing pressure on T9-L2 injured patients was significantly increased (p＜0.05).

Conclusion: The elecrical stimulation to the sacral dermatomes increased the mean squeezing pressure of rectoanal manometry more significantly on the T9-L2 injured patients than the group of spinal cord injured level above T9. However, there was no statistically significant difference in the colon transit time before and after the electrical stimulation between two groups (J Korean Acad Rehab Med 2003; 27: 880-885)

Objective: To evaluate effects of the electrical stimulation to the sacral dermatomes for the neurogenic bowel of the spinal cord injured patients.

Method: Eleven patients with cervical and thoracic cord injury were enrolled, and classified into two groups, control and electrical stimulation (ES) group. The colon transit time before and after electrical stimulation for 4 weeks to the sacral dermatomes were measured on the ES group, and measured at the same time on control group. The rectoanal manometries were performed after studies of colon transit time on the ES group.

Results: The colon transit time measured before electrical stimulation were 16.1⁑13.8 hours for the right colon; 20.1⁑23.3 hours for the left colon; 14.7⁑12.3 hours for the rectosigmoid colon; and the total transit time was 51.0⁑23.4 hours. The time of after electrical stimulation was 8.0⁑5.7 hours for the right colon; 12.8⁑2.2 hours for the left colon; 15.4⁑13.8 hours for the rectosigmoid colon; and the total transit time was 36.2⁑12.8 hours. The left colon transit time and total colon transit time before electrical stimulation were significantly improved compared to after electrical stimulation on the ES group (p＜0.05). The left colon transit time of the ES group was significantly improved compared with control group (p＜0.05). In the rectoanal manometry, the mean resting anal pressure and threshold of rectoanal inhibitory reflex were increased after the electrical stimulation.

Conclusion: The electrical stimulation to the sacral dermatomes on the spinal cord injured patient could effectively enhance colon transit, especially on the left colon. In addition, muscular activity of the anal sphincter was enhanced.

Objective: To evaluate changes of colon transit time according to prokinetic medication and characteristics of the anorectal manometry in patients with neurogenic bowel due to spinal cord injury.

Method: Twelve patients with cervical and thoracic cord injury were enrolled, and classified into complete and incomplete spinal cord injury according to the severity of injury. The colon transit time before and after prokinetic medications were measured. The anorectal manometry was performed after the first study of colon transit time.

Results: The colon transit time of pre-prokinetic medications were 17.1⁑12.6 hours for the right colon, 26.9⁑13.2 for the left colon, 21.5⁑14.0 for the rectosigmoid colon, and the total transit time was 65.5⁑5.3 hours. The time of post-prokinetic medications was 14.3⁑7.6 hours for the right colon, 25.8⁑10.3 for the left colon, 7.4⁑5.3 for the rectosigmoid colon, and the total transit time was 33.1⁑11.5 hours. The rectosigmoid colon transit time and total colon transit time were significantly different between pre- and post-prokinetic medications (p＜0.05). In the anorectal manometry, mean resting anal pressure was 33.3⁑10.7 mmHg and maximal resting anal pressure was 99.0⁑43.4 mmHg. There were no difference in the colon transit time and anorectal manometry between complete and incomplete injured patients.

Conclusion: The difficulties of defecation in spinal cord injured patients were not only due to uncontrolled anal sphincter but also due to dysfunction of colon motility. The prokinetic medications were effective in reducting the rectosigmoid and total colon transit time.