Use of Prokinetics During Inpatient Bowel Care for SCI Patients
Unknown status
James J. Peters Veterans Affairs Medical Center
Phase 1
2012-12-01
Bowel care (BC) is a time-consuming and cumbersome activity of daily living for most
individuals with SCI. Previous studies have reported that the average time to complete a BC
routine is 45 minutes; 10-20% of SCI individuals report BC routines lasting for more than 1
hour. In past studies, the investigators have shown that a medication called neostigmine can
increase bowel activity and thus, promote bowel movement. The investigators have successfully
used this medication with traditional and novel methods of colonoscopic preparations, and
have shown that it improves the quality of these preparations. In this study, we would like
to test the applicability of this medication to bowel care routines.
The investigators believe that the addition of this medication to the beginning of regular
bowel regiments will significantly decrease the time and effort needed to complete BC, thus
improving patient perception of their BC routines and quality of life. SCI individuals
followed by the James J Peters VA Medical Center (JJPVAMC) SCI Medical Service are admitted
on a routine basis for inpatient respite care, therapy, and/or annual physicals. Such
inpatient stays typically range in duration from 1 week to 3 weeks, during which the patient
undergo BC routines assisted by the inpatient care team. BC routines are typically performed
every other day, or thrice weekly (Monday, Wednesday, Friday) in "Blue Rooms" located on the
inpatient SCI wards (IE and ID). The bowel care routine, including duration of procedure, use
of assistive medications or devices, and completeness of bowel care are documented in the
patients' electronic medical chart (CPRS) by care providers. The investigators propose to
perform the described protocol in individuals who have been admitted to the hospital for
routine care and are otherwise healthy. In doing so, the investigators can ensure that
patients are vigilantly monitored during each BC session, and that any changes in BC pattern
are accurately observed and documented. Furthermore, by performing these procedures on an
inpatient basis, study investigators can ensure the consistency of care and daily routine,
allowing for better control of study conditions.
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