Neurogenic bowel dysfunction in subjects with brain injury : prevalence, risk factors, clinical characterization and physiopathology

Haya Hidalgo, Jenny Rosario

Neurogenic bowel dysfunction in subjects with brain injury : prevalence, risk factors, clinical characterization and physiopathology

Document Type

Doctoral thesis
Published Version

Author

Haya Hidalgo, Jenny Rosario

Director

Delgado Aros, Silvia

Publication Date

2018-12-19

Pages

49 p.

Citation

Haya Hidalgo, J. Neurogenic bowel dysfunction in subjects with brain injury : prevalence, risk factors, clinical characterization and physiopathology. Universitat Pompeu Fabra; 2018. handle: http://hdl.handle.net/10803/665842

This citation was generated automatically.

Doctoral program

Programa de doctorat en Biomedicina

Abstract

To date, there are scarce data on bowel dysfunction (BD) in patients after brain injury (BI). Until now, only fecal incontinence (FI) has received attention and it has been mainly associated to patients’ age or performance status after the brain damage. In this thesis we report on the elevated incidence of BD in patients after an acute BI event, including FI but also diarrhea, severe constipation, abdominal pain and distention. We have characterized the clinical manifestations of these gut dysfunctions and measured their impact on QOL. We have also explored risks factors and underlying pathophysiologic mechanisms. We conclude that BD is very common and long-lasting in patients who experiment acute BI, it may have a major impact on QOL and it appears to depend on damaged brain area. The physiologic studies suggest bowel dysfunctions have a distinct etiopathogenesis compared to patients with the same clinical manifestations but no brain injury.
Hi ha poques dades sobre disfunció intestinal (DI) en pacients que han patit lesió cerebral (LC). La incontinència fecal (IF) és la única que ha rebut atenció i s’ha considerat associada a edat i l’estatus funcional després de la LC. En aquesta tesi comuniquem la elevada incidència de DI en aquests pacients, incloent-hi la IF però també el restrenyiment sever, el dolor i la distensió abdominals. Hem caracteritzat les manifestacions clíniques d’aquestes DI i hem mesurat el seu impacte en la qualitat de vida. Hem explorat també factors de risc i mecanismes fisiopatològics subjacents. Concloem que la DI és molt comú i perdura en pacients amb LC. Pot tenir un gran impacte en la qualitat de vida i sembla que depèn de la zona cerebral afectada. Els estudis fisiològics realitzats suggereixen que les disfuncions intestinals tenen una etiopatogènesi diferent a la dels pacients amb similars manifestacions però sense lesió cerebral.

Keywords

Brain injury, Bowel dysfunction, Fecal incontinence, Constipation, Pathophisiologycal, Mechanism, Lesió cerebral, Disfunció intestinal, Incontinència fecal, Restrenyiment, Mecanismes fisiopatològics