M - BOWEL
Define the level and completeness of SCI according to the current International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) scale. (PVA-NBD 2020, p.452; Level C)
A systematic comprehensive evaluation of bowel function, impairment, and possible problems should be completed at the onset of SCI and at least annually throughout the continuum of care. (PVA-NBD 2020, p.452; Level C)
A comprehensive, detailed gastrointestinal history should be completed at the onset of SCI, annually, and as needed when any significant gastrointestinal changes occur. (PVA-NBD 2020, p.452; Level C)
A physical examination should be done at the onset of SCI, annually, and upon any significant change in bowel function or health. This should include thorough abdominal and rectal examinations. (PVA-NBD 2020, p.452; Level C)
An abdominal x-ray/computed tomography scan can be used to evaluate the extent of fecal loading, fecal incontinence due to stool overflow, and other bowel problems such as fecal impaction, bowel obstruction, megacolon, and megarectum. (PVA-NBD 2020, p.452; Level B)
Colonic transit time testing with radiopaque markers or scintigraphy can be used to provide more information on neurogenic bowel dysfunction. (PVA-NBD 2020, p.452; Level B)
A wireless motility capsule can be used to evaluate gastric emptying time, small intestinal transit time, and colonic transit time. (PVA-NBD 2020, p.452; Level B)
Anorectal manometry can be used for a detailed assessment of pelvic floor dysfunction in individuals with motor incomplete SCI (AIS C and D). (PVA-NBD 2020, p.452; Level B)